Protecting Digital Evidence Integrity and Preserving Chain of Custody

Evidence is the key to solve any crime. Evidence integrity needs to be protected in order to make it admissible in the court of law. Digital evidence is more revealing, but it is fragile; it can easily be tampered with or modified. There are different techniques available to protect the integrity of digital evidence. Different automated digital evidence acquisition tools are available in the market. In this paper, we have analyzed two automated tools (EnCase and FTK Imager) that are used for disk imaging. These tools claim to protect the integrity of digital evidence. The techniques used by these tools are analyzed in this paper. Problems with their approaches are discussed and a solution is proposed to address the problems. A prototype of an automated tool is developed with an implementation of the proposed solution

Impact of duration of antibiotic prophylaxis on rates of surgical site infection (SSI) in patients undergoing mastectomy without immediate reconstruction, comparing a single prophylactic dose versus continued antibiotic prophylaxis postoperatively: A multicentre, double-blinded randomised control trial protocol

Introduction: In breast surgeries, prophylactic antibiotics given before the surgical incision as per Joint Commission Surgical Care Improvement Project guidelines have been shown to decrease the rate of postoperative infections. There is, however, no clear consensus on postoperative antibiotic prophylaxis in patients undergoing mastectomy with indwelling drains. This trial protocol proposes to study the difference in rates of surgical site infection (SSI) with or without continuation of postoperative antibiotics in patients undergoing mastectomy without immediate reconstruction and with indwelling drains.Methods and analysis: In this multicentre, double-blinded clinical trial, all patients undergoing mastectomy (without immediate reconstruction) will receive a single prophylactic dose of preoperative antibiotics at induction of anaesthesia and will then get randomised to either continue antibiotic prophylaxis or a placebo postoperatively, for the duration of indwelling drains. The primary and secondary outcomes will be development of an SSI and antibiotic-associated adverse effects, respectively. Data will be collected through a standard questionnaire by wound assessors. Intention-to-treat analysis will be carried out using STATA V.12. For categorical variables, frequencies and percentages will be assessed by χ2 test/Fisher\u27s exact test as appropriate. The quantitative variables will be computed by their mean±SD or median (IQR) and will be assessed by independent t-test/Mann-Whitney test as appropriate. Unadjusted and adjusted relative risk with their 95% CI will be reported using Cox proportional regression. A p value of \u3c0.05 will be considered statistically significant.Ethics and dissemination: Ethical approval has been obtained from each site\u27s Ethical Review Board. The study background and procedure will be explained to the study participants and informed consent will be obtained. Participation in the study is voluntary. All data will be deidentified and kept confidential. The study findings will be published in scientific media and authorship guidelines of International Committee of Medical Journal Editors will be followed.Trial registration number: NCT04577846. (patient recruitment)

Operability, acceptability, and usefulness of a mobile app to track routine immunization performance in rural Pakistan: Interview study among vaccinators and key informants

Background: There has been a recent spate of mobile health (mHealth) app use for immunizations and other public health concerns in low- and middle-income countries. However, recent evidence has largely focused on app development or before-and-after effects on awareness or service coverage. There is little evidence on the factors that facilitate adoption of mHealth programs, which is critical to effectively embed digital technology into mainstream health systems. Objective: This study aimed to provide the qualitative experiences of frontline health staff and district managers while engaging with real-time digital technology to improve the coverage of routine childhood immunization in an underserved rural district in Pakistan. Methods: An Android-based app was iteratively developed and used for a 2-year period in 11 union councils of the Tando Muhammad Khan district, an underserved rural district with poor immunization coverage in Pakistan. We used iterative methods to examine the (1) acceptability and operability of the app, (2) validity of the collected data, and (3) use of the collected data. In addition, we collected the barriers and enablers for uptake of the mHealth app. Each of these topics was further explored related to changes in work as well as the enabling factors for and barriers to app use. In-depth interviews were conducted with the 26 vaccinators posted in the 11 union councils and 7 purposively selected key informants (government district managers) involved with the Expanded Program for Immunization. Findings were triangulated in line with the three broad research areas. Results: Digital immunization tracking was considered acceptable by vaccinators and district managers. Real-time immunization data were used to monitor vaccination volume, track children with incomplete vaccinations, develop outreach visit plans, correct existing microplans, and disburse a fuel allowance for outreach sessions. The validity of the app data was perceived to be superior to that of data from manual records. Ease of operability, satisfaction with data, personal recognition, links to field support, and a sense of empowerment served as powerful enablers. Taking twice the time to complete both manual and digital entries and outdated phones over time were considered constraints. An unintended knock-on effect was improved coordination and strengthening of Expanded Program for Immunization review platforms across district stakeholders through digitalized data. Conclusions: Embedding digital technology into mainstream health systems relies on use by both end users and district stakeholders. Ease of operability, satisfaction with data reliability, personal recognition, links to field support, and empowerment are powerful enablers, whereas improved coordination as a result of easy, transparent data access can be an important by-product of digitalization. Findings are relevant not only for wide-scale implementation of immunization tracking apps in Pakistan but also for informing the use of digital technology for results-based delivery by frontline health workers

Stock market efficiency: Behavioral or traditional paradigm?Evidence from Karachi Stock Exchange (KSE) and investors community of Pakistan

Traditional finance explains the investment process on rational and logical grounds based on the assumption of rationality of average investor. This paper attempts to understand why traditional finance models fail to capture stock market movements and how behavioral finance explains that failure in the context of Pakistan’s financial market. Beginning with the basics of behavioral finance, the discussion unfolds to explain any association that investor’s decision making process has with the behavioral biases like overconfidence, regret, pyramid and risk. Primary data based on questionnaire and interviews of investors trading at Karachi Stock Exchange of Pakistan was used. The study concluded that behavioral traits have significant association with investment decision. The study will also open up the doors to further analyze the deviated scenarios which cause the market to create the loss spiral for one group and unbounded gain for the other

Can Different Salt Formulations Revert the Depressing Effect of Salinity on Maize by Modulating Plant Biochemical Attributes and Activating Stress Regulators through Improved N Supply?

Salinity is a major constraint in improving agricultural productivity due to its adverse impact on various physiological and biochemical attributes of plants, and its effect on reducing nitrogen (N) use efficiency due to ion toxicity. To understand the relationship between sodium chloride (NaCl) and increased N application rates, a pot study was performed in which the ammonical (NH4+) form of N was applied as urea to maize crops at different rates (control, 160, 186, 240, 267, 293, and 320 kg N ha−1) using two salinity levels (control and 10 dS m−1 NaCl). The results indicate that all biochemical and physiological attributes of the maize plant improved with increased concentration of N up to 293 kg ha−1, compared to those in the control treatment. Similarly, the optimal N concentration regulated the activities of antioxidant enzymes, i.e., catalase activity (CAT), peroxidase activity (POD), and superoxide dismutases (SOD), and also increased the N use efficiencies of the maize crop up to 293 kg N ha−1. Overall, our results show that the optimum level of N (293 kg ha−1) improved the salinity tolerance in the maize plant by activating stress coping physiological and biochemical mechanisms. This may have been due to the major role of N in the metabolic activity of plants and N assimilation enzymes activity such as nitrate reductase (NR) and nitrite reductase (NiR)

Hepatoprotective effect of aqeous methanolic extract of Rumex dentatus in paracetamol induced hepatotoxicity in mice

Rumex dentatus is well known plant of Polygonaceae family which is widely used in traditional medicine to treat gastrointestinal tract. R. dentatus at doses 250 and 500 mg/kg significance decreased (p<0.001) the elevated level of ALT, AST, ALP and bilirubin induced by paracetamol and results are comparable (p<0.001) with silymarin. The results were supported by histopathological investigations, phytochemical screening and detection of hepatoprotective active constituents e.g quercetin, kaempferol, myricetin by HPLC. So, it is concluded that R. dentatus has hepatoprotective effect against paracetamol liver damage in mice

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Doctors’ Attitude Toward Patient Demand and Direct-To-Consumer Pharmaceutical Advertisements in Pakistan: Abid Shahzad, Syed Gohar Abbas, Gohar Saleem, Muhammad Wahab

Since the COVID-19 phenomenon has emerged, e-patient attitudes have created a new normal for abnormal situations. This study sees how the patient demands will affect physician persistence habits from the perspective of physician-patient relationship, which is reinforced by increased digital health advertisements such as direct to consumer pharmaceutical advertisements. In this respect, primary data was collected from 300 doctors of Peshawar, using cluster random sampling through an adapted questionnaire and applied Creswell (2014) mixed method. SPSS-AMOs was utilized to evaluate the data from the first phase. In the second phase, Atlas.ti was applied to validate the first phase results. Patient demands backed by direct to consumer advertisements are more likely to be considered by physicians. Escalated physician patient relationship can also serve as a partial mediator between patient demand and physician persistence habits. Moreover, DTCPA has a direct effect on physician persistence habits and moderates the mediation of physician-patient relationship between patient demand and physician persistence habits. Consequently, majority of physicians advocate the use of DTCPA to raise patient awareness and allow them to express unspoken concerns to physicians. However, self-medication and unnecessary patient interventions may increase healthcare risks. The study contributes to the substantial body of knowledge about DTCPA's impact on Pakistani physicians and physician–patient relationship by modifying the behavioral theories

An Intelligent and Robust Framework towards Anomaly Detection, Medical Diagnosis, and Shortest Path Problems Based on Interval-Valued T-Spherical Fuzzy Information

The recent emerging advancements in the domain of the fuzzy sets are the framework of the T-spherical fuzzy set (TSFS) and interval valued T-spherical fuzzy set (IVTSFS). Keeping in view the promising significance of the latest research trend in the fuzzy sets and the enabling impact of IVTSFS, we proposed a novel framework for decision assembly using interval valued TSFS based upon encompassing the four impressive dimensions of human judgement including favor, abstinence, disfavor, and refusal degree. Another remarkable contribution is the optimization of information modeling and prevention of information loss by redefining the concept of each membership in interval. Moreover, the proposed research made a worthy contribution work by demonstrating the effective utilization of the interval valued TSFS based framework in anomaly detection, medical diagnosis, and shortest path problem. The proposed work demonstrates the effective remedial measure for the anomaly detection problem based on several parameters using the aggregation operators of IVTSFS. Moreover, the interval valued T-spherical fuzzy relations and their composition are illustrated to investigate the medical diagnosis problem. Furthermore, the notion of interval valued T-spherical fuzzy graph is also presented and fundamental notions of graph theory are also demonstrated with the help of real world instances. In the context of interval valued T-spherical fuzzy graphs (IVTSFGs), a modified Dijkstra Algorithm (DA) is developed and applied to the shortest path problem. The in-depth quantitative assessment and comparative analysis revealed that the proposed notion outpaces contemporary progressive approaches