A Systematic Review of the Availability and Efficacy of Countermeasures to Internal Threats in Healthcare Critical Infrastructure

Insider attacks are becoming increasingly detrimental and frequent, affecting critical infrastructure at a massive scale. Recent attacks such as the UK National Health Service (NHS) WannaCry ransomware attack which partly depends on internal users for initial infection highlight the increasing role of the malicious insiders in cyber attack campaigns . The objective of this research is to ascertain the existing technological capability to mitigate insider threats within computer security systems by way of a mixed-method systematic review. Evidence was acquired from major sources of mainstream and grey literature by analysing about 300, 000 papers. Crude aggregated results were analysed across the literature, the results were TPR 0.75, FPR 0.32, σ 0.24 and 0.36 respectively, σ 2 0.06 and 0.13 respectively. In totality, the literature evidence suggests that there is high heterogeneity across crude data indicating that the effectiveness of security measures varies significantly. No solution is able to totally mitigate an insider threat. Themes when set against that data suggest that most, if not all, security measures require breaches to occur before an analysis of malicious activity can prevent it in future through recall. Such a reactive approach is not effective to protect our critical infrastructure including our healthcare systems. Consequently, there is a major theoretical shortfall in current cyber defence architecture

A novel semi-active TMD with folding variable stiffness spring

An innovative variable stiffness device is proposed and investigated based on numerical simulations. The device, called a folding variable stiffness spring (FVSS), can be widely used, especially in tuned mass dampers (TMDs) with adaptive stiffness. An important characteristic of FVSS is its capability to change the stiffness between lower and upper bounds through a small change of distance between its supports. This special feature results in lower time-lag errors and readjustment in shorter time intervals. The governing equations of the device are derived and simplified for a symmetrical FVSS with similar elements. This device is then used to control a single-degree-of-freedom (SDOF) structure as well as a multi-degree-of-freedom (MDOF) structure via a semi-active TMD. Numerical simulations are conducted to compare several control cases for these structures. To make it more realistic, a real direct current motor with its own limitations is simulated in addition to an ideal control case with no limitations and both the results are compared. It is shown that the proposed device can be effectively used to suppress undesirable vibrations of a structure and considerably improves the performance of the controller compared to a passive device

Electronic Cigarette Use Among High School Students and Its Association With Cigarette Use And Smoking Cessation, North Carolina Youth Tobacco Surveys, 2011 and 2013

Although adolescent cigarette use continues to decline in the United States, electronic cigarette (e-cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e-cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina

Scintigraphic evaluation of remote pre-conditioning protection against unilateral renal ischemia/reperfusion injury in rats: a longitudinal study

Purpose: To determine the role of remote perconditioning (RPeC) on renal function and histology in an animal model of unilateral renal ischemia and reperfusion (IR) injury. Methods: Rats were subjected to 60 min unilateral renal ischemia. RPeC protocol was the application of four cycles of 5 min IR of left femoral artery during renal ischemia. Assessments of histological changes and renal function were made 24 h, 1 week, or 3 weeks later. 99mTc-DMSA scan was performed using a small-animals SPECT system. Results: 24-h reperfusion decreased the 99mTc-DMSA uptake in the left kidney compared to the intact kidney of control animals. RPeC group has higher uptake compared to the IR group. After 1 week and 3 weeks, uptakes were gradually increased in both groups and no differences were observed. Severe morphological changes in the ischemic kidneys of both groups were observed after 24 h which attenuated after 1 week and 3 weeks. Moreover, no differences in creatinine and BUN levels between IR-treated and intact animals were observed. Conclusion: These data suggest that RPeC exerts a partially transient improvement in the renal function in the first day after reperfusion. However, long-term follow-up study showed no beneficial effects of RPeC. Moreover, noninvasive 99mTc-DMSA scan revealed a suitable tool in the follow-up evaluation of recovery process in the unilateral renal IR injury models

Granulomatous enteritis in rainbow trout (Oncorhynchus mykiss) associated with soya bean meal regardless of water dissolved oxygen level

This study investigated morphological changes associated with soya bean meal-induced enteritis (SBMIE) in distal intestine (DI) of rainbow trout (Oncorhynchus mykiss) fed a soya bean meal (SBM)-based diet and exposed to normoxia or hypoxia created by optimal and low water flow rates, respectively. A 28-day adaption period was followed by a 42-day challenge period where 600 fish were subjected to dietary challenge and/or hypoxia. Twelve tanks each containing 50 juvenile trout were assigned randomly in triplicate to each treatment. Histopathological and immunohistochemical evaluation revealed pathological features that have not previously been described in association with SBMIE. Vacuolar degeneration of epithelial cells mainly at the base of mucosal folds, epithelial cysts, epithelial dysplasia, necrosis, shedding of necrotic cells, and granulomatous inflammation including infiltration of enlarged, sometimes finely vacuolated or “foamy” macrophages, multinucleated giant cells and increased proliferation of fibroblasts were observed. Acid-fast bacteria were not detected in enlarged macrophages; however, these cells contained AB-PAS- and sometimes cytokeratin-positive material, which was interpreted to be of epithelial/goblet cell origin. Hypoxia did not affect the morphological changes in DI. These results suggest that SBM was associated with a granulomatous form of enteritis in DI of rainbow trout regardless of water oxygen level

Evaluation of the effects of pycnogenol (French maritime pine bark extract) supplementation on inflammatory biomarkers and nutritional and clinical status in traumatic brain injury patients in an intensive care unit: A randomized clinical trial protocol

Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective: The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods: This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration: This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018. © 2020 The Author(s)

Sirenomelia in a Nigerian triplet: a case report

<p>Abstract</p> <p>Introduction</p> <p>Sirenomelia, also known as mermaid syndrome, is a very rare fatal congenital abnormality in which the legs are fused together, giving them the appearance of a mermaid's tail. It is commonly associated with abnormal kidney development, genital and rectal abnormalities. A handful of cases have been reported in other parts of the world, however, no cases have previously been reported in a Nigerian neonate. To the best of our knowledge, we believe that this is the first case reported from West Africa and in a triplet.</p> <p>Case presentation</p> <p>A 16-hour-old baby boy, the second of a set of Nigerian triplets, presented to our facility with fusion of the entire lower limbs, imperforate anus, indiscernible genital structures, single umbilical artery and a neural tube defect. His parents were from the Hausa ethnic group and not related.</p> <p>Conclusion</p> <p>Sirenomelia has not been previously described in a set of triplets, and it is hoped that this report from West Africa will give information about the non-racial predilection of this condition.</p