Hiding algorithm based fused images and Caesar cipher with intelligent security enhancement

The process of sending confidential data through the communication media and in complete secrecy is now necessary, whether the data is related to patients, a particular military operation, or a specified office. On the other hand, with the development of various ciphering algorithms, and information hiding algorithms, there is a need to obtain ciphered and hidden data securely without the need to exchange secret keys between the two ends of the communication. In this paper, a hiding algorithm based on fused images and Caesar cipher with intelligent methods to strengthen the security of confidential information is proposed. Firstly, fused image scattering is obtained using 1’s complement and circularly shifting the bits of fused pixels by specified positions before the hiding process. Secondly, the keys for the Caesar cipher are derived from the length of secret information according to the mathematical equation. Thirdly, strengthen the security of Caesar’s cipher by taking a 1’s complement of each letter in the cipher data. The results guarantee the security of the presented algorithm

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Rhetorical loss in translating prepositional phrases of the Holy Qur’an

Translators of the Holy Quran confront many quandaries in their attempt to transfer the Qur’anic verses from Arabic into English. One of these quandaries is how to rhetorically communicate the intended meanings (implicatures) of the prepositional phrases in the Holy Qur’an. The translation of Arabic prepositional phrases in the Holy Qur’an as a source text (ST) may lead, in some Qur’anic verses, to a rhetorical loss in communicating their implicature in the target text (TT). That implicature or implicitly communicated meaning other than the explicature is the one intended to be expressed and required to be faithfully translated. In rendering the preposition into the target language (TL), translators bring into home only the explicitly stated meaning unaware of the implicitly stated meaning created as a result of the application of this specific rhetorical device. This study investigates the problem of the rhetorical loss encountered in the translation of prepositional phrases of the Qur’anic verses and identifies the cause of this problem. It also attempts to suggest a mechanism that is, to some extent, helpful and insightful in coping with the difficulties of translating Arabic prepositional phrases in Qur’anic verses. This research adopts a descriptive qualitative content analysis of the Qur’anic verses and their English translations that are relevant to the focus of the research. The source of failure of the English translations of the verses in conveying the rhetorical meanings of prepositional phrases has been identified in terms of the Relevance Theory and the distinction between explicature and implicature of these phrases. The study concludes that meaning equivalence in translation requires translators to be aware of not only the explicitly stated meanings of prepositions but the implicitly communicated ones as well which are recoverable through referring to Arabic heritage resources and interpretation books dedicated to exploring the rhetorical purposes of prepositions alternation in Qur’anic verses. The results of the analysis and the new suggested mechanism have been verified by an Arabic language and Qur’anic sciences expert who is a proficient speaker of English as well

Phylotypes and Pathotypes of Diarrheagenic <em>Escherichia coli</em> of Gastroenteritis

Escherichia coli responsible for wide range of common bacterial infections, the frequent one is gastroenteritis. Bacterial gastroenteritis mainly attributed to diarrheagenic E. coli and accompanied by diarrhea and vomiting. Actually pathogenic E. coli can be classified according to the site of infection whether it be within intestine (called intestinal pathogenic E. coli InPEC) or cause infection outside intestine (called extraintestinal pathogenic E. coli ExPEC). They are assigned to 4 main phylogenetic groups: InPEC include A and B1 while ExPEC have B2 and D groups. Seven Pathotypes have been assigned: Enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), enterohemorrhagic (Shiga-toxin producing E. coli (EHEC/STEC), enteroaggregative E. coli (EAEC), diffusely adherent E. coli (DAEC), enteroinvasive E. coli (EIEC) and adherent invasive E. coli (AIEC). The patho-phylotyping of diarrheagenic E. coli interaction along with antibiotic resistance and biofilm formation capacity may be valuable insight to know real threat of this pathogen and this is tried to be covered with this chapter. The results revealed that the among DEC, EPEC and ETEC were assigned in high rate to B1 followed by A, B2, D, E, C and F while EAEC show different assignment: D followed by B2, A, B1, C, E and F. The other DEC pathotypes showed different styles

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population