A Review of Wireless Body Area Networks for Medical Applications

Recent advances in Micro-Electro-Mechanical Systems (MEMS) technology, integrated circuits, and wireless communication have allowed the realization of Wireless Body Area Networks (WBANs). WBANs promise unobtrusive ambulatory health monitoring for a long period of time and provide real-time updates of the patient's status to the physician. They are widely used for ubiquitous healthcare, entertainment, and military applications. This paper reviews the key aspects of WBANs for numerous applications. We present a WBAN infrastructure that provides solutions to on-demand, emergency, and normal traffic. We further discuss in-body antenna design and low-power MAC protocol for WBAN. In addition, we briefly outline some of the WBAN applications with examples. Our discussion realizes a need for new power-efficient solutions towards in-body and on-body sensor networks.Comment: 7 pages, 7 figures, and 3 tables. In V3, the manuscript is converted to LaTe

A Study of IEEE 802.15.4 Security Framework for Wireless Body Area Network

A Wireless Body Area Network (WBAN) is a collection of low-power and lightweight wireless sensor nodes that are used to monitor the human body functions and the surrounding environment. It supports a number of innovative and interesting applications, including ubiquitous healthcare and Consumer Electronics (CE) applications. Since WBAN nodes are used to collect sensitive (life-critical) information and may operate in hostile environments, they require strict security mechanisms to prevent malicious interaction with the system. In this paper, we first highlight major security requirements and Denial of Service (DoS) attacks in WBAN at Physical, Medium Access Control (MAC), Network, and Transport layers. Then we discuss the IEEE 802.15.4 security framework and identify the security vulnerabilities and major attacks in the context of WBAN. Different types of attacks on the Contention Access Period (CAP) and Contention Free Period (CFP) parts of the superframe are analyzed and discussed. It is observed that a smart attacker can successfully corrupt an increasing number of GTS slots in the CFP period and can considerably affect the Quality of Service (QoS) in WBAN (since most of the data is carried in CFP period). As we increase the number of smart attackers the corrupted GTS slots are eventually increased, which prevents the legitimate nodes to utilize the bandwidth efficiently. This means that the direct adaptation of IEEE 802.15.4 security framework for WBAN is not totally secure for certain WBAN applications. New solutions are required to integrate high level security in WBAN.Comment: 14 pages, 7 figures, 2 table

Brain calcinosis and seizures in an adolescent boy.

The article focuses on the manifestation of cerebral calcification in an adolescent boy. Cerebral calcification, which is detected using computed tomography, is usually associated with disorders like sporadic and heredofamilial entities. The Patient was rushed to the hospital after his mother observed that he have altered behavior and generalized tonic-clonic seizures. He was started on intravenous calcium supplementation, phosphate binder and vitamin D supplementation and during later observations, he was found to have developed according to his age

A Study of Medium Access Control Protocols for Wireless Body Area Networks

The seamless integration of low-power, miniaturised, invasive/non-invasive lightweight sensor nodes have contributed to the development of a proactive and unobtrusive Wireless Body Area Network (WBAN). A WBAN provides long-term health monitoring of a patient without any constraint on his/her normal dailylife activities. This monitoring requires low-power operation of invasive/non-invasive sensor nodes. In other words, a power-efficient Medium Access Control (MAC) protocol is required to satisfy the stringent WBAN requirements including low-power consumption. In this paper, we first outline the WBAN requirements that are important for the design of a low-power MAC protocol. Then we study low-power MAC protocols proposed/investigated for WBAN with emphasis on their strengths and weaknesses. We also review different power-efficient mechanisms for WBAN. In addition, useful suggestions are given to help the MAC designers to develop a low-power MAC protocol that will satisfy the stringent WBAN requirements.Comment: 13 pages, 8 figures, 7 table

A comprehensive survey of wireless body area networks on PHY, MAC, and network layers solutions

Recent advances in microelectronics and integrated circuits, system-on-chip design, wireless communication and intelligent low-power sensors have allowed the realization of a Wireless Body Area Network (WBAN). A WBAN is a collection of low-power, miniaturized, invasive/non-invasive lightweight wireless sensor nodes that monitor the human body functions and the surrounding environment. In addition, it supports a number of innovative and interesting applications such as ubiquitous healthcare, entertainment, interactive gaming, and military applications. In this paper, the fundamental mechanisms of WBAN including architecture and topology, wireless implant communication, low-power Medium Access Control (MAC) and routing protocols are reviewed. A comprehensive study of the proposed technologies for WBAN at Physical (PHY), MAC, and Network layers is presented and many useful solutions are discussed for each layer. Finally, numerous WBAN applications are highlighted

Clinical profile and treatment of infantile spasms using vigabatrin and ACTH - a developing country perspective

Background: Infantile spasms represent a serious epileptic syndrome that occurs in the early infantile age. ACTH and Vigabatrin are actively investigated drugs in its treatment. This study describes the comparison of their efficacy in a large series of Patients with infantile spasms from Pakistan. Methods: All Patients with infantile spasms who presented to Aga Khan University Hospital, Karachi, Pakistan from January, 2006 to April, 2008 were included in this study. Inclusion criteria were clinical symptoms of infantile spasms, hypsarrythmia or modified hyparrythmia on electroencephalography, at least six months of follow-up period and receipt of any of the two drugs mentioned above. The type of drug distribution was random according to the availability, cost and ease of administration. Results: Fifty six cases fulfilled the inclusion criteria. 62.5% were males. Mean age at onset of seizures was 5 +/- 1.4 months. Fifty two (92.8%) Patients demonstrated hypsarrythmia on electroencephalography. 64.3% cases were identified as symptomatic while 19.6% were cryptogenic and 16.1% were idiopathic. Eighteen Patients received ACTH while 38 Patients received Vigabatrin as first line therapy. Initial response to first line therapy was similar (50% for ACTH and 55.3% for Vigabatrin). Overall, the symptomatic and idiopathic groups responded better to Vigabatrin. The relapse rate was higher for ACTH as compared to Vigabatrin (55.5% vs. 33.3%) when considering the first line therapy. Four Patients evolved to Lennox-Gastaut variant, all of these Patients had initially received Vigabatrin and then ACTH. Conclusion: Vigabatrin and ACTH showed no significant difference in the initial treatment of infantile spasms. However, Patients receiving ACTH were 1.2 times more likely to relapse as compared to the Patients receiving Vigabatrin when considering monotherapy. We suggest that Vigabatrin should be the initial drug of choice in Patients presenting with infantile spasms. However, larger studies from developing countries are required to validate the therapeutic trends observed in this study

Telomerecat: A ploidy-agnostic method for estimating telomere length from whole genome sequencing data.

Telomere length is a risk factor in disease and the dynamics of telomere length are crucial to our understanding of cell replication and vitality. The proliferation of whole genome sequencing represents an unprecedented opportunity to glean new insights into telomere biology on a previously unimaginable scale. To this end, a number of approaches for estimating telomere length from whole-genome sequencing data have been proposed. Here we present Telomerecat, a novel approach to the estimation of telomere length. Previous methods have been dependent on the number of telomeres present in a cell being known, which may be problematic when analysing aneuploid cancer data and non-human samples. Telomerecat is designed to be agnostic to the number of telomeres present, making it suited for the purpose of estimating telomere length in cancer studies. Telomerecat also accounts for interstitial telomeric reads and presents a novel approach to dealing with sequencing errors. We show that Telomerecat performs well at telomere length estimation when compared to leading experimental and computational methods. Furthermore, we show that it detects expected patterns in longitudinal data, repeated measurements, and cross-species comparisons. We also apply the method to a cancer cell data, uncovering an interesting relationship with the underlying telomerase genotype

Publisher Correction: Telomerecat: A ploidy-agnostic method for estimating telomere length from whole genome sequencing data.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Production Relationships in Pakistan's Manufacturing Industries

Despite the fact that there are great disparities in factor endowments, techniques employed in the manufacturing sector of underdeveloped labour surplus countries are comparable to those of highly industrialized capital -abundant countries like the United States. A.R. Khan in his paper on capital intensities and factor use [13] concluded from an international comparison of factor intensities that Pakistani capital intensities are near the American level in a number of industries while in some cases they are even higher. Explanations of this paradox are based on two different assumptions regarding the magnitude of the elasticity of substitution between capital and labour. On the one hand it is assumed that the elasticity of substitution and thereby the possibility of labour absorption via changes in factor prices are very limited due to the dominance of techniques borrowed from the West and oriented to the needs of capital rich nations. On the other hand, significant substitution possibilities are assumed in production techniques and the presence of high capital intensities in the industrial sector is attributed to distortions in the factor markets in the form of exchange rate regulations, low rates of bank borrowing, etc., which lead to the price of capital being much lower than it's social cost