Emerging and Established Trends to Support Secure Health Information Exchange

This work aims to provide information, guidelines, established practices and standards, and an extensive evaluation on new and promising technologies for the implementation of a secure information sharing platform for health-related data. We focus strictly on the technical aspects and specifically on the sharing of health information, studying innovative techniques for secure information sharing within the health-care domain, and we describe our solution and evaluate the use of blockchain methodologically for integrating within our implementation. To do so, we analyze health information sharing within the concept of the PANACEA project that facilitates the design, implementation, and deployment of a relevant platform. The research presented in this paper provides evidence and argumentation toward advanced and novel implementation strategies for a state-of-the-art information sharing environment; a description of high-level requirements for the transfer of data between different health-care organizations or cross-border; technologies to support the secure interconnectivity and trust between information technology (IT) systems participating in a sharing-data “community”; standards, guidelines, and interoperability specifications for implementing a common understanding and integration in the sharing of clinical information; and the use of cloud computing and prospectively more advanced technologies such as blockchain. The technologies described and the possible implementation approaches are presented in the design of an innovative secure information sharing platform in the health-care domain

Comparative analytical performance of multiple plasma Aβ42 and Aβ40 assays and their ability to predict positron emission tomography amyloid positivity

INTRODUCTION: This report details the approach taken to providing a dataset allowing for analyses on the performance of recently developed assays of amyloid beta (Aβ) peptides in plasma and the extent to which they improve the prediction of amyloid positivity. METHODS: Alzheimer's Disease Neuroimaging Initiative plasma samples with corresponding amyloid positron emission tomography (PET) data were run on six plasma Aβ assays. Statistical tests were performed to determine whether the plasma Aβ measures significantly improved the area under the receiver operating characteristic curve for predicting amyloid PET status compared to age and apolipoprotein E (APOE) genotype. RESULTS: The age and APOE genotype model predicted amyloid status with an area under the curve (AUC) of 0.75. Three assays improved AUCs to 0.81, 0.81, and 0.84 (P < .05, uncorrected for multiple comparisons). DISCUSSION: Measurement of Aβ in plasma contributes to addressing the amyloid component of the ATN (amyloid/tau/neurodegeneration) framework and could be a first step before or in place of a PET or cerebrospinal fluid screening study. HIGHLIGHTS: The Foundation of the National Institutes of Health Biomarkers Consortium evaluated six plasma amyloid beta (Aβ) assays using Alzheimer's Disease Neuroimaging Initiative samples. Three assays improved prediction of amyloid status over age and apolipoprotein E (APOE) genotype. Plasma Aβ42/40 predicted amyloid positron emission tomography status better than Aβ42 or Aβ40 alone

Identification of Antifungal Compounds Active against Candida albicans Using an Improved High-Throughput Caenorhabditis elegans Assay

Candida albicans, the most common human pathogenic fungus, can establish a persistent lethal infection in the intestine of the microscopic nematode Caenorhabditis elegans. The C. elegans–C. albicans infection model was previously adapted to screen for antifungal compounds. Modifications to this screen have been made to facilitate a high-throughput assay including co-inoculation of nematodes with C. albicans and instrumentation allowing precise dispensing of worms into assay wells, eliminating two labor-intensive steps. This high-throughput method was utilized to screen a library of 3,228 compounds represented by 1,948 bioactive compounds and 1,280 small molecules derived via diversity-oriented synthesis. Nineteen compounds were identified that conferred an increase in C. elegans survival, including most known antifungal compounds within the chemical library. In addition to seven clinically used antifungal compounds, twelve compounds were identified which are not primarily used as antifungal agents, including three immunosuppressive drugs. This assay also allowed the assessment of the relative minimal inhibitory concentration, the effective concentration in vivo, and the toxicity of the compound in a single assay

Θέματα Δρομολόγησης σε ad-hoc ΤΗΛΕΠΙΚΟΙΝΩΝΙΑΚΑ δίκτυα

A vast expansion of wireless telecommunications technologies has been observed over the last years. A Mobile Ad hoc NETwork (MANET) is an autonomous and dynamic system of mobile hosts that use wireless communication technologies for data transfer. Routing is the process of defining the path of the transmitted data that need to be traversed through a MANET and it is one of the basic network functions. Routing in mobile ad-hoc networks constitutes a basic field of research because the existing routing protocols perform poorly due to the special characteristics of this kind of networks. We will describe the most important suggested protocols and categorize them according to their individual features. The most important amongst them is the Dynamic Source Routing protocol (DSR) is a simple and efficient routing protocol designed specifically for use in multi-hop wireless ad hoc networks of mobile nodes. Using DSR, the network is completely self-organizing and self-configuring, requiring no existing network infrastructure or administration. The use of this protocol has raised many questions concerning its performance. There are several ways for improving the DSR protocols performance; we present and compare the results of using a technique for the management of the routing data stored in the route caches of the nodes by optimizing the cached route lifetime using a Time-To-Live (TTL) interval. Firstly, we study the route lifetime for different length routes in an ad-hoc wireless network. We compare the result with those obtained from a mathematical analysis and conclude that the use of this technique enables the protocol to avoid using routes that lead to time consuming errors. In addition, an algorithm that estimates the lifetime of all routes while the network is active and uses this estimate for routing, was developed. Finally we confirm that the use of the Time-To-Live (TTL) parameter in route caching in a on-demand routing protocol, can significantly improve the networks throughput, decrease the total data transmission delay, and decrease the route caches erroneous information ratio.Τα τελευταία χρόνια παρατηρείται μία ραγδαία εξάπλωση των ασύρματων τηλεπικοινωνιακών τεχνολογιών. Ένα ad-hoc ασύρματο τηλεπικοινωνιακό δίκτυο κινητών κόμβων έχει την δυνατότητα για ασύρματη μεταφορά δεδομένων και δημιουργείται δυναμικά και αυτόνομα. Η διαδικασία εύρεσης των διαδρομών που πρέπει να ακολουθήσουν τα δεδομένα για να μεταφερθούν από τον ένα κόμβο στον άλλο ονομάζεται δρομολόγηση και είναι μία από τις ουσιώδεις λειτουργίες που πρέπει να υποστηρίζει ένα δίκτυο. Η δρομολόγηση σε δίκτυα ad-hoc αποτελεί βασικό πεδίο έρευνας επειδή τα υπάρχοντα πρωτόκολλα δρομολόγησης δεν είναι αποδοτικά εξαιτίας των ιδιαίτερων χαρακτηριστικών των δικτύων αυτών. Η ομάδα εργασίας ΜΑΝΕΤ του IETF έχει στόχο την προτυποποίηση ενός αποδοτικού πρωτοκόλλου δρομολόγησης για τα δίκτυα αυτά. Στην παρούσα εργασία περιγράφουμε τα σημαντικότερα από τα πρωτόκολλα δρομολόγησης που έχουν προταθεί και τα κατηγοριοποιούμε σύμφωνα με τα ιδιαίτερα χαρακτηριστικά τους. Μελετούμε διεξοδικά το σημαντικότερο από αυτά, το πρωτόκολλο δυναμικής δρομολόγησης πηγής (Dynamic Source Routing). Ο αλγόριθμος δρομολόγησης αυτού του πρωτοκόλλου είναι απλός και αποδοτικός, σχεδιασμένος ειδικά για χρήση πάνω από ασύρματα δίκτυα ad-hoc πολλαπλών συνδέσεων με κινούμενους κόμβους. Ο αλγόριθμος του DSR επιτρέπει στο δίκτυο να είναι πλήρως αυτόνομο, τόσο στη διαδικασία οργάνωσης, όσο και στη διαδικασία δρομολόγησης, χωρίς να είναι απαραίτητη η παρουσία κάποιας προϋπάρχουσας υποδομής δικτύου ή διαχείρισης δικτύου. Η ανάλυση του συγκεκριμένου πρωτοκόλλου δημιουργεί ερωτηματικά σχετικά με την απόδοσή του. Αν και έχουν ήδη προταθεί πολλοί τρόποι βελτίωσης του πρωτοκόλλου, στην παρούσα εργασία μελετάμε, παρουσιάζουμε και συγκρίνουμε τα αποτελέσματα της προσπάθειας βελτίωσης της απόδοσης του πρωτοκόλλου δρομολόγησης DSR με χρήση τεχνικών για την καλύτερη διαχείριση των αποθηκευμένων πληροφοριών δρομολόγησης στις Route Cache των κόμβων του δικτύου. Αρχικά μελετάμε διεξοδικά, μέσω προσομοίωσης στο OPNET, το πρωτόκολλο DSR. Εστιάζουμε στο χρόνο ζωής των διαδρομών διαφορετικού μήκους σε ένα ασύρματο δίκτυο ad-hoc. Επιβεβαιώνουμε, για το πρωτόκολλο DSR, τα αποτελέσματα που προβλέπει η μαθηματική ανάλυση. Στη συνέχεια επεκτείνουμε τις λειτουργίες της Route Cache, ώστε να μη χρησιμοποιεί μία διαδρομή πέραν του προβλεπόμενου χρόνου ζωής της. Για το σκοπό αυτό αναπτύσσουμε αλγόριθμο, ο οποίος εκτιμά το χρόνο ζωής των διαδρομών κατά τη διάρκεια λειτουργίας του δικτύου και χρησιμοποιεί την εκτίμηση αυτή στη διαδικασία της δρομολόγησης. Επιβεβαιώνουμε, ότι η χρήση της παραμέτρου Time-To-Live (ΤΤL) των αποθηκευμένων διαδρομών δρομολόγησης επιτυγχάνει σημαντικές βελτιώσεις: α) στη μείωση της συνολική καθυστέρησης μετάδοσης των δεδομένων, β) στη αύξηση της διαπερατότητας του δικτύου (throughput) και γ) στη μείωση του ποσοστού λανθασμένων πληροφοριών που υπάρχουν σε μία Route Cache

Cross Layer Interference Management in Wireless Biomedical Networks

Interference, in wireless networks, is a central phenomenon when multiple uncoordinated links share a common communication medium. The study of the interference channel was initiated by Shannon in 1961 and since then this problem has been thoroughly elaborated at the Information theoretic level but its characterization still remains an open issue. When multiple uncoordinated links share a common medium the effect of interference is a crucial limiting factor for network performance. In this work, using cross layer cooperative communication techniques, we study how to compensate interference in the context of wireless biomedical networks, where many links transferring biomedical or other health related data may be formed and suffer from all other interfering transmissions, to allow successful receptions and improve the overall network performance. We define the interference limited communication range to be the critical communication region around a receiver, with a number of surrounding interfering nodes, within which a successful communication link can be formed. Our results indicate that we can achieve more successful transmissions by adapting the transmission rate and power, to the path loss exponent, and the selected mode of the underline communication technique allowing interference mitigation and when possible lower power consumption and increase achievable transmission rates

MyHealthAvatar: personalized and empowerment health services through Internet of Things technologies

The interconnection of heterogeneous data sources could provide a comprehensive picture of health parameters, thereby triggering an intervention by the medical staff upon detection of conditions that may lead to health deterioration, thus realizing preventive care. Supported Internet of Things technologies can be used to allow health related information to be locally aggregated and transmitted for remote monitoring and response. We present MyHealthAvatar (MHA), a personal digital health related collection bag, carried by individual citizens throughout their lifetime able to sustain in a meaningful manner all collected information. MHA acts as a unique companion continually following and empowering citizen and patients through a number of health related services. We describe the efforts on creating MHA patient-centered healthcare services for accessing, collecting and sharing long term multilevel personal health data through an integrated environment including: clinical data, genetic data, medical sensor data and devices, human behavior data and activity data for clinical data analysis, prediction and prevention for the individual citizen

FRDV: A DTN Routing Based on Human Moving Status in Urban Environments

It is a fast and simple way to run a Delay Tolerant Network (DTN) by mobile terminals in an urban environment, therefore DTN currently plays an important role as a network for Internet of Things (IoT). The network metrics are important for performance of DTN based communication systems. Because moving characteristics in urban environments are different from other challenging network environments, then the routing method is also different in various environments. In general, routing algorithm decides the DTN performance, so it cannot release potential performance with traditional routing algorithms in cities. In this paper, we propose a routing algorithm for urban areas, named Forward Routing based Distance Variation (FRDV), and we designed such approach according to human moving characteristics. FRDV comprises two stages which include selecting relay node and messages transmission decision. At the first stage, FRDV select a relay node depend on sending activity which depends on delivery frequency of nodes. During the short encounter time, the nodes selectively sent messages to the relay node based on moving status of nodes at the second stage. The simulation results suggest that FRDV outperforms than classical algorithms such as Epidemic, Prophet, Direct Delivery and First Contact algorithms in urban environments

A case of imported Middle East Respiratory Syndrome coronavirus infection and public health response, Greece, April 2014

On 18 April 2014, a case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection was laboratory confirmed in Athens, Greece in a patient returning from Jeddah, Saudi Arabia. Main symptoms upon initial presentation were protracted fever and diarrhoea, during hospitalisation he developed bilateral pneumonia and his condition worsened. During 14 days prior to onset of illness, he had extensive contact with the healthcare environment in Jeddah. Contact tracing revealed 73 contacts, no secondary cases had occurred by 22 April