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A security-enhanced ultra-lightweight and anonymous user authentication protocol for telehealthcare information systems
No full textThe surge in smartphone and wearable device usage has propelled the advancement of the Internet of Things (IoT) applications. Among these, e-healthcare stands out as a fundamental service, enabling the remote access and storage of patient-related data on a centralized medical server (MS), and facilitating connections between authorized individuals such as doctors, patients, and nurses over the public Internet. However, the inherent vulnerability of the public Internet to diverse security threats underscores the critical need for a robust and secure user authentication protocol to safeguard these essential services. This research presents a novel, resource-efficient user authentication protocol specifically designed for healthcare systems. Our proposed protocol leverages the lightweight authenticated encryption with associated data (AEAD) primitive Ascon combined with hash functions and XoR, specifically tailored for encrypted communication in resource-constrained IoT devices, emphasizing resource efficiency. Additionally, the proposed protocol establishes secure session keys between users and MS, facilitating future encrypted communications and preventing unauthorized attackers from illegally obtaining users\u27 private data. Furthermore, comprehensive security validation, including informal security analyses, demonstrates the protocol\u27s resilience against a spectrum of security threats. Extensive analysis reveals that our proposed protocol significantly reduces computational and communication resource requirements during the authentication phase in comparison to similar authentication protocols, underscoring its efficiency and suitability for deployment in healthcare systems
Nurses’ and midwives’ job satisfaction and retention during COVID-19: A scoping review
Get PDFBackground: The COVID-19 pandemic focused attention on the previously well-documented world-wide shortage of nurses and midwives. The pandemic accentuated this crisis, which resulted in nurses and midwives questioning their roles and their careers. The impact of the pandemic on job satisfaction and the intention of nurses and midwives to stay has not been adequately explored. Aim: The aim of this scoping review was to identify and map the literature that describes the intrinsic and extrinsic factors that influenced nurses’ and midwives’ job satisfaction and intent to stay or leave their employment or profession during the COVID-19 pandemic. Method: This scoping review was conducted according to the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute (JBI) guidelines. Studies written in English and published between 2019 and December 2023 were included, and consisted of quantitative, qualitative and mixed methods studies. MEDLINE, CINAHL, and PsychINFO were the key information sources. The search terms for this review were developed using the PCC mnemonic: Population, Concept and Context. The JBI approach to sources selection, data extraction and presentation of data was used. Results: A total of 1833 relevant articles were identified. Of these, 17 articles met the inclusion criteria. Ten factors were identified as impacting on nurses and midwives job satisfaction and retention during the COVID-19 pandemic. Conclusion: The findings reveal key factors, such as patient acuity, staffing dynamics, leadership quality, and resource availability, have significantly shaped the professional experiences of nurses and midwives during the pandemic. These insights can inform targeted policies and interventions to improve job satisfaction and retention, while future research should address gaps, particularly the unique challenges faced by midwives, to strengthen the healthcare workforce for future crises. Summary of relevance: Problem: Little is known about the impact of the COVID-19 pandemic on job satisfaction and intention to stay among nurses and midwives. What is already known: The pandemic resulted in unprecedented and demanding working environments for nurses and midwives. What this paper adds: This scoping review maps the intrinsic and extrinsic factors regarding nurses’ and midwives’ job satisfaction and intent to stay in their professions during the COVID-19 pandemic. There were multifaceted challenges and adaptations in the nursing and midwifery work environments during the COVID-19 pandemic. More research is required, especially about the effects of the pandemic on midwives
Risk factors associated with Helicobacter pylori infection in the urban population of China: A nationwide, multi-center, cross-sectional study
Get PDFObjectives: To assess the risk factors associated with Helicobacter pylori infection in the urban Chinese population. Methods: The study was conducted from March to November 2023, including 12,902 urban participants aged 18-60 years across 52 cities distributed over 26 provinces in China. Risk factors included socioeconomic status, lifestyles, and public understanding. Univariate and multivariate logistic regression analysis was used to calculate corrected odds ratios (ORs) and 95% confidence intervals (CIs). Results: According to multivariate logistic regression, risk factors associated with significantly higher H. pylori infection rates included residency in developing (OR 1.27, 95% CI 1.13-1.43) and undeveloped cities (OR 1.15, 95% CI 1.02-1.29), obesity (OR 1.37, 95% CI 1.05-1.78), alcohol consumption (OR 1.16, 95% CI 1.05-1.29), tea consumption (OR 1.11, 95% CI 1.01-1.21), and soft drink consumption (OR 1.24, 95% CI 1.09-1.40). Conversely, individuals with moderate awareness (OR 0.79, 95% CI 0.71-0.88) and high awareness (OR 0.57, 95% CI 0.48-0.69) of H. pylori had lower infection rates. Conclusion: Our findings highlight the importance of promoting a healthy lifestyle and improving the understanding of H. pylori in reducing the infection rate of the bacterial pathogen in the urban Chinese population
Chronicles of film tourism: An integrative review and future research directions
Get PDFThis study triangulates historiographical and scientometric reviews to provide a systems perspective on film tourism. The three phases of historiographical analysis (exploration, growth, and maturity) correspond to the three clusters of scientometric analysis: (i) initial research exploring film tourism development and management, (ii) growing the field through studies on film tourists’ perceptions and practices, and (iii) reaching maturity through extending research into different cultural contexts and meaning-making processes. Based on the analysis, we offer a set of directions for future research, including the need to integrate sustainability research and film tourism studies in developing country contexts, as well as intertextuality and its impact on film tourism. We further recommend research on developments in media consumption and its impact on film tourism, investigation of the relationship between digitalization and film tourism, and the need for interdisciplinary research. Finally, we suggest combining product life cycle analysis to complement historiographical analysis for robustness
Intrapartum hydration assessment and management: A cross-sectional survey of Australian and New Zealand maternity units
Get PDFBackground: Hydration assessment and management during labour play an important role in maternal and newborn outcomes. Studies indicate that clinical practice is inconsistent, with limited consensus evident in clinical guidelines. Current practices in fluid management across public and private maternity units within Australia and New Zealand remain unknown. Respondents highlighted the importance of maternal hydration assessment and management to well-being. However, inconsistencies were noted in the documentation, medication use and adherence to clinical protocols. Aim: Our study aimed to investigate unit-level clinical practice regarding intrapartum hydration assessment and management across Australian and New Zealand private and public hospitals. The scope of this study focuses on fluid management during both spontaneous and induced labour. Method: We conducted a cross-sectional, descriptive survey to assess the fluid management practices of Australian and New Zealand maternity services. Results: Of the 307 eligible maternity units, 89 participated (responding key informants included midwives, obstetricians, managers, and educators). All acknowledged the importance of maternal intrapartum hydration assessment and management. However, variations existed in assessment methods, with urine colour (87.6 %, n = 78) and frequency (84.3 %, n = 75), as well as maternal and fetal vital sign assessments (83.1 %, n = 74) being most prevalent. Documentation format and tools varied, and midwives identified this as their role. Despite the significance attributed to hydration by clinicians, not all felt confident in their capabilities to assess or manage intrapartum hydration. Free-text responses emphasised the significance of this topic from an educational perspective. Conclusion: Respondents highlighted the significance of maternal intrapartum hydration assessment and maternal and newborn well-being management. However, inconsistent documentation, medication usage, including intravenous fluids, and clinical protocols were evident
Investigating the impact of sorghum on tau protein phosphorylation and mitochondrial dysfunction modulation in Alzheimer’s disease: An in vitro study
Get PDFBackground: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder with poorly understood pathology. Elevated tau, phospho-tau and mitochondrial dysfunction are significantly correlated with an increased risk of AD and are therefore targets for disease-modifying therapy. In this study, we examined the effects of polyphenolic extracts from six different varieties of sorghum: Shawaya short black-1 (Black), IS1311C (Brown), QL33/QL36 (Red), B923296 (Red), QL12 (White), and QL33 (Red) on the attenuation of beta amyloid-induced phospho-tau levels, total tau levels, and mitochondrial dysfunction in neuronal cells. Method: Tau proteins (231 (pT231), Serine- 199 (pS199), and total tau proteins (T-tau)) were detected and quantified using sandwich ELISA kits, while mitochondrial dysfunction was measured in terms of mitochondrial membrane potential (Δψm) and adenosine triphosphate (ATP) levels. Results: Almost all varieties of the sorghum extracts reduced the beta amyloid-induced pS199 and pT231 levels (p ≤ 0.05). The optimum concentration of QL33/QL36 (1000 µg/mL), QL12 (2000 µg/mL), and QL33 (2000 µg/mL) strongly attenuated the phospho-tau level. Sorghum IS1311C (750 µg/mL) showed the highest Δψm reduction (39.8%), whereas QL33 (2000 µg/mL) most strongly improved the ATP level (37.7%) (p ≤ 0.01). For both Δψm and ATP assays, the least activity was observed in sorghum B923296 at 21% and 25.5%, respectively (p ≤ 0.01). Conclusions: The polyphenol extracts from sorghum attenuated the tau toxicity and Aβ-induced mitochondrial dysfunction in a variety- and dose-dependent manner and made a promising disease-modifying agent against AD. However, extensive research is needed to validate the efficacy of the sorghum extracts prior to animal and clinical studies
Neoadjuvant anti-PD-1 alone or in combination with anti-TIGIT or an oncolytic virus in resectable stage IIIB–D melanoma: A phase 1/2 trial
Get PDFNeoadjuvant immunotherapies have shown antitumor activity in melanoma. Substudy 02C of the global, rolling-arm, phase 1/2, adaptive-design KEYMAKER-U02 trial is evaluating neoadjuvant pembrolizumab (anti-PD-1) alone or in combination, followed by adjuvant pembrolizumab, for stage IIIB–D melanoma. Here we report results from the first three arms: pembrolizumab plus vibostolimab (anti-TIGIT), pembrolizumab plus gebasaxturev (coxsackievirus A21) and pembrolizumab monotherapy. Pathologic complete responses occurred in 10 of 26 patients (38%) with pembrolizumab plus vibostolimab, 7 of 25 (28%) with pembrolizumab plus gebasaxturev and 6 of 15 (40%) with pembrolizumab monotherapy. Major pathologic responses occurred in 13 (50%), 10 (40%) and 7 (47%) patients, respectively. Safety was manageable. Treatment-related adverse events occurred in 24 of 26 patients (92%) with pembrolizumab plus vibostolimab, 21 of 25 (84%) with pembrolizumab plus gebasaxturev and 12 of 15 (80%) with pembrolizumab monotherapy; grade 3 or 4 treatment-related adverse events occurred in 2 (8%), 7 (28%) and 1 (7%) patient in each arm, respectively. No deaths due to adverse events occurred. Exploratory objective responses per RECIST v1.1 were observed in 13 (50%), 8 (32%) and 4 (27%) patients, in each arm, respectively. In a post hoc analysis, scores for tumor mutational burden and an 18-gene T cell-inflamed gene expression profile were generally higher in patients with major pathologic response. Longer follow-up will provide insight into the incremental benefit of combining neoadjuvant pembrolizumab with other therapies in stage IIIB–D melanoma. ClinicalTrials.gov registration: NCT04303169
Optimization of energy management in Malaysian microgrids using fuzzy logic-based EMS scheduling controller
Get PDFThe microgrid (MG) faces significant security issues due to the two-way power and information flow. Integrating an Energy Management System (EMS) to balance energy supply and demand in Malaysian microgrids, this study designs a Fuzzy Logic Controller (FLC) that considers intermittent renewable sources and fluctuating demand patterns. FLC offers a flexible solution to energy scheduling effectively assessed by MATLAB/Simulink simulations. The microgrid consists of PV, battery, grid, and load. A Maximum Power Point Tracking (MPPT) controller helps to extract the maximum PV output and manages the power storage by providing or absorbing excess power. System analysis is performed by observing the State of Charge (SoC)of the battery and output power for each source. The grid supplies additional power if the battery and PV fail to meet the load demand. Total Harmonic Distortion (THD) analysis compares the performance of the Proportional-Integral Controller (PIC) and FLC. The results show that the PI controller design reduces the THD in the current signal, while FLC does not reduce the THD of the grid current when used in the EMS. However, FLC offers better control over the battery’s SOC, effectively preventing overcharging and over-discharging. While PI reduces THD, FLC provides superior SOC control in a system comprising PV, battery, grid, and load. The findings demonstrate that the output current is zero when the SOC is higher than 80% or lower than 20%, signifying that no charging or discharging takes place to avoid overcharging and over-discharging. The third goal was accomplished by comparing and confirming that the grid current’s THD for the EMS designed with both the PI Controller and the FLC is maintained below 5%, following the IEEE 519 harmonic standard, using the THD block in MATLAB Simulink. This analysis highlights FLC’s potential to address demand-supply mismatches and renewable energy variability, which is crucial for optimizing microgrid performance