Low complexity smart grid security protocol based on elliptic curve cryptography, biometrics and hamming distance.

The incorporation of information and communication technologies in the power grids has greatly enhanced efficiency in the management of demand-responses. In addition, smart grids have seen considerable minimization in energy consumption and enhancement in power supply quality. However, the transmission of control and consumption information over open public communication channels renders the transmitted messages vulnerable to numerous security and privacy violations. Although many authentication and key agreement protocols have been developed to counter these issues, the achievement of ideal security and privacy levels at optimal performance still remains an uphill task. In this paper, we leverage on Hamming distance, elliptic curve cryptography, smart cards and biometrics to develop an authentication protocol. It is formally analyzed using the Burrows-Abadi-Needham (BAN) logic, which shows strong mutual authentication and session key negotiation. Its semantic security analysis demonstrates its robustness under all the assumptions of the Dolev-Yao (DY) and Canetti- Krawczyk (CK) threat models. From the performance perspective, it is shown to incur communication, storage and computation complexities compared with other related state of the art protocols.

Investigating the potential of aggregated mobility indices for inferring public transport ridership changes.

Aggregated mobility indices (AMIs) derived from information and communications technologies have recently emerged as a new data source for transport planners, with particular value during periods of major disturbances or when other sources of mobility data are scarce. Particularly, indices estimated on the aggregate user concentration in public transport (PT) hubs based on GPS of smartphones, or the number of PT navigation queries in smartphone applications have been used as proxies for the temporal changes in PT aggregate demand levels. Despite the popularity of these indices, it remains largely untested whether they can provide a reasonable characterisation of actual PT ridership changes. This study aims to address this research gap by investigating the reliability of using AMIs for inferring PT ridership changes by offering the first rigorous benchmarking between them and ridership data derived from smart card validations and tickets. For the comparison, we use monthly and daily ridership data from 12 cities worldwide and two AMIs shared globally by Google and Apple during periods of major change in 2020-22. We also explore the complementary role of AMIs on traditional ridership data. The comparative analysis revealed that the index based on human mobility (Google) exhibited a notable alignment with the trends reported by ridership data and performed better than the one based on PT queries (Apple). Our results differ from previous studies by showing that AMIs performed considerably better for similar periods. This finding highlights the huge relevance of dealing with methodological differences in datasets before comparing. Moreover, we demonstrated that AMIs can also complement data from smart card records when ticketing is missing or of doubtful quality. The outcomes of this study are particularly relevant for cities of developing countries, which usually have limited data to analyse their PT ridership, and AMIs may offer an attractive alternative.

A Smart Card-Based Two-Factor Mutual Authentication Scheme for Efficient Deployment of an IoT-Based Telecare Medical Information System.

The integration of the Internet of Things (IoT) and the telecare medical information system (TMIS) enables patients to receive timely and convenient healthcare services regardless of their location or time zone. Since the Internet serves as the key hub for connection and data sharing, its open nature presents security and privacy concerns and should be considered when integrating this technology into the current global healthcare system. Cybercriminals target the TMIS because it holds a lot of sensitive patient data, including medical records, personal information, and financial information. As a result, when developing a trustworthy TMIS, strict security procedures are required to deal with these concerns. Several researchers have proposed smart card-based mutual authentication methods to prevent such security attacks, indicating that this will be the preferred method for TMIS security with the IoT. In the existing literature, such methods are typically developed using computationally expensive procedures, such as bilinear pairing, elliptic curve operations, etc., which are unsuitable for biomedical devices with limited resources. Using the concept of hyperelliptic curve cryptography (HECC), we propose a new solution: a smart card-based two-factor mutual authentication scheme. In this new scheme, HECC's finest properties, such as compact parameters and key sizes, are utilized to enhance the real-time performance of an IoT-based TMIS system. The results of a security analysis indicate that the newly contributed scheme is resistant to a wide variety of cryptographic attacks. A comparison of computation and communication costs demonstrates that the proposed scheme is more cost-effective than existing schemes.

Acceptability and user experiences of a patient-held smart card for antenatal services in Nigeria: a qualitative study.

BACKGROUND: Poor maternal, newborn and child health outcomes remain a major public health challenge in Nigeria. Mobile health (mHealth) interventions such as patient-held smart cards have been proposed as effective solutions to improve maternal health outcomes. Our objectives were to assess the acceptability and experiences of pregnant women with the use of a patient-held smartcard for antenatal services in Nigeria. METHODS: Using focus group discussions, qualitative data were obtained from 35 pregnant women attending antenatal services in four Local Government Areas (LGAs) in Benue State, Nigeria. The audio-recorded data were transcribed and analyzed using framework analysis techniques such as the PEN-3 cultural model as a guide. RESULTS: The participants were 18-44 years of age (median age: 24 years), all were married and the majority were farmers. Most of the participants had accepted and used the smartcards for antenatal services. The most common positive perceptions about the smartcards were their ability to be used across multiple health facilities, the preference for storage of the women's medical information on the smartcards compared to the usual paper-based system, and shorter waiting times at the clinics. Notable facilitators to using the smartcards were its provision at the "Baby showers" which were already acceptable to the women, access to free medical screenings, and ease of storage and retrieval of health records from the cards. Costs associated with health services was reported as a major barrier to using the smartcards. Support from health workers, program staff and family members, particularly spouses, encouraged the participants to use the smartcards. CONCLUSION: These findings revealed that patient-held smart card for maternal health care services is acceptable by women utilizing antenatal services in Nigeria. Understanding perceptions, barriers, facilitators, and supportive systems that enhance the use of these smart cards may facilitate the development of lifesaving mobile health platforms that have the potential to achieve antenatal, delivery, and postnatal targets in a resource-limited setting.

Encouraging gender-inclusive acceptance of multipurpose national-identity smart cards.

PURPOSE: Gender-inclusive adoption of multipurpose national-identity smart cards (MNIS) is important to ensure gender equality, particularly in accessing public services offered by the card e.g. identity verification, healthcare, transit, banking, driving license, passport, etc. The aim is to study the gender differences in terms of the motivation and impediments of adopting MNIS to recommend gender-specific adoption strategies. METHODOLOGY: The research framework is based on the Unified Theory of Acceptance and Use of Technology (UTAUT) with the added constructs of perceived credibility and anxiety. The data was collected through five hundred questionnaires from Malaysia (the MNIS pioneer) and analyzed using structural equation modeling. FINDINGS: The results show that females have significantly higher perceived credibility while males have significantly higher performance expectancy for MNIS. The correlation between performance expectancy and perceived credibility is significantly stronger among males. PRACTICAL IMPLICATIONS: Strategies recommended to policymakers include having social messages related to MNIS utility and convenience in campaigns targeting males while alleviating concerns over security and privacy for campaigns targeting females. ORIGINALITY/VALUE: This is the first study that investigated the gender differences in adoption of MNIS by comparing the structural UTAUT models of both genders. The gender differences in MNIS adoption were explained using gender theories.

Travel pattern-based bus trip origin-destination estimation using smart card data.

Smart card data are widely used in generating the origin and destination (O-D) matrix for public transit, which contains important information for transportation planning and operation. However, the generation of the O-D matrix is limited by the smart card data information that includes the boarding (origin) information without the alighting (destination) information. To solve this problem, trip chain methods have been proposed, thereby greatly contributing in estimating the destination using the smart card data. Nevertheless, unlinked trips, that is, trips with unknown destinations, are a persisting issue. The purpose of this study is to develop a method for estimating the destination of unlinked trips, in which trip chain methods cannot be applied, using temporal travel patterns and historical boarding records of the passengers based on long-term smart card data. The passengers were clustered by k-means clustering, and the time-of-day travel patterns were estimated for each cluster using a Gaussian mixture model. The travel patterns were formulated to estimate the destination of the passengers from the smart card data. The proposed method was verified using the 2018 smart card data collected in Sejong City, South Korea. The existing trip chain method matched the destinations of 60.0% of the total trips, whereas the proposed method improved the matching to 74.9% by additionally matching the destinations of 37.2% of the unlinked trips.

Equity in Health-Seeking Behavior of Groups Using Different Transportations.

The equity of health-seeking behaviors of groups using different transportations is an important metric for health outcome disparities among them. Recently, smart card data and taxi trajectory data have been used extensively but separately to quantify the spatiotemporal patterns of health-seeking behavior and healthcare accessibility. However, the differences in health-seeking behavior among groups by different transportations have hitherto received scant attention from scholars. To fill the gap, this paper aimed to investigate the equity in health-seeking behavior of groups using different transportations. With sets of spatial and temporal constraints, we first extracted health-seeking behaviors by bus and taxi from smart card data and taxi trajectory data from Beijing during 13-17 April 2015. Then, health-seeking behaviors of groups by bus and taxi were compared regarding the coverage of hospital service areas, time efficiency to seek healthcare, and transportation access. The results indicated that there are inequities in groups using different travel modes to seek healthcare regarding the coverage of hospital service areas, time efficiency to seek healthcare, and transportation access. They provide some suggestions for mode-specific interventions to narrow health disparity, which might be more efficient than a one-size-fits-all intervention.

Acceptability and perceived facilitators and barriers to the usability of biometric registration among infants and children in Manhiça district, Mozambique: A qualitative study.

In low-and middle-income countries, many infants and children remain unregistered in both civil registration and healthcare records, limiting their access to essential rights-based services, including healthcare. A novel biometric registration prototype, applying a non-touch platform using smart phones and tablets to capture physical characteristics of infants and children for electronic registration, was tested in rural Mozambique. This study assessed acceptability and perceived barriers and facilitators to the usability of this biometric registration prototype in Manhiça district, southern Mozambique. The study followed a qualitative design consisting of 5 semi-structured interviews with healthcare providers, 7 focus group discussions with caregivers of infants aged between 0 and 5 years old, and 2 focus group discussions with data collectors involved in the implementation of the biometric registration pilot project. Data were thematically analysed. The results of this study show that there is wide acceptability of the biometric registration prototype among healthcare providers and caregivers. Participants were aware of the benefits of the biometric registration prototype. The perceived benefits included that the biometric registration prototype would solve the inefficiency of paper-based registration, and the perception of biometric registration as "healthcare norm". Perceived potential barriers to the implementation of the biometric registration prototype included: myths and taboos, lack of information, lack of time, lack of father's consent, and potential workload among healthcare providers. In conclusion, the biometric prototype was widely accepted due to its perceived usefulness. However, there is a need to address the perceived barriers, and involvement of children's fathers and/or other relevant family members in the process of biometric registration.

SCB-HC-ECC-Based Privacy Safeguard Protocol for Secure Cloud Storage of Smart Card-Based Health Care System.

The advent of the internet has brought an era of unprecedented connectivity between networked devices, making one distributed computing, called cloud computing, and popular. This has also resulted in a dire need for remote authentication schemes for transferring files of a sensitive nature, especially health-related information between patients, smart health cards, and cloud servers via smart health card solution providers. In this article, we elaborate on our proposed approach for such a system and accomplish an informal analysis to demonstrate the claim that this scheme provides sufficient security while maintaining usability.

Fractional chaotic maps based short signature scheme under human-centered IoT environments.

Introduction: The Internet of Things (IoT) comprises of various smart devices for the sharing of sensed data through online services. People will be directly contacted to check their health parameters and the reports will be collected centrally through smart devices. The requirement is protection of messages during the exchange of data between sender and receiver in order to tackle human malicious attacks. Various signature-based schemes are discussed in the literature to provide secure communication. Smart devices however require lightweight tasks by ensuring critical safety strengths. An important problem in the signature based method is that it incurs more computational expenses for signing and verification process in large numbers. Objectives: In this study, we introduced an efficient Short Signature Scheme (SSS) that uses Fractional Chaotic Map (FCM) for secure communication in IoT based smart devices, the security of which is closely related to a random oracle based on FCM assumption. Methods: In this study, we have designed new short signature scheme using FCM. The presented scheme consist of four sub-algorithm as follows: setup, key generation, signing and verification. We have used less rigorous operations based on the FCM to carry out signing and verification procedures, similar to human signing on valid documents and then verifying them as per witness. Results: The proposed SSS offers a better security assurance than currently established signature schemes. The key advantage of the SSS over the DSA schemes is that at the verification stage and signing period it takes less computation; it retains the degree of protection. The presented SSS takes less bandwidth for storage, communication, and computing resources; particularly applicable to wireless devices and smart cards. Conclusion: We concluded that the uses of fractional chaotic maps is more effective for secure communication in human-centered IoT to present a provably secure short signature technique.

Whether Public Hospital Reform Affects the Hospital Choices of Patients in Urban Areas: New Evidence from Smart Card Data.

The effects of public hospital reforms on spatial and temporal patterns of health-seeking behavior have received little attention due to small sample sizes and low spatiotemporal resolution of survey data. Without such information, however, health planners might be unable to adjust interventions in a timely manner, and they devise less-effective interventions. Recently, massive electronic trip records have been widely used to infer people's health-seeking trips. With health-seeking trips inferred from smart card data, this paper mainly answers two questions: (i) how do public hospital reforms affect the hospital choices of patients? (ii) What are the spatial differences of the effects of public hospital reforms? To achieve these goals, tertiary hospital preferences, hospital bypass, and the efficiency of the health-seeking behaviors of patients, before and after Beijing's public hospital reform in 2017, were compared. The results demonstrate that the effects of this reform on the hospital choices of patients were spatially different. In subdistricts with (or near) hospitals, the reform exerted the opposite impact on tertiary hospital preference compared with core and periphery areas. However, the reform had no significant effect on the tertiary hospital preference and hospital bypass in subdistricts without (or far away from) hospitals. Regarding the efficiency of the health-seeking behaviors of patients, the reform positively affected patient travel time, time of stay at hospitals, and arrival time. This study presents a time-efficient method to evaluate the effects of the recent public hospital reform in Beijing on a fine scale.

Evaluating the Inequality of Medical Service Accessibility Using Smart Card Data.

The measurement of medical service accessibility is typically based on driving or Euclidean distance. However, in most non-emergency cases, public transport is the travel mode used by the public to access medical services. Yet, there has been little evaluation of the public transport system-based inequality of medical service accessibility. This work uses massive real smart card data (SCD) and an improved potential model to estimate the public transport-based medical service accessibility in Beijing, China. These real SCD data are used to calculate travel costs in terms of time and distance, and medical service accessibility is estimated using an improved potential model. The spatiotemporal variations and patterns of medical service accessibility are explored, and the results show that it is unevenly spatiotemporally distributed across the study area. For example, medical service accessibility in urban areas is higher than that in suburban areas, accessibility during peak periods is higher than that during off-peak periods, and accessibility on weekends is generally higher than that on weekdays. To explore the association of medical service accessibility with socio-economic factors, the relationship between accessibility and house price is investigated via a spatial econometric analysis. The results show that, at a global level, house price is positively correlated with medical service accessibility. In particular, the medical service accessibility of a higher-priced spatial housing unit is lower than that of its neighboring spatial units, owing to the positive spatial spillover effect of house price. This work sheds new light on the inequality of medical service accessibility from the perspective of public transport, which may benefit urban policymakers and planners.

Do Targeted User Fee Exemptions Reach the Ultra-Poor and Increase their Healthcare Utilisation? A Panel Study from Burkina Faso.

Background: A component of the performance-based financing intervention implemented in Burkina Faso was to provide free access to healthcare via the distribution of user fee exemption cards to previously identified ultra-poor. This study examines the factors that led to the receipt of user fee exemption cards, and the effect of card possession on the utilisation of healthcare services. Methods: A panel data set of 1652 randomly selected ultra-poor individuals was used. Logistic regression was applied on the end line data to identify factors associated with the receipt of user fee exemption cards. Random-effects modelling was applied to the panel data to determine the effect of the card possession on healthcare service utilisation among those who reported an illness six months before the surveys. Results: Out of the ultra-poor surveyed in 2017, 75.51% received exemption cards. Basic literacy (p = 0.03), living within 5 km from a healthcare centre (p = 0.02) and being resident in Diébougou or Gourcy (p = 0.00) were positively associated with card possession. Card possession did not increase health service utilisation (ß = -0.07; 95% CI = -0.45; 0.32; p = 0.73). Conclusion: A better intervention design and implementation is required. Complementing demand-side strategies could guide the ultra-poor in overcoming all barriers to healthcare access.

Inferring transit-based health seeking patterns from smart card data - A case study in Beijing, China.

Massive electronic trip records have recently been utilized to infer people's trips for healthcare. Many inferential methods were developed to derive healthcare trips by taxi using GPS trajectory records, but little attention is paid to public transit, as a common travel mode for healthcare. This paper proposes a method to fill this gap by mining a big data of smart transit cards with spatio-temporal constraints. We demonstrate and validate this method in Beijing, China. The inferred trips achieve a high degree of consistency, in space and time, with empirically observed trips from a survey. The inferred trips are further used to identify spatial disparities in transit-based access to healthcare, which might have been overlooked by health policy makers.

Patient Identification Techniques - Approaches, Implications, and Findings.

OBJECTIVES: To identify current patient identification techniques and approaches used worldwide in today's healthcare environment. To identify challenges associated with improper patient identification. METHODS: A literature review of relevant peer-reviewed and grey literature published from January 2015 to October 2019 was conducted to inform the paper. The focus was on: 1) patient identification techniques and 2) unintended consequences and ramifications of unresolved patient identification issues. RESULTS: The literature review showed six common patient identification techniques implemented worldwide ranging from unique patient identifiers, algorithmic approaches, referential matching software, biometrics, radio frequency identification device (RFID) systems, and hybrid models. The review revealed three themes associated with unresolved patient identification: 1) treatment, care delivery, and patient safety errors, 2) cost and resource considerations, and 3) data sharing and interoperability challenges. CONCLUSIONS: Errors in patient identification have implications for patient care and safety, payment, as well as data sharing and interoperability. Different patient identification techniques ranging from unique patient identifiers and algorithms to hybrid models have been implemented worldwide. However, no current patient identification techniques have resulted in a 100% match rate. Optimizing algorithmic matching through data standardization and referential matching software should be studied further to identify opportunities to enhance patient identification techniques and approaches. Further efforts to improve patient identity management include adoption of patients' photos at registration, naming conventions, and standardized processes for recording patients' demographic data attributes.

"You Need ID to Get ID": A Scoping Review of Personal Identification as a Barrier to and Facilitator of the Social Determinants of Health in North America.

Personal identification (PID) is an important, if often overlooked, barrier to accessing the social determinants of health for many marginalized people in society. A scoping review was undertaken to explore the range of research addressing the role of PID in the social determinants of health in North America, barriers to acquiring and maintaining PID, and to identify gaps in the existing research. A systematic search of academic and gray literature was performed, and a thematic analysis of the included studies (n = 31) was conducted. The themes identified were: (1) gaining and retaining identification, (2) access to health and social services, and (3) facilitating identification programs. The findings suggest a paucity of research on PID services and the role of PID in the social determinants of health. We contend that research is urgently required to build a more robust understanding of existing PID service models, particularly in rural contexts, as well as on barriers to accessing and maintaining PID, especially among the most marginalized groups in society.

Effect of Clinical Geriatric Assessments and Collaborative Medication Reviews by Geriatrician and Family Physician for Improving Health-Related Quality of Life in Home-Dwelling Older Patients Receiving Polypharmacy: A Cluster Randomized Clinical Trial.

Importance: Polypharmacy and inappropriate drug regimens are major health concerns among older adults. Various interventions focused on medication optimization strategies have been carried out, but the effect on patient-relevant outcomes remains uncertain. Objective: To investigate the effect of clinical geriatric assessments and collaborative medication reviews by geriatrician and family physician (FP) on health-related quality of life and other patient-relevant outcomes in home-dwelling older patients receiving polypharmacy. Design, Setting, and Participants: Cluster randomized, single-blind, clinical trial. Norwegian FPs were recruited from March 17, 2015, to March 16, 2017, to participate in the trial with their eligible patients. Participants were home-dwelling patients 70 years or older, using at least 7 medications regularly, and having their medications administered by the home nursing service. Patients in the control group received usual care. Randomization occurred at the FP level. A modified intent-to-treat analysis was used. Intervention: The intervention consisted of 3 main parts: (1) clinical geriatric assessment of the patients combined with a thorough review of their medications; (2) a meeting between the geriatrician and the FP; and (3) clinical follow-up. Main Outcomes and Measures: The primary outcome was health-related quality of life as assessed by the 15D instrument (score range, 0-1; higher scores indicate better quality of life, with a minimum clinically important change of ±0.015) at week 16. Secondary outcomes included changes in medication appropriateness, physical and cognitive functioning, use of health services, and mortality. Results: Among 174 patients (mean [SD] age, 83.3 [7.3] years; 67.8% women; 87 randomized to the intervention group and 87 randomized to the control [usual care] group) in 70 FP clusters (36 intervention and 34 control), 158 (90.8%) completed the trial. The mean (SD) 15D instrument score at baseline was 0.708 (0.121) in the intervention group and 0.714 (0.113) in the control group. At week 16, the mean (SD) 15D instrument score was 0.698 (0.164) in the intervention group and 0.655 (0.184) in the control group, with an estimated between-group difference of 0.045 (95% CI, 0.004-0.086; P = .03). Several secondary outcomes were also in favor of the intervention. There were more drug withdrawals, reduced dosages, and new drug regimens started in the intervention group. Conclusions and Relevance: This study's findings indicate that, among older patients exposed to polypharmacy, clinical geriatric assessments and collaborative medication reviews carried out by a geriatrician in cooperation with the patient's FP can result in positive effects on health-related quality of life. Trial Registration: ClinicalTrials.gov identifier: NCT02379455.

Authenticated Key Agreement Scheme with Strong Anonymity for Multi-Server Environment in TMIS.

The technology of Internet of Things (IoT) has appealed to both professionals and the general public to its convenience and flexibility. As a crucial application of IoT, telecare medicine information system (TMIS) provides people a high quality of life and advanced level of medical service. In TMIS, smart card-based authenticated key agreement schemes for multi-server architectures have gathered momentum and positive impetus due to the conventional bound of a single server. However, we demonstrate that most of the protocols in the literatures can not implement strong security features in TMIS, such as Lee et al.'s and Shu's scheme. They store the identity information directly, which fail to provide strong anonymity and suffer from password guessing attack. Then we propose an extended authenticated key agreement scheme (short for AKAS) with strong anonymity for multi-server environment in TMIS, by enhancing the security of the correlation parameters stored in the smart cards and calculating patients' dynamic identities. Furthermore, the proposed chaotic map-based scheme provides privacy protection and is formally proved under Burrows-Abadi-Needham (BAN) logic. At the same, the informal security analysis attests that the AKAS scheme not only could resist the multifarious security attacks but also improve efficiency by 21% compared with Lee et al.'s and Shu's scheme.

Strengthening the Voice of Those with Mental Health Issues: A Community Approach to Developing a Mental Health Identification System.

This article describes how an action research approach was used to involve a community of individuals with mental health issues and their support systems in the development and adoption of a mental health identification (ID) card. The intent of the card was to provide individuals with mental health issues a way to communicate and manage the idiosyncratic nature of their behaviors. A credit card-size ID card was developed that has the individual's picture, address, diagnosis, idiosyncratic behaviors, best approach with the individual when those behaviors are present, medications, allergies, and emergency contact information. Benefits and concerns about the ID system in regard to the cardholder, card recipients, the provision of consent, Health Insurance Portability and Accountability Act compliance, and the balancing of reducing and increasing stigmas and stereotypes emerged throughout the process. In the end, the ID card has come to be seen as a social justice mechanism that allows for communication and awareness for those with mental health issues.