Improvement of DBR routing protocol in underwater wireless sensor networks using fuzzy logic and bloom filter.

Routing protocols for underwater wireless sensor networks (UWSN) and underwater Internet of Things (IoT_UWSN) networks have expanded significantly. DBR routing protocol is one of the most critical routing protocols in UWSNs. In this routing protocol, the energy consumption of the nodes, the rate of loss of sent packets, and the rate of drop of routing packets due to node shutdown have created significant challenges. For this purpose, in a new scenario called FB-DBR, clustering is performed, and fuzzy logic and bloom filter are used in each cluster's new routing protocol in underwater wireless sensor networks. Due to the fuzzy nature of the parameters used in DBR, better results are obtained and bloom filters are used in routing tables to compensate for the deceleration. as the average number of accesses to routing table entries, dead nodes, Number of Packets Sent to Base Station (BS), Number of Packets Received at BS, Packet Dropped, and Remaining Energy has improved significantly.

5G-enabled contactless multi-user presence and activity detection for independent assisted living.

Wireless sensing is the state-of-the-art technique for next generation health activity monitoring. Smart homes and healthcare centres have a demand for multi-subject health activity monitoring to cater for future requirements. 5G-sensing coupled with deep learning models has enabled smart health monitoring systems, which have the potential to classify multiple activities based on variations in channel state information (CSI) of wireless signals. Proposed is the first 5G-enabled system operating at 3.75 GHz for multi-subject, in-home health activity monitoring, to the best of the authors' knowledge. Classified are activities of daily life performed by up to 4 subjects, in 16 categories. The proposed system combines subject count and activities performed in different classes together, resulting in simultaneous identification of occupancy count and activities performed. The CSI amplitudes obtained from 51 subcarriers of the wireless signal are processed and combined to capture variations due to simultaneous multi-subject movements. A deep learning convolutional neural network is engineered and trained on the CSI data to differentiate multi-subject activities. The proposed system provides a high average accuracy of 91.25% for single subject movements and an overall high multi-class accuracy of 83% for 4 subjects and 16 classification categories. The proposed system can potentially fulfill the needs of future in-home health activity monitoring and is a viable alternative for monitoring public health and well being.

Cross-instrument feasibility, validity, and reproducibility of wireless heart rate monitors: Novel opportunities for extended daily life monitoring.

Wired ambulatory monitoring of the electrocardiogram (ECG) is an established method used by researchers and clinicians. Recently, a new generation of wireless, compact, and relatively inexpensive heart rate monitors have become available. However, before these monitors can be used in scientific research and clinical practice, their feasibility, validity, and reproducibility characteristics have to be investigated. Therefore, we tested how two wireless heart rate monitors (i.e., the Ithlete photoplethysmography (PPG) finger sensor and the Cortrium C3 ECG monitor perform against an established wired reference method (the VU-AMS ambulatory ECG monitor). Monitors were tested on cross-instrument and test-retest reproducibility in a controlled laboratory setting, while feasibility was evaluated in protocolled ambulatory settings at home. We found that the Cortrium and the Ithlete monitors showed acceptable agreement with the VU-AMS reference in laboratory setting. In ambulatory settings, assessments were feasible with both wireless devices although more valid data were obtained with the Cortrium than with the Ithlete. We conclude that both monitors have their merits under controlled laboratory settings where motion artefacts are minimized and stationarity of the ECG signal is optimized by design. These findings are promising for long-term ambulatory ECG measurements, although more research is needed to test whether the wireless devices' feasibility, validity, and reproducibility characteristics also hold in unprotocolled daily life settings with natural variations in posture and activities.

Security analysis and secure channel-free certificateless searchable public key authenticated encryption for a cloud-based Internet of things.

With the rapid development of informatization, an increasing number of industries and organizations outsource their data to cloud servers, to avoid the cost of local data management and to share data. For example, industrial Internet of things systems and mobile healthcare systems rely on cloud computing's powerful data storage and processing capabilities to address the storage, provision, and maintenance of massive amounts of industrial and medical data. One of the major challenges facing cloud-based storage environments is how to ensure the confidentiality and security of outsourced sensitive data. To mitigate these issues, He et al. and Ma et al. have recently independently proposed two certificateless public key searchable encryption schemes. In this paper, we analyze the security of these two schemes and show that the reduction proof of He et al.'s CLPAEKS scheme is incorrect, and that Ma et al.'s CLPEKS scheme is not secure against keyword guessing attacks. We then propose a channel-free certificateless searchable public key authenticated encryption (dCLPAEKS) scheme and prove that it is secure against inside keyword guessing attacks under the enhanced security model. Compared with other certificateless public key searchable encryption schemes, this scheme has higher security and comparable efficiency.

Communication cost of consensus for nodes with limited memory.

Motivated by applications in wireless networks and the Internet of Things, we consider a model of n nodes trying to reach consensus with high probability on their majority bit. Each node i is assigned a bit at time 0 and is a finite automaton with m bits of memory (i.e., [Formula: see text] states) and a Poisson clock. When the clock of i rings, i can choose to communicate and is then matched to a uniformly chosen node j. The nodes j and i may update their states based on the state of the other node. Previous work has focused on minimizing the time to consensus and the probability of error, while our goal is minimizing the number of communications. We show that, when [Formula: see text], consensus can be reached with linear communication cost, but this is impossible if [Formula: see text] A key step is to distinguish when nodes can become aware of knowing the majority bit and stop communicating. We show that this is impossible if their memory is too low.

Biosensors to monitor MS activity.

Advances in wearable and wireless biosensing technology pave the way for a brave new world of novel multiple sclerosis (MS) outcome measures. Our current tools for examining patients date back to the 19th century and while invaluable to the neurologist invite accompaniment from these new technologies and artificial intelligence (AI) analytical methods. While the most common biosensor tool used in MS publications to date is the accelerometer, the landscape is changing quickly with multi-sensor applications, electrodermal sensors, and wireless radiofrequency waves. Some caution is warranted to ensure novel outcomes have clear clinical relevance and stand-up to the rigors of reliability, reproducibility, and precision, but the ultimate implementation of biosensing in the MS clinical setting is inevitable.

Cyber Attacks on Healthcare Devices Using Unmanned Aerial Vehicles.

The growing use of wireless technology in healthcare systems and devices makes these systems particularly open to cyber-based attacks, including denial of service and information theft via sniffing (eaves-dropping) and phishing attacks. Evolving technology enables wireless healthcare systems to communicate over longer ranges, which opens them up to greater numbers of possible threats. Unmanned aerial vehicles (UAV) or drones present a new and evolving attack surface for compromising wireless healthcare systems. An enumeration of the types of wireless attacks capable via drones are presented, including two new types of cyber threats: a stepping stone attack and a cloud-enabled attack. A real UAV is developed to test and demonstrate the vulnerabilities of healthcare systems to this new threat vector. The UAV successfully attacked a simulated smart hospital environment and also a small collection of wearable healthcare sensors. Compromise of wearable or implanted medical devices can lead to increased morbidity and mortality.

MARC: A Novel Framework for Detecting MITM Attacks in eHealthcare BLE Systems.

Real-time and ubiquitous patient monitoring demands the use of wireless data acquisition through resource constrained medical sensors, mostly configured with No-input No-output (NiNo) capabilities. Bluetooth is one of the most popular and widely adopted means of communicating this sensed information to a mobile terminal. However, over simplified implementations of Bluetooth low energy (BLE) protocol in eHealth sector is susceptible to several wireless attacks, in particular the Man-in-the-Middle (MITM) attack. The issue arises due to a lack of mutual authentication and integrity protection between the communicating devices, which may lead to compromise of confidentiality, availability and even the integrity of this safety-critical information. This research paper presents a novel framework named MARC to detect, analyze, and mitigate Bluetooth security flaws while focusing upon MITM attack against NiNo devices. For this purpose, a comprehensive solution has been proposed, which can detect MITM signatures based upon four novel anomaly detection metrics: analyzing Malicious scan requests, Advertisement intervals, RSSI levels, and Cloned node addresses. The proposed solution has been evaluated through practical implementation and demonstration of different attack scenarios, which show promising results concerning accurate and efficient detection of MITM attacks.

Reliability of a wearable wireless patch for continuous remote monitoring of vital signs in patients recovering from major surgery: a clinical validation study from the TRaCINg trial.

OBJECTIVE: To validate whether a wearable remote vital signs monitor could accurately measure heart rate (HR), respiratory rate (RR) and temperature in a postsurgical patient population at high risk of complications. DESIGN: Manually recorded vital signs data were paired with vital signs data derived from the remote monitor set in patients participating in the Trial of Remote versus Continuous INtermittent monitoring (TRaCINg) study: a trial of continuous remote vital signs monitoring. SETTING: St James's University Hospital, UK. PARTICIPANTS: 51 patients who had undergone major elective general surgery. INTERVENTIONS: The intervention was the SensiumVitals monitoring system. This is a wireless patch worn on the patient's chest that measures HR, RR and temperature continuously. The reference standard was nurse-measured manually recorded vital signs. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were the 95% limits of agreement between manually recorded and wearable patch vital sign recordings of HR, RR and temperature. The secondary outcomes were the percentage completeness of vital sign patch data for each vital sign. RESULTS: 1135 nurse observations were available for analysis. There was no clinically meaningful bias in HR (1.85 bpm), but precision was poor (95% limits of agreement -23.92 to 20.22 bpm). Agreement was poor for RR (bias 2.93 breaths per minute, 95% limits of agreement -8.19 to 14.05 breaths per minute) and temperature (bias 0.82°C, 95% limits of agreement -1.13°C to 2.78°C). Vital sign patch data completeness was 72.8% for temperature, 59.2% for HR and 34.1% for RR. Distributions of RR in manually recorded measurements were clinically implausible. CONCLUSIONS: The continuous monitoring system did not reliably provide HR consistent with nurse measurements. The accuracy of RR and temperature was outside of acceptable limits. Limitations of the system could potentially be overcome through better signal processing. While acknowledging the time pressures placed on nursing staff, inaccuracies in the manually recorded data present an opportunity to increase awareness about the importance of manual observations, particularly with regard to methods of manual HR and RR measurements.

Stakeholder perceptions of smart infusion pumps and drug library updates: A multisite, interdisciplinary study.

PURPOSE: Results of a questionnaire-based study to evaluate smart infusion pump end users' perceptions and understanding of the drug library update process are reported. METHODS: The Indianapolis Coalition for Patient Safety, Inc., in partnership with the Regenstrief Center for Healthcare Engineering, conducted a 33-item electronic, cross-sectional survey across 5 Indiana health systems from May through November 2017. Interdisciplinary participants identified for survey distribution included nurses, pharmacists, biomedical engineers, administrators, and medication safety officers. The survey assessed the following domains: patient safety, the drug library update process, knowledge of drug libraries and the update process, and end-user perceptions. RESULTS: A total of 778 submitted surveys were included in the data analysis, with a large majority of responses (90.2%) provided by nurses. The use of drug libraries for ensuring patient safety was deemed extremely important or important by 88% of respondents, but 36% indicated that they were unsure of whether drug libraries are updated on a routine basis in their health system. Approximately two-thirds agreed that the current update process improves quality of care (65.0%) and patient safety (68.1%). Moreover, 53.3% agreed that the current drug library update process was effective. However, less than 10% responded correctly when asked about the steps required to update the drug library. Furthermore, only 18% correctly indicated that when a pump is on it may not necessarily contain the most up-to-date version of the drug library. CONCLUSION: A survey of 5 health systems in Indianapolis identified several end-user knowledge gaps related to smart pump drug library updates. The results suggest that these gaps were most likely due to a combination of the 2-step update process and the fact that the current drug library version is not easy to find and/or user-friendly and it is unclear when an update is pending.

Wireless measurement of rectal temperature during exercise: Comparing an ingestible thermometric telemetric pill used as a suppository against a conventional rectal probe.

Wireless measurement of rectal temperature during exercise may circumvent some limitations associated with the use of a conventional wired probe. We determined, for the first time, whether temperatures provided in vivo by wireless ingestible thermometric telemetric pills and a rectal probe compare favorably under conditions producing slow and rapid increases and decreases in rectal temperature. While wearing a rectal probe linked to a wireless ingestible thermometric telemetric pill, 13 participants completed the following phases: 1) 30 min sitting; 2) 45 min passive heat exposure (40-42 °C); 3) 45 min sitting while ingesting 7.5 g of ice slurry · kg body mass-1; 4) running exercise (38 °C) at 68% V˙O2max until a 39.5 °C increase in rectal probe temperature and; 5) cold-water (10 °C) immersion until a 1.5 °C decrease in rectal probe temperature. Acceptable differences between devices were taken as ≤ 0.3 °C. Mean differences within phases were all < 0.3 °C, whereas 95% limits of agreement ranged from ±0.2 °C to ±0.4 °C, coefficient of variations from ±0.3% to ±0.6% and typical error of measurements from ±0.1 °C to ±0.2°. Of the 14881 rectal temperature values measured over the experiment with the wireless ingestible thermometric telemetric pills and rectal probe, 91% of the differences between devices were found to be ≤ 0.3 °C. Results suggest that rectal temperatures provided by a wireless ingestible thermometric telemetric pill used as a suppository agree with those of a conventional wired probe. Hence, rectal temperature can reliably be measured using a wireless ingestible thermometric telemetric pill as a suppository.

A comparative evaluation of signal quality between a research-grade and a wireless dry-electrode mobile EEG system.

OBJECTIVE: Electroencephalography (EEG) is widely used by clinicians, scientists, engineers and other professionals worldwide, with an increasing number of low-cost, commercially-oriented EEG systems that have become available in recent years. One such system is the Cognionics Quick-20 (Cognionics Inc., San Diego, USA), which uses dry electrodes and offers the convenience of portability thanks to its built-in amplifier and wireless connection. Because of such characteristics, this system has been used in several applications for both clinical and basic research studies. However, an investigation of the quality of the signals that are recorded using this system has not yet been reported. APPROACH: To bridge this gap, here we conducted a systematic comparison of signal quality between the Cognionics Quick-20 system and the Brain Products actiCAP/actiCHamp (Brain Products GmbH, Munich, Germany), a state-of-the-art, wet-electrode, research-oriented EEG system. Resting-state EEG data were recorded from twelve human participants at rest in eyes open and eyes closed conditions. For both systems we evaluated the similarity of mean recorded power spectral density, and detection of alpha suppression associated with eyes open relative to eyes closed. MAIN RESULTS: Power spectral densities were highly correlated across systems, with only minor topographical variability across the scalp. Both systems recorded alpha suppression during eyes open relative to eyes closed conditions. SIGNIFICANCE: These results attest to the robustness and reliability of the dry-electrode Cognionics system relatively to the widely used Brain Products laboratory EEG system, and thus validate its utility for clinical and basic research purposes, at least in studies in which participants do not move.

Long-Term Study on the Effects of Housing C57BL/6NCrl Mice in Cages Equipped With Wireless Technology Generating Extremely Low-Intensity Electromagnetic Fields.

The recent development of mouse cages equipped with monitoring wireless technology raised questions on the potential effects on animals induced by electromagnetic fields (EMFs) generated by electronic boards positioned underneath the cages. The aims of this study were to characterize the EMF produced by digitally ventilated cages (DVC) and perform a clinicopathological study on mice maintained in DVC for up to 1 year. The EMFs were measured in empty individually ventilated cages (IVC) and DVC. Male (n = 160) and female (n = 160) C57BL/6NCrl mice were randomly housed in IVC and DVC in a single rack, 4 mice per cage. Body weight and food and water consumption were recorded at 14-day intervals. At sacrifice (days 60, 120, 180, and 365), body and testes weight was measured, and necropsy, hematology, bone marrow cytology, histology, and immunohistochemistry for cleaved-caspase 3 on the testes were performed. Digitally ventilated cages produced extremely low-intensity electric fields ranging from 5 Hz to 3 GHz. No exposure-related clinical signs and mortality occurred. Occasional statistical differences in body weight, food and water consumption, hematology, bone marrow, and histopathology were recorded, but considered without biological or clinical relevance. In conclusion, long-term maintenance in DVC had no definite effects on C57BL/6NCrl mice.

System Accuracy Assessment of a Blood Glucose Meter With Wireless Internet Access Associated With Unusual Hypoglycemia Patterns in Clinical Trials.

BACKGROUND: In recent randomized clinical trials, an unusual reporting pattern of glycemic data and hypoglycemic events potentially related to an internet enabled blood glucose meter (MyGlucoHealth, BGM) was observed. Therefore, this clinical study was conducted to evaluate the system accuracy of the BGM in accordance with the ISO15197:2015 guidelines with additional data collection. METHODS: To investigate system accuracy, 10 of 3088 devices and 6 of 23 strip lots, used in the trials, were selected by a randomization procedure and a standard repeatability assessment. YSI 2300 STAT Plus was used as the standard reference method. The samples were distributed as per the ISO15197:2015 recommendations with 20 additional samples in the hypoglycemic range. Each sample was tested with 6 devices and 6 strip lots with double determinations. RESULTS: Overall, 121 subjects with blood glucose values 26-423 mg/dL were analyzed, resulting in 1452 data points. In all, 186/1452 readings (12.8%) did not meet the ISO acceptance criteria. Data evaluated according to the FDA guidelines showed that 336/1452 (23.1%) readings did not meet the acceptance criteria. A clear bias toward elevated values was observed for BG <100 mg/dL (MARD: 11.0%). CONCLUSIONS: The results show that the BGM, although approved according to standard regulatory guidelines, did not meet the level of analytical accuracy required for clinical treatment decisions according to ISO 15197:2015 and FDA requirements. In general, caution should be exercised before selection of BGMs for patients and in clinical trials.

Evaluation of commercial, wireless dermal thermometers for surrogate measurements of core temperature.

Extensive research has been devoted to developing methods for assessing core body temperature, and to determine which method is most accurate. A number of wireless dermal thermometers for home use are presently available, but their relation to core body temperature and suitability for use in clinical research has hitherto not been assessed. The current study aimed to evaluate such thermometers by comparing them to the results of a rectal thermometer. Four wireless dermal thermometers for home use (FeverSmart, iThermonitor, Quest Temp Sitter, and Thermochron iButton) were applied to 15 patients during 24 h, and rectal temperature was measured at four occasions. Pearson correlation revealed moderate correlation for the Feversmart (r = 0.75), iThermonitor (r = 0.79), and Thermochron iButton (r = 0.71) systems. The Quest Temp Sitter system malfunctioned repeatedly, and the correlation (r = 0.29) for this method should therefore be assessed with caution. All dermal thermometers rendered lower average temperatures than Terumo c405 (Feversmart -0.70 ± 0.65 °C; iThermonitor -0.77 ± 0.53 °C, Quest Temp Sitter -1.18 ± 0.66 °C, and Thermochron iButton -0.87 ± 0.65 °C). Sensitivity of the dermal thermometers for detecting core temperatures ≥38.0 °C was low, ranging from 0.33 to 0.6, but improved to 0.60 to 0.80 after adjusting temperatures by the methods' average deviation from rectal temperature. The results from the dermal thermometers tested here showed an insufficient correlation to core temperature to be used for core temperature monitoring in clinical research and practice. Unfortunately, other options for non-invasive temperature measurements are few. The two thermometers with the least unsatisfactory performance profile in our evaluations were the Feversmart and iThermonitor systems.

Enabling Covert Body Area Network using Electro-Quasistatic Human Body Communication.

Radiative communication using electro-magnetic (EM) fields amongst the wearable and implantable devices act as the backbone for information exchange around a human body, thereby enabling prime applications in the fields of connected healthcare, electroceuticals, neuroscience, augmented and virtual reality. However, owing to such radiative nature of the traditional wireless communication, EM signals propagate in all directions, inadvertently allowing an eavesdropper to intercept the information. In this context, the human body, primarily due to its high water content, has emerged as a medium for low-loss transmission, termed human body communication (HBC), enabling energy-efficient means for wearable communication. However, conventional HBC implementations suffer from significant radiation which also compromises security. In this article, we present Electro-Quasistatic Human Body Communication (EQS-HBC), a method for localizing signals within the body using low-frequency carrier-less (broadband) transmission, thereby making it extremely difficult for a nearby eavesdropper to intercept critical private data, thus producing a covert communication channel, i.e. the human body. This work, for the first time, demonstrates and analyzes the improvement in private space enabled by EQS-HBC. Detailed experiments, supported by theoretical modeling and analysis, reveal that the quasi-static (QS) leakage due to the on-body EQS-HBC transmitter-human body interface is detectable up to <0.15 m, whereas the human body alone leaks only up to ~0.01 m, compared to >5 m detection range for on-body EM wireless communication, highlighting the underlying advantage of EQS-HBC to enable covert communication.

Adaptive Risk Prediction and Anonymous Secured Communication in MANET for Medical Informatics.

Location-based services (LBS) and information security is a major concern in communication system.With the increasing popularity of location based services more attention is paid to preserve location information to protect the data. In order to protect and preserve the MANET and location based services, there are various existing location based anonymity protocols such as k-anonymity location based, but these protocols are more overhead due to the dynamic mobility nature of ad-hoc networks. In this paper we proposed an Adaptive Risk Prediction and Anonymous Secured Communication protocol to predict the risk before processing anonymous communication. The proposed protocol estimates the risk against adjacent nodes and estimates the vulnerability paths using hidden markov model and decision tree. The decision tree determines the evidence to identify the trusted paths. The anonymous communication message authentication scheme assigns the anonymous communication and organize the secured authentication scheme. We simulated the network by considering different attacks to determine the efficiency of Adaptive Risk Prediction and Anonymous Secured Communication using NS2 simulator.

Behavioral validation of a wireless low-power neurostimulation technology in a conditioned place preference task.

OBJECTIVE: Neurostimulation technologies are important for studying neural circuits and the connections that underlie neurological and psychiatric disorders. However, current methods come with limitations such as the restraint on movement imposed by the wires delivering stimulation. The objective of this study was to assess whether the e-Particle (EP), a novel wireless neurostimulator, could sufficiently stimulate the brain to modify behavior without these limitations. APPROACH: Rats were implanted with the EP and a commercially available stimulating electrode. Animals received rewarding brain stimulation, and performance in a conditioned place preference (CPP) task was measured. To ensure stimulation-induced neuronal activation, immediate early gene c-fos expression was also measured. MAIN RESULTS: The EP was validated in a commonly used CPP task by demonstrating that (1) wireless stimulation via the EP induced preference behavior that was comparable to that induced by standard wired electrodes and (2) neuronal activation was observed in projection targets of the stimulation site. SIGNIFICANCE: The EP may help achieve a better understanding of existing brain stimulation methods while overcoming their limitations. Validation of the EP in a behavioral model suggests that the benefits of this technology may extend to other areas of animal research and potentially to human clinical applications.