A secure remote user authentication scheme for 6LoWPAN-based Internet of Things.

One of the significant challenges in the Internet of Things (IoT) is the provisioning of guaranteed security and privacy, considering the fact that IoT devices are resource-limited. Oftentimes, in IoT applications, remote users need to obtain real-time data, with guaranteed security and privacy, from resource-limited network nodes through the public Internet. For this purpose, the users need to establish a secure link with the network nodes. Though the IPv6 over low-power wireless personal area networks (6LoWPAN) adaptation layer standard offers IPv6 compatibility for resource-limited wireless networks, the fundamental 6LoWPAN structure ignores security and privacy characteristics. Thus, there is a pressing need to design a resource-efficient authenticated key exchange (AKE) scheme for ensuring secure communication in 6LoWPAN-based resource-limited networks. This paper proposes a resource-efficient secure remote user authentication scheme for 6LoWPAN-based IoT networks, called SRUA-IoT. SRUA-IoT achieves the authentication of remote users and enables the users and network entities to establish private session keys between themselves for indecipherable communication. To this end, SRUA-IoT uses a secure hash algorithm, exclusive-OR operation, and symmetric encryption primitive. We prove through informal security analysis that SRUA-IoT is secured against a variety of malicious attacks. We also prove the security strength of SRUA-IoT through formal security analysis conducted by employing the random oracle model. Additionally, we prove through Scyther-based validation that SRUA-IoT is resilient against various attacks. Likewise, we demonstrate that SRUA-IoT reduces the computational cost of the nodes and communication overheads of the network.

Working online due to the COVID-19 pandemic: a research and literature review.

Given the contemporary situation of many analysts in the world now being forced to work online due to the effects of the COVID-19 pandemic, it is important to review the working online issue. Substantial debate over previous years has questioned whether a genuine analytic process can unfold through online work. This debate is reviewed with the conclusion that such a process is not necessarily precluded. Research outcomes are then reviewed to highlight those things that can facilitate positive outcomes when working online. These cover the 'online disinhibition effect', the therapeutic alliance, particular ways of using the screen, focussing on trauma, the importance of self-awareness, knowing the predictors of mental health, certain potential positives of isolation/quarantine and psychotherapy interventions that may be currently needed. Final recommendations and suggestions are then presented as in the diagnosis issue, professional development and guidelines to do with practical and ethical considerations.

Etant donnée la situation actuelle dans laquelle beaucoup d'analystes dans le monde sont maintenant obligés de travailler en ligne du fait des effets de la pandémie de COVID-19, il est important de revisiter le sujet du travail en ligne. Dans les dernières années, il y a eu un débat important sur la question de savoir si un authentique travail analytique pouvait se déployer dans le cadre d'un travail en ligne. Ce débat est revisité ici avec la conclusion qu'un tel processus n'est pas nécessairement rendu impossible. Les résultats de recherches sont alors étudiés afin de souligner les éléments qui peuvent faciliter des effets positifs quand on travaille en ligne. Cela recouvre 'l'effet de désinhibition du travail en ligne', l'alliance thérapeutique, les manières particulières d'utiliser l'écran, se concentrer sur le traumatisme, l'importance de la conscience de soi, la connaissance des indicateurs de santé mentale, certains aspects potentiellement positifs de l'isolation/la quarantaine et les interventions psychothérapeutiques qui peuvent alors être avisées. Des recommandations et des suggestions sont enfin présentées au sujet du diagnostic, de la formation continue et des consignes sur les considérations pratiques et éthiques.

Dada la situación contemporánea de muchos analistas en el mundo forzados en la actualidad a trabajar en línea debido a los efectos de la pandemia COVID-19, es importante revisar el tema del trabajo online. Durante los años previos, un debate sustancial ha cuestionado si un genuino proceso analítico puede llevarse a cabo a través del trabajo online. Este debate es revisado con la conclusión de que semejante proceso no está necesariamente impedido. Los resultados de la investigación son luego revisados para destacar aquellos elementos que pueden facilitar resultados positivos al trabajar online. Los mismos abarcan, 'el efecto online de desinhibición', la alianza terapéutica, los modos particulares de usar la pantalla, el focalizarse en el trauma, la importancia del autoconocimiento, el conocer los predictores en salud mental, ciertos potenciales positivos del aislamiento/cuarentena e intervenciones en psicoterapia que pueden ser necesarias en la actualidad. Se presentan recomendaciones finales y sugerencias, en el tema diagnóstico, desarrollo profesional y guías con consideraciones prácticas y éticas.

Facilitating Virtual Visitation in Critical Care Units During a Pandemic.

Presence of support persons enhances patient and family satisfaction. The introduction of the coronavirus disease-2019 (COVID-19) pandemic has impacted hospital operations and has reduced visitation. A virtual visitation program was implemented in critical care units to replicate visitation by video chat to ease stress on patients and family members to improve communication.

How real is a virtual interview? Perspectives of orthopaedic surgery residency directors.

OBJECTIVE: As a result of COVID-19 pandemic, the 2021 US residency MATCH was devoid of the traditional in-person interviews. Herein, we assess the impact of Virtual Interviews (VIs) on resident selection, from the perspectives of Orthopedic Surgery (OS) Program Directors (PDs). MATERIALS AND METHODS: A 14-item survey was sent to PDs of ACGME-accredited OS residencies. Questions were designed to assess the pros, cons, and robustness of VIs compared to their antecedent in-person format. RESULTS: Forty-seven PDs responded to our survey. VIs antagonized PDs' ability to assess applicants' fit to program (76.6%), commitment to specialty (64%), and interpersonal skills (68.1%). This led to heavier dependence upon applicants' portfolios (64%). Almost all respondents (97.9%) found VIs to be more cost-efficient, saving a median of $3000 in interview-related expenses. Overall, only 8.5% of PDs were willing to conduct exclusive VIs in future cycles, compared to the majority in favor of dual formats (51.5%) or exclusive in-person interviews (40.4%). CONCLUSIONS: VIs have been an overall success, making most PDs opt for dual interview formats in future cycles. How this technology is further implemented in the future remains to be seen.

The APPCN multisite didactic initiative: Development, benefits, and challenges.

Objective: The Covid-19 pandemic disrupted instructional activity in neuropsychology training programs. In response, the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) launched a multisite didactic initiative (MDI). This manuscript describes the development and implementation of the MDI and presents findings from a recently conducted online survey concerning MDI participation.Methods: Faculty and trainees at APPCN member programs were recruited to complete the MDI survey, administered using the Qualtrics platform, through email announcements and via website link and on-screen quick response code shared at online didactic sessions. The MDI survey instrument was designed to capture basic demographics and professional role; information regarding level of site participation, benefits of participation, barriers to participation, online conference platform(s) used, and interest in continued participation; as well as anxiety and work engagement ratings.Results: The response rate was estimated to be 21-29%. Transition to videoconferencing for didactics was noted by 80% due to Covid-19, with 17% of respondents experiencing cancellation or reduction in didactic activities. About 79% endorsed that participation in MDI activities was always or nearly always beneficial. Barriers to participation included not having time, difficulty accessing didactic information, and not knowing about the MDI. Interestingly, trainees at nonparticipating sites reported greater anxiety than trainees at participating sites.Conclusion: It is hoped that these findings will inform future efforts to develop and implement online training activities. The benefits reported by respondents suggest that this work is warranted, while reported barriers to participation identify areas for improvement.

Perspectives on Telephone and Video Communication in the Intensive Care Unit during COVID-19.

Rationale: During the coronavirus disease (COVID-19) pandemic, many intensive care units (ICUs) have shifted communication with patients' families toward chiefly telehealth methods (phone and video) to reduce COVID-19 transmission. Family and clinician perspectives about phone and video communication in the ICU during the COVID-19 pandemic are not yet well understood. Increased knowledge about clinicians' and families' experiences with telehealth may help to improve the quality of remote interactions with families during periods of hospital visitor restrictions during COVID-19.Objectives: To explore experiences, perspectives, and attitudes of family members and ICU clinicians about phone and video interactions during COVID-19 hospital visitor restrictions.Methods: We conducted a qualitative interviewing study with an intentional sample of 21 family members and 14 treating clinicians of cardiothoracic and neurologic ICU patients at an academic medical center in April 2020. Semistructured qualitative interviews were conducted with each participant. We used content analysis to develop a codebook and analyze interview transcripts. We specifically explored themes of effectiveness, benefits and limitations, communication strategies, and discordant perspectives between families and clinicians related to remote discussions.Results: Respondents viewed phone and video communication as somewhat effective but inferior to in-person communication. Both clinicians and families believed phone calls were useful for information sharing and brief updates, whereas video calls were preferable for aligning clinician and family perspectives. Clinicians and families expressed discordant views on multiple topics-for example, clinicians worried they were unsuccessful in conveying empathy remotely, whereas families believed empathy was conveyed successfully via phone and video. Communication strategies suggested by families and clinicians for remote interactions include identifying a family point person to receive updates, frequently checking family understanding, positioning the camera on video calls to help family see the patient and their clinical setting, and offering time for the family and patient to interact without clinicians participating.Conclusions: Telehealth communication between families and clinicians of ICU patients appears to be a somewhat effective alternative when in-person communication is not possible. Use of communication strategies specific to phone and video can improve clinician and family experiences with telehealth.

Program and candidate experience with virtual interviews for the 2020 Complex General Surgical Oncology interview season during the COVID pandemic.

BACKGROUND: The COVID crisis hit during the interview season for the Complex General Surgical Oncology (CGSO) fellowship. With minimal time to adapt, all programs transitioned to virtual interviews. Here we describe the experience of both program directors (PDs) and candidates with virtual interviews, and provide guidelines for implementation based on the results. METHODS: Surveys regarding interview day specifics and perceptions were created for CGSO fellowship PDs and candidates. They were distributed at the conclusion of the season, prior to match. RESULTS: Thirty (94%) PDs and 64 (79%) candidates responded. Eighty-three% of PDs and 79% of candidates agreed or strongly agreed that they felt comfortable creating a rank list. If given the choice, 60% of PDs and 45% of candidates would choose virtual interviews over in-person interviews. The majority of candidates found PD overviews, fellows only sessions and pre-interview materials helpful. CONCLUSION: Overall, the majority of PDs and candidates felt comfortable creating a rank list; however, more PDs preferred virtual interviews for the future. Our results also confirm key components of a virtual interview day.

Virtual education in neurosurgery during the COVID-19 pandemic.

OBJECTIVE: Neurosurgical education in the US has changed significantly as a consequence of the novel coronavirus (COVID-19) pandemic. Institutional social distancing requirements have resulted in many neurosurgical programs utilizing video conferencing for educational activities. However, it is unclear how or if these practices should continue after the pandemic. The objective of this study was to characterize virtual education in neurosurgery and understand how it should be utilized after COVID-19. METHODS: A 24-question, 3-part online survey was administered anonymously to all 117 US neurosurgical residency programs from May 15, 2020, to June 15, 2020. Questions pertained to the current use of virtual conferencing, preferences over traditional conferences, and future inclinations. The Likert scale (1 = strongly disagree, 3 = neutral, 5 = strongly agree) was used. Comparisons were calculated using the Mann-Whitney U-test. Statistical significance was set at 0.05. RESULTS: One-hundred eight responses were recorded. Overall, 38 respondents (35.2%) were attendings and 70 (64.8%) were trainees. Forty-one respondents (38.0%) indicated attending 5-6 conferences per week and 70 (64.8%) attend national virtual conferences. When considering different conference types, there was no overall preference (scores < 3) for virtual conferences over traditional conferences. In regard to future use, respondents strongly agreed that they would continue the practice at some capacity after the pandemic (median score 5). Overall, respondents agreed that virtual conferences would partially replace traditional conferences (median score 4), whereas they strongly disagreed with the complete replacement of traditional conferences (median score 1). The most common choices for the partial replacement of tradition conferences were case conferences (59/108, 55%) and board preparation (64/108, 59%). Lastly, there was a significant difference in scores for continued use of virtual conferencing in those who attend nationally sponsored conferences (median score 5, n = 70) and those who do not (median score 4, n = 38; U = 1762.50, z = 2.97, r = 0.29, p = 0.003). CONCLUSIONS: Virtual conferences will likely remain an integral part of neurosurgical education after the COVID-19 pandemic has abated. Across the country, residents and faculty report a preference for continued use of virtual conferencing, especially virtual case conferences and board preparation. Some traditional conferences may even be replaced with virtual conferences, in particular those that are more didactic. Furthermore, nationally sponsored virtual conferences have a positive effect on the preferences for continued use of virtual conferences.

A review of studies on the COVID-19 epidemic crisis disease with a preventive approach.

BACKGROUND: COVID-19 is a highly contagious acute respiratory syndrome and has been declared a pandemic in more than 209 countries worldwide. At the time of writing, no preventive vaccine has been developed and tested in the community. This study was conducted to review studies aimed at preventing the spread of the coronavirus worldwide. METHODS: This study was a review of the evidence-based literature and was conducted by searching databases, including Google Scholar, PubMed, and ScienceDirect, until April 2020. The search was performed based on keywords including "coronavirus", "COVID-19", and "prevention". The list of references in the final studies has also been re-reviewed to find articles that might not have been obtained through the search. The guidelines published by trustworthy organizations such as the World Health Organization and Center for Disease Control have been used in this study. CONCLUSION: So far, no vaccine or definitive treatment for COVID-19 has been invented, and the disease has become a pandemic. Therefore, observation of hand hygiene, disinfection of high-touch surfaces, observation of social distance, and lack of presence in public places are recommended as preventive measures. Moreover, to control the situation and to reduce the incidence of the virus, some of the measures taken by the decision-making bodies and the guidelines of the deterrent institutions to strengthen telecommuting of employees and reduce the presence of people in the community and prevent unnecessary activities, are very important.

[Communication through electronic media in pediatrics. Use recommendations]. / Comunicación a través de medios electrónicos en pediatría. Recomendaciones de uso.

New information and communication technologies have had an impact on our lives in general, as well as in our health care and pediatric practice. Given this fact, it is essential to establish an initial framework for this type of interactions between physicians and patients in order to provide the necessary security tools to all the involved parties. The existing legislative gap to date has not been an impediment to the use of these technologies in medical communication, but it is necessary to establish what the responsibilities, obligations and rights of each party are, arising from their use. This document briefly describes the available electronic communication channels, with their advantages and disadvantages, and suggests recommendations for the responsible and safe use. Our aim is to frame this new modality of interaction between doctors and their patients, in order to highlight its value and evaluate its limitations.

Las nuevas tecnologías de información y comunicación, como parte de la revolución digital, han impactado en nuestras vidas en general y han atravesado la práctica pediátrica. Consideramos esencial establecer un primer encuadre para este tipo de interacciones entre médicos y pacientes a los fines de brindar la seguridad necesaria a todas las partes involucradas. El vacío legislativo, hasta la fecha, no es un impedimento para la utilización de estas tecnologías en la comunicación médica, pero es necesario establecer cuáles son las responsabilidades, obligaciones y derechos de cada parte, emergentes de su utilización. Este documento describe brevemente los distintos canales de comunicación electrónica disponibles con sus respectivas ventajas y desventajas, y se generan recomendaciones para el uso responsable y seguro de cada herramienta. Su objetivo es enmarcar esta nueva modalidad de interacción médico-paciente, resaltar su valor y, a su vez, reconocer sus limitaciones.

Participant Engagement in and Perspectives on a Web-Based Mindfulness Intervention for 9-1-1 Telecommunicators: Multimethod Study.

BACKGROUND: Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Web-based mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit the effectiveness of the intervention. OBJECTIVE: The aim of this study was to assess participant engagement in a Web-based MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe the following: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and (3) perceived challenges and facilitators to engaging. METHODS: We used qualitative and quantitative data from participant surveys (n=149) that were collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI. RESULTS: We found that no individual participant characteristics were associated with the level of engagement (low vs high number of lessons completed). Participant engagement did vary by the call center (P<.001). We identified the following overarching qualitative themes: (1) the participants perceived benefits of mindfulness practice, (2) the participants perceived challenges to engage with mindfulness and the intervention, and (3) intervention components that facilitated engagement. The participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to participate in the intervention at work. Facilitators included shorter meditation practices and the availability of multiple formats and types of intervention content. CONCLUSIONS: The findings of this study suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work. TRIAL REGISTRATION: ClinicalTrials.gov NCT02961621; https://clinicaltrials.gov/ct2/show/NCT02961621.

Hearing Aid Compatibility Standards. Final rule; announcement of effective date.

In this document, the Commission announces that the Office of Management and Budget (OMB) has approved, for a period of three years, the information collection associated with rules adopted in the Commission's document Access to Telecommunication Equipment and Services by Persons with Disabilities; Amendment of the Commission's Rules Governing Hearing Aid-Compatible Mobile Handsets et. al., Report and Order and Order on Reconsideration (Order). This document is consistent with the Order, which stated that the Commission would publish a document in the Federal Register announcing the effective date of those rules.

Initial study of clinical pharmacy work prioritization tools.

PURPOSE: The development, implementation, and validity of clinical pharmacy work prioritization tools (CPWPTs) were analyzed. METHODS: Informatics pharmacists were contacted and asked to participate in 30-minute teleconference interviews, as they have primary responsibility for the technical configuration of CPWPTs. A total of 19 respondents participated in the survey. The qualitative data collected encompassed the thoughts and ideas of practicing informatics pharmacists who are knowledgeable about the design, configuration, management, and use of CPWPTs. In addition to capturing their thoughts and ideas with open-ended questions, demographic data were collected, as was information about the sites where respondents worked and the CPWPTs they used. RESULTS: Most of the CPWPTs were built into existing electronic health record platforms. There was considerable variation among the prioritization factors used at each site. The most commonly identified categories of prioritization factors were patient-specific factors, therapeutic classes of medications, and potential pharmacist interventions. All respondents reported that the prioritized tasks generated by their CPWPTs were examined for face validity. Of the 19 respondents, only 4 reported that the priorities generated by their CPWPT had been empirically validated in some way. Qualitative data analysis revealed that informatics pharmacists have 5 general perceptions about CPWPT factors, validation, and use in practice: (1) mirroring practice, (2) pharmacist consensus-based design, (3) complexity of logic, (4) tension between task-oriented and patient-centric approaches to practice, and (5) comfort from tracking tasks to completion. CONCLUSION: Early CPWPTs vary significantly in their prioritization factors. These tools partially reflect the scope of clinical pharmacy practice at the sites where they are used.

Electronic Communication in Plastic Surgery: Guiding Principles from the American Society of Plastic Surgeons Health Policy Committee.

BACKGROUND: With the advancement of technology, electronic communication has become an important mode of communication within plastic and reconstructive surgery. This can take the form of e-mail, text messaging, video conferencing, and social media, among others. There are currently no defined American Society of Plastic Surgeons guidelines for appropriate professional use of these technologies. METHODS: A search was performed on PubMed and the Cochrane database; terms included "telemedicine," "text messaging," "HIPAA," "metadata," "video conferencing," "photo sharing," "social media," "Facebook," "Twitter," and "Instagram." Initial screening of all identified articles was performed; the level of evidence, limitations, and recommendations were evaluated and articles were reviewed. RESULTS: A total of 654 articles were identified in the level I screening process; after more comprehensive review, 41 articles fit inclusion criteria: social networking, 12; telemedicine, 11; text messaging, 10; metadata, four; video conferencing, three; and Health Insurance Portability and Accountability Act, one. General themes were identified from these articles and guidelines proposed. CONCLUSION: Electronic communication can provide an efficient method of information exchange for professional purposes within plastic surgery but should be used thoughtfully and with all professional, legal, and ethical considerations.

ICT and the future of healthcare: Aspects of pervasive health monitoring.

Along with the digital revolution, information and communication technology applications are currently transforming the delivery of health and social care services. This paper investigates prevailing opinions toward future technology-based healthcare solutions among Austrian healthcare professionals. During a biphasic online Delphi survey, panelists rated expected outcomes of two future scenarios describing pervasive health monitoring applications. Experts perceived that the scenarios were highly innovative, but only moderately desirable, and that their implementation could especially improve patients' knowledge, quality of healthcare, and living standard. Contrarily, monetary aspects, technical prerequisites, and data security were identified as key obstacles. We further compared the impact of professional affiliation. Clearly, opinions toward pervasive healthcare differed between the interest groups, medical professionals, patient advocates, and administrative personnel. These data suggest closer collaborations between stakeholder groups to harmonize differences in expectations regarding pervasive health monitoring.

Influence of Telecommunication Modality, Internet Transmission Quality, and Accessories on Speech Perception in Cochlear Implant Users.

BACKGROUND: Telecommunication is limited or even impossible for more than one-thirds of all cochlear implant (CI) users. OBJECTIVE: We sought therefore to study the impact of voice quality on speech perception with voice over Internet protocol (VoIP) under real and adverse network conditions. METHODS: Telephone speech perception was assessed in 19 CI users (15-69 years, average 42 years), using the German HSM (Hochmair-Schulz-Moser) sentence test comparing Skype and conventional telephone (public switched telephone networks, PSTN) transmission using a personal computer (PC) and a digital enhanced cordless telecommunications (DECT) telephone dual device. Five different Internet transmission quality modes and four accessories (PC speakers, headphones, 3.5 mm jack audio cable, and induction loop) were compared. As a secondary outcome, the subjective perceived voice quality was assessed using the mean opinion score (MOS). RESULTS: Speech telephone perception was significantly better (median 91.6%, P<.001) with Skype compared with PSTN (median 42.5%) under optimal conditions. Skype calls under adverse network conditions (data packet loss > 15%) were not superior to conventional telephony. In addition, there were no significant differences between the tested accessories (P>.05) using a PC. Coupling a Skype DECT phone device with an audio cable to the CI, however, resulted in higher speech perception (median 65%) and subjective MOS scores (3.2) than using PSTN (median 7.5%, P<.001). CONCLUSIONS: Skype calls significantly improve speech perception for CI users compared with conventional telephony under real network conditions. Listening accessories do not further improve listening experience. Current Skype DECT telephone devices do not fully offer technical advantages in voice quality.

A Brief Report on the Ethical and Legal Guides For Technology Use in Marriage and Family Therapy.

Marriage and family therapists (MFTs) use ethical codes and state licensure laws/rules as guidelines for best clinical practice. It is important that professional codes reflect the potential exponential use of technology in therapy. However, current standards regarding technology use lack clarity. To explore this gap, a summative content analysis was conducted on state licensure laws/rules and professional ethical codes to find themes and subthemes among the many aspects of therapy in which technology can be utilized. Findings from the content analysis indicated that while there have been efforts by both state and professional organizations to incorporate guidance for technology use in therapy, a clear and comprehensive "roadmap" is still missing. Future scholarship is needed that develops clearer guidelines for therapists.