Using attack graphs to defend healthcare systems from cyberattacks: a longitudinal empirical study.

Cyber security encompasses a variety of financial, political, and social aspects with significant implications for the safety of individuals and organisations. Hospitals are among the least secure and most vulnerable organisations in terms of cybersecurity. Protecting medical records from cyberattacks is critical for protecting personal and financial records of those involved in medical institutions. Attack graphs, like in other systems, can be used to protect medical and hospital records from cyberattacks. In the current study, a total of 352 real-life cyberattacks on healthcare institutions using common vulnerability scoring system (CVSS) data were statistically examined to determine important trends and specifications in regard to those attacks. Following that, several machine learning techniques and an artificial neural network model were used to model industrial control systems (ICS) vulnerability data of those attacks. The average vulnerability score for attacks on healthcare IT systems was found to be very high. Moreover, this score was found to be higher in healthcare institutions which have experienced cyberattacks in the past and no mitigation actions were implemented. Using Python programming software, the most successful model that can be used in modelling cyberattacks on IT systems of healthcare institutions was found to be the K-nearest neighbours (KNN) algorithm. The model was then enhanced further and then it was tried to make predictions for future cyberattacks on IT systems of healthcare institutions. Results indicate that the overall score is critical indicating that medical records are, in general, at high risk and that there is a high risk of cyberattacks on medical records in healthcare institutions. It is recommended, therefore, that those institutions should take urgent precautionary measures to mitigate such a high risk of cyberattacks and to make them more secure, reliable, and robust.

Effects of high ambient temperature on construction workers performance: A longitudinal empirical study.

INTRODUCTION: The construction industry is known to be of high-risk when compared to other industries. Ambient temperature can also exacerbate this risk, where hot weather conditions can lead to increased physical and mental fatigue, reduced performance, slower reactions and more human errors. Yet this issue is rarely researched objectively. This paper describes a longitudinal empirical study that aimed to assess how high ambient temperatures affect construction workers performance. METHOD: A sample of 120 randomly selected workers (age range 22-35 years) from a large construction company in Dubai participated in this study. Since construction workers performance cannot be directly measured due to the nature of work involved, performance of 60 participants was measured on a task battery involving single reaction time and choice reaction time in summer months before starting work and 5.5 h after starting work. Then the same procedure was repeated on 60 workers in winter months. Accident reports for one full year within the same company were also collected and analyzed. RESULTS: Results show that performance on both tasks before starting work was significantly lower in summer than in winter months possibly due to accumulated fatigue resulting from the high ambient temperature in summer. Results also show that performance on both tasks significantly deteriorated during the first 5.5 h of work to a greater extent in summer months than in winter months. Results also indicate that accidents showed an increasing trend in summer months. CONCLUSIONS: Accumulated fatigue due to high ambient temperature in Summer is thought to cause this drop in performance and increase in accidents. PRACTICAL IMPLICATIONS: Based on the findings, recommendations to enhance construction workers performance and reduce accidents are given.

Development of a multicriteria decision-making model for selecting optimal aviation fatigue measurement methods.

Human fatigue has been proved to directly cause or contribute to a significant share of aviation accidents. Although fatigue measurement is a major input to any solution that targets reduction of fatigue adverse influences on aviation operations, there is a critical lack of evidence on what optimum sets of fatigue measurement strategies could be applied given the vast organizational and operational differences between various industry players. The current study utilizes the published aviation safety literature, the technology acceptance model and expert opinion to propose a new multicriteria decision model, the aviation fatigue measurement selection model, to decide on what fatigue measurement methods are most suitable for each aviation operator. The model addresses the validity, user acceptance, cost and other limitations of each currently acknowledged fatigue measurement method. The model was then applied through comprehensive scenario-based simulations and was found to be sensitive to changes in user preferences and valid.

Burden of Transport-Related Injuries in the Eastern Mediterranean Region: A Systematic Analysis for the Global Burden of Disease Study 2017.

BACKGROUND: Transport-related injuries (TIs) are a substantial public health concern for all regions of the world. The present study quantified the burden of TIs and deaths in the Eastern Mediterranean region (EMR) in 2017 by sex and age. METHODS: TIs and deaths were estimated by age, sex, country, and year using Cause of Death Ensemble modelling (CODEm) and DisMod-MR 2.1. Disability-adjusted life years (DALYs), which quantify the total burden of years lost due to premature death or disability, were also estimated per 100000 population. All estimates were reported along with their corresponding 95% uncertainty intervals (UIs). RESULTS: In 2017, there were 5.5 million (UI 4.9-6.2) transport-related incident cases in the EMR - a substantial increase from 1990 (2.8 million; UI 2.5-3.1). The age-standardized incidence rate for the EMR in 2017 was 787 (UI 705.5-876.2) per 100000, which has not changed significantly since 1990 (-0.9%; UI -4.7 to 3). These rates differed remarkably between countries, such that Oman (1303.9; UI 1167.3-1441.5) and Palestine (486.5; UI 434.5-545.9) had the highest and lowest age-standardized incidence rates per 100000, respectively. In 2017, there were 185.3 thousand (UI 170.8-200.6) transport-related fatalities in the EMR - a substantial increase since 1990 (140.4 thousand; UI 118.7-156.9). The age-standardized death rate for the EMR in 2017 was 29.5 (UI 27.1-31.9) per 100000, which was 30.5% lower than that found in 1990 (42.5; UI 36.8-47.3). In 2017, Somalia (54; UI 30-77.4) and Lebanon (7.1; UI 4.8-8.6) had the highest and lowest age-standardized death rates per 100,000, respectively. The age-standardised DALY rate for the EMR in 2017 was 1,528.8 (UI 1412.5-1651.3) per 100000, which was 34.4% lower than that found in 1990 (2,331.3; UI 1,993.1-2,589.9). In 2017, the highest DALY rate was found in Pakistan (3454121; UI 2297890- 4342908) and the lowest was found in Bahrain (8616; UI 7670-9751). CONCLUSION: The present study shows that while road traffic has become relatively safer (measured by deaths and DALYs per 100000 population), the number of transport-related fatalities in the EMR is growing and needs to be addressed urgently.

Factors affecting pedestrian behaviors at signalized crosswalks: An empirical study.

INTRODUCTION: Safety of pedestrians depends, among other factors, on their behavior while crossing the road. This study aims to assess behaviors of pedestrians at signalized crosswalks. METHOD: Following a literature review and a pilot study, 25 vital pedestrian crossing factors and behaviors were determined. Then data was randomly collected for 708 pedestrians at 10 lighted crossings in Sharjah (UAE), five at road intersections and five mid-block crossings. RESULTS: Results indicated that 17.4% of pedestrians observed crossed partly or fully on red and that crossing speed was 1.22 m/s, on the average, which is slightly faster than most speeds recorded in the literature. Moreover, female pedestrians were more likely to cross while chatting with others, less likely to cross on red, and more likely to walk slower than male pedestrians. Results also showed that pedestrians who crossed at road intersections walked slower than those who crossed at mid-block crossings. It was also found that longer red pedestrian times and narrower roads tended to encourage pedestrians to cross on red and that the majority of pedestrians did not look around before crossing. PRACTICAL IMPLICATIONS: Use of the Health Belief Model for pedestrian safety are discussed.

Objective assessment of the effects of texting while driving: a simulator study.

Recent advances in electronic communication technology led to many drivers opting to send and receive text messages while driving. This, inevitably, has a potential to distract drivers, impair driving performance and lead to crashes. This study aims to assess the risk involved in texting while driving through assessing the distraction caused and determining the change in key driving performance indicators. Twenty-one paid young male volunteers were recruited to participate in this study. Each participant drove a driving simulator on four different scenarios involving driving while texting and without texting on highways and town roads. Results showed that texting while driving led, on average, to five times more crashes than driving without texting. Due to distraction also, participants unnecessarily crossed lane boundaries and road boundaries more often while texting as compared to driving without texting. Moreover, distraction due to texting led to participants deviating their eyes off the road while texting 15 times per session, on average, more than without texting. Results demonstrated a high-risk level of distraction and clear impairment in drivers' ability to drive safely due to texting. Based on the results, practical recommendations to combat this phenomenon are given.

An ergonomics evaluation of certain ATM dimensions.

Although millions of automatic teller machines (ATMs) are currently used all over the world, users of ATMs still have usability problems including inappropriate user-ATM interaction, display problems and others. Many developed countries already have standards in place for ATMs. However, this is not the case in many other countries. This paper aims to assess certain dimensions of ATM machines and their suitability for users in Middle Eastern countries using anthropometric measurements of the user population taking Saudi Arabia as a case study. Dimensions of all ATMs used in Saudi Arabia were measured and compared with recommended dimensions based on anthropometric measurements of the user population. Results show that there is a mismatch between the dimensions of ATMs used in Saudi Arabia and the recommended dimensions based on the user population. Practical recommendations are given as to improve the usability of ATMs in Saudi Arabia and other Middle Eastern countries.

In-depth analysis of pedestrian crashes in Riyadh.

OBJECTIVE: Problems facing authorities and researchers of road traffic accidents in most developing countries include lack of data and clarity and accessibility problems with existing data. This resulted in a severe scarcity in information on pedestrian crashes, which, in turn, served as an obstacle facing all efforts to reduce these crashes. This study aims at studying pedestrian crashes with regard to their causes and characteristics in Riyadh, analyzing the bodily distribution of injuries in victims and determining the characteristics of pedestrians and drivers involved in these collisions. METHODS: Data on randomly selected road traffic accidents involving pedestrians between July 2005 and June 2008 were collected from five different sources. Data collected included date and location, casualty details, accident sketch, weather conditions, site characteristics, road surface conditions, vehicle characteristics, type of collision, vehicle(s) direction and movement, damage description, and causes as well as details of parties involved such as nationality, age, education level, severity of injury, and others. RESULTS: The number of pedestrian crashes investigated was 460, involving 551 victims over a 3-year period (out of an estimated 1500 crashes). Results showed that the average rate of pedestrian fatalities per accident was as high as 0.32 and that almost two thirds of drivers and slightly less than half of the victims were less than 30 years of age. In contrast to other road traffic accidents (RTAs) in this city, two thirds of pedestrian crashes occurred between 4:00 pm and midnight. Results also revealed that non-Saudis and men were at a significantly greater risk than Saudis and women to be involved in pedestrian crashes. It was also found that two thirds of pedestrians involved in RTAs were struck while crossing the road. Moreover, although 8.7 percent of Riyadh's population lives in the southern and northern regions of the city, pedestrian crashes in these two regions constituted 32.2 percent of all pedestrian crashes. As related to injury type, head, thorax, and spinal injuries formed most of the serious injuries. It was also found that the most often injured body regions were the upper and lower extremities and the head. CONCLUSIONS: Practical recommendations are given that researchers, traffic police, medical authorities, nongovernmental organizations (NGOs), educational institutions, and municipalities can adopt to lower the risk of pedestrian crashes.

Seat belt utilization in Saudi Arabia and its impact on road accident injuries.

Most industrialized countries and many developing countries have passed laws that require the use of seat belts in motor vehicles. It is widely believed that seat belt use is an effective way to reduce road accident fatalities and injuries. Saudi Arabia joined these countries when it enacted a similar law on 5 December 2000 making seat belt use compulsory for all drivers and front-seat passengers. This study measures seat belt use rate and its impact on the number of road accident injuries during the first few months that followed the enactment of the law. It also investigates drivers' behaviour and personal characteristics and their relationship with using seat belts by using a questionnaire specially prepared for this purpose. Results show that seat belt use rate in two Riyadh suburbs were 33% and 87%, respectively, for drivers and 4% and 41%, respectively, for front-seat passengers (FSP's). Such belt use rates are considered low yet encouraging when compared with use rates before enacting the law. Results also show that there was a significant drop in certain types of injuries due to traffic accidents after the enactment of the seat belt law. Questionnaire results show that certain personal characteristics were correlated with seat belt use rate. Finally, implications of these findings in terms of future plans for improving traffic safety are discussed.