A Secure IoT-Based Irrigation System for Precision Agriculture Using the Expeditious Cipher.

Due to the recent advances in the domain of smart agriculture as a result of integrating traditional agriculture and the latest information technologies including the Internet of Things (IoT), cloud computing, and artificial intelligence (AI), there is an urgent need to address the information security-related issues and challenges in this field. In this article, we propose the integration of lightweight cryptography techniques into the IoT ecosystem for smart agriculture to meet the requirements of resource-constrained IoT devices. Moreover, we investigate the adoption of a lightweight encryption protocol, namely, the Expeditious Cipher (X-cipher), to create a secure channel between the sensing layer and the broker in the Message Queue Telemetry Transport (MQTT) protocol as well as a secure channel between the broker and its subscribers. Our case study focuses on smart irrigation systems, and the MQTT protocol is deployed as the application messaging protocol in these systems. Smart irrigation strives to decrease the misuse of natural resources by enhancing the efficiency of agricultural irrigation. This secure channel is utilized to eliminate the main security threat in precision agriculture by protecting sensors' published data from eavesdropping and theft, as well as from unauthorized changes to sensitive data that can negatively impact crops' development. In addition, the secure channel protects the irrigation decisions made by the data analytics (DA) entity regarding the irrigation time and the quantity of water that is returned to actuators from any alteration. Performance evaluation of our chosen lightweight encryption protocol revealed an improvement in terms of power consumption, execution time, and required memory usage when compared with the Advanced Encryption Standard (AES). Moreover, the selected lightweight encryption protocol outperforms the PRESENT lightweight encryption protocol in terms of throughput and memory usage.

Premedication with midazolam prior to cesarean delivery in preeclamptic parturients: A randomized controlled trial.

BACKGROUND: Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. METHODS: A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia. Maternal anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS); postoperative maternal satisfaction was assessed using Maternal Satisfaction Scale for Cesarean Section (MSSCS). Newborns were assessed using Apgar score, Neonatal Neurologic and Adaptive Capacity Score (NACS), and umbilical artery blood gases. RESULTS: Mothers premedicated with midazolam showed a lower level of preoperative anxiety and a higher degree of postoperative satisfaction than the control group. There were no between-group differences regarding the neonatal outcome. CONCLUSION: Preeclamptic parturients premedicated with midazolam (0.035 mg/kg) before spinal anesthesia have lower anxiety and higher postoperative satisfaction levels, with no adverse effects on the newborns.

Management of pelvic discontinuity in revision total hip arthroplasty: a review of the literature.

Pelvic discontinuity is a complex problem in revision total hip arthroplasty. Although rare, the incidence is likely to increase due to the ageing population and the increasing number of total hip arthroplasties being performed. The various surgical options available to solve this problem include plating, massive allografts, reconstruction rings, custom triflanged components and tantalum implants. However, the optimal solution remains controversial. None of the known methods completely solves the major obstacles associated with this problem, such as restoration of massive bone loss, implant failure in the short- and long-term and high complication rates. This review discusses the diagnosis, decision making, and treatment options of pelvic discontinuity in revision total hip arthroplasty.

Frailty and delayed graft function in kidney transplant recipients.

The ability to predict outcomes following a kidney transplant is limited by the complex physiologic decline of kidney failure, a latent factor that is difficult to capture using conventional comorbidity assessment. The frailty phenotype is a recently described inflammatory state of increased vulnerability to stressors resulting from decreased physiologic reserve and dysregulation of multiple physiologic systems. We hypothesized that frailty would be associated with delayed graft function, based on putative associations between inflammatory cytokines and graft dysfunction. We prospectively measured frailty in 183 kidney transplant recipients between December 2008 and April 2010. Independent associations between frailty and delayed graft function were analyzed using modified Poisson regression. Preoperative frailty was independently associated with a 1.94-fold increased risk for delayed graft function (95% CI, 1.13-3.36; P = .02). The assessment of frailty may provide further insights into the pathophysiology of allograft dysfunction and may improve our ability to preoperatively risk-stratify kidney transplant recipients.

Audit of acute asthma management at the Paediatric Emergency Department at Wad Madani Children's Hospital, Sudan.

This audit of hospital care of acute wheeze and asthma aimed to assess the degree of adherence of the acute care of the asthma patients to the published international guidelines. Information was collected in six key areas: patient demographics; initial asthma severity assessment; in-hospital treatment; asthma prophylaxis; asthma education and emergency planning; and follow-up arrangements. The area of initial asthma severity assessment showed defciencies in the clinical measures currently used to verify case severity. In- hospital treatment on the other hand was consistent with recommendations in the use of the inhaled ß-2 agonist salbutamol as bronchodilator, the discrete use of aminophylline and the small number of patients ordered chest X-ray. However, the treatment was incoherent with recommendations in the delivery method used for inhaled bronchodilator in relation to the age group of treated patients, absence of ipratropium bromide as a bronchodilator in the management and the large use of antibiotics. Assessment of the areas of asthma prophylaxis, asthma education and emergency- planning and follow-up arrangements illustrated that little efforts were made to assure safe discharge, although these measures have been shown to reduce morbidity after the exacerbation and reduce relapse rates and signifcantly reduce hospitalizations, unscheduled acute visits, missed work days, as well as improving quality of life. This audit emphasizes the need for the adoption of a management protocol for acute asthma care in the emergency department based on published international guidelines and the assurance of its implementation, monitoring and evaluation using the right tools to improve patient care.