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1.
BMC Musculoskelet Disord ; 22(1): 245, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673844

RESUMEN

OBJECTIVE: To explore orthopaedic and musculoskeletal clinicians' views and experiences of legal, safety, safeguarding and security issues regarding the use of virtual consultations (VC) during the COVID-19 pandemic. A secondary objective was to suggest ways to overcome these issues. METHODS: A mixed method cross-sectional survey was conducted, seeking the views and experiences of orthopaedic and musculoskeletal medically qualified and Allied Health Professionals in the United Kingdom. Descriptive statistical analysis was employed for quantitative data and a qualitative content analysis undertaken for qualitative data. Findings were presented in accordance with the four key issues. RESULTS: Two hundred and ninety professionals (206 physiotherapists, 78 medically qualified professionals, 6 'other' therapists) participated in the survey. Of the 290 participants, 260 (90%) were not using VC prior to the COVID-19 pandemic, 248 respondents (86%) were unsure whether their professional indemnity insurance covered VC, 136 (47%) had considered how they would handle an issue of safeguarding whilst the remainder had not, 126 (43%) had considered what they would do if, during a virtual consultation, a patient suffered an injury (e.g. bang on their head) or a fall (e.g. mechanical or a medical event like syncope) and 158 (54%) reported they felt the current technological solutions are secure in terms of patient data. Qualitative data provided additional context to support the quantitative findings such as validity of indemnification, accuracy of diagnosis and consent using VC, safeguarding issues; and security and sharing of data. Potential changes to practice have been proposed to address these issues. CONCLUSIONS: VC have been rapidly deployed since the onset of the COVID-19 pandemic often without clear guidance or consensus on many important issues. This study identified legal, safeguarding, safety and security issues. There is an urgent need to address these and develop local and national guidance and frameworks to facilitate ongoing safe virtual orthopaedic practice beyond the COVID-19 pandemic.


Asunto(s)
/epidemiología , Encuestas de Atención de la Salud , Pandemias , Seguridad del Paciente , Telemedicina/legislación & jurisprudencia , Telemedicina/normas , Técnicos Medios en Salud , Seguridad Computacional , Confidencialidad , Estudios Transversales , Femenino , Humanos , Masculino , Ortopedia
3.
J Occup Health ; 63(1): e12198, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33527667

RESUMEN

OBJECTIVES: The health effects of telework, which was introduced extensively in the immediate context of the COVID-19 pandemic crisis in Japan, on teleworkers, their families, and non-teleworkers, are unknown. Accordingly, we developed a rapid health impact assessment (HIA) to evaluate positive and negative health effects of telework on these groups and recommended easily implementable countermeasures. METHODS: Immediately after an emergency was declared in Japan, we implemented a rapid, five-step HIA. We screened and categorized health effects of telework for the three above-mentioned groups, extracting their content, directionality, and likelihood. Following a scoping exercise to determine the HIA's overall implementation, five experienced occupational health physicians appraised and prioritized the screened items and added new items. We outlined specific countermeasures and disseminated the results on our website. A short-term evaluation was conducted by three external occupational health physicians and three nurses. RESULTS: Following screening and appraisal, 59, 29, and 27 items were listed for teleworkers, non-teleworkers, and family members of teleworkers, respectively, covering work, lifestyle, disease and medical care, and home and community. Targeted countermeasures focused on the work environment, business management, communications, and lifestyles for teleworkers; safety and medical guidelines, work prioritization, and regular communication for non-teleworkers; and shared responsibilities within families and communication outside families for family members of teleworkers. CONCLUSION: The HIA's validity and the countermeasures' practical applicability were confirmed by the external evaluators. They can be easily applied and adapted across diverse industries to mitigate the wider negative effects of telework and enhance its positive effects.


Asunto(s)
Evaluación del Impacto en la Salud , Salud Laboral , Actitud del Personal de Salud , Comunicación , Seguridad Computacional , Ejercicio Físico , Familia , Evaluación del Impacto en la Salud/métodos , Estado de Salud , Humanos , Japón , Estilo de Vida , Seguridad , Administración del Tiempo , Trabajo/psicología , Lugar de Trabajo/organización & administración
5.
Sensors (Basel) ; 21(3)2021 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-33573308

RESUMEN

Wireless sensor networks (WSN) are widely used to provide users with convenient services such as health-care, and smart home. To provide convenient services, sensor nodes in WSN environments collect and send the sensing data to the gateway. However, it can suffer from serious security issues because susceptible messages are exchanged through an insecure channel. Therefore, secure authentication protocols are necessary to prevent security flaws in WSN. In 2020, Moghadam et al. suggested an efficient authentication and key agreement scheme in WSN. Unfortunately, we discover that Moghadam et al.'s scheme cannot prevent insider and session-specific random number leakage attacks. We also prove that Moghadam et al.'s scheme does not ensure perfect forward secrecy. To prevent security vulnerabilities of Moghadam et al.'s scheme, we propose a secure and lightweight mutual authentication protocol for WSNs (WSN-SLAP). WSN-SLAP has the resistance from various security drawbacks, and provides perfect forward secrecy and mutual authentication. We prove the security of WSN-SLAP by using Burrows-Abadi-Needham (BAN) logic, Real-or-Random (ROR) model, and Automated Verification of Internet Security Protocols and Applications (AVISPA) simulation. In addition, we evaluate the performance of WSN-SLAP compared with existing related protocols. We demonstrate that WSN-SLAP is more secure and suitable than previous protocols for WSN environments.


Asunto(s)
Seguridad Computacional , Confidencialidad , Simulación por Computador , Lógica
6.
Int J Qual Health Care ; 33(1)2021 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-33538778

RESUMEN

Federated learning (FL) as a distributed machine learning (ML) technique has lately attracted increasing attention of healthcare stakeholders as FL is perceived as a promising decentralized approach to address data privacy and security concerns. The FL approach stores and maintains the privacy-sensitive data locally while allows multiple sites to train ML models collaboratively. We aim to describe the most recent real-world cases using the FL in both COVID-19 and non-COVID-19 scenarios and also highlight current limitations and practical challenges of FL.


Asunto(s)
/epidemiología , Seguridad Computacional/estadística & datos numéricos , Confidencialidad/normas , Registros Electrónicos de Salud/organización & administración , Aprendizaje Automático/normas , Registros Electrónicos de Salud/normas , Humanos
7.
Am J Nurs ; 121(2): 18, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33497116
9.
Methods Mol Biol ; 2190: 317-336, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32804374

RESUMEN

Recently, digitization of biomedical processes has accelerated, in no small part due to the use of machine learning techniques which require large amounts of labeled data. This chapter focuses on the prerequisite steps to the training of any algorithm: data collection and labeling. In particular, we tackle how data collection can be set up with scalability and security to avoid costly and delaying bottlenecks. Unprecedented amounts of data are now available to companies and academics, but digital tools in the biomedical field encounter a problem of scale, since high-throughput workflows such as high content imaging and sequencing can create several terabytes per day. Consequently data transport, aggregation, and processing is challenging.A second challenge is maintenance of data security. Biomedical data can be personally identifiable, may constitute important trade-secrets, and be expensive to produce. Furthermore, human biomedical data is often immutable, as is the case with genetic information. These factors make securing this type of data imperative and urgent. Here we address best practices to achieve security, with a focus on practicality and scalability. We also address the challenge of obtaining usable, rich metadata from the collected data, which is a major challenge in the biomedical field because of the use of fragmented and proprietary formats. We detail tools and strategies for extracting metadata from biomedical scientific file formats and how this underutilized metadata plays a key role in creating labeled data for use in the training of neural networks.


Asunto(s)
Investigación Biomédica/métodos , Recolección de Datos/métodos , Algoritmos , Seguridad Computacional , Aprendizaje Automático , Redes Neurales de la Computación , Flujo de Trabajo
10.
J Nucl Med Technol ; 49(1): 2-6, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33380520

RESUMEN

The current pandemic has created a situation where nuclear medicine practitioners and medical physicists read or process nuclear medicine images remotely from their home office. This article presents recommendations on the components and specifications when setting up a remote viewing station for nuclear medicine imaging.


Asunto(s)
/epidemiología , Imagen Molecular/instrumentación , Medicina Nuclear/instrumentación , Guías de Práctica Clínica como Asunto , Seguridad Computacional , Computadores , Humanos , Internet , Pandemias , Relación Señal-Ruido
12.
Int J Qual Health Care ; 33(1)2021 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-33351134

RESUMEN

The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in widespread disruption to the healthcare industry. Alongside complex issues relating to ensuring sufficient healthcare capacity and resourcing, healthcare organizations and universities are now also facing heightened cyber-security threats in the midst of the pandemic. Since the outbreak began, various healthcare providers and academic institutions across the world have been targeted in a variety of complex and coordinatized cyber-attacks. International and national regulatory bodies have stressed the urgent need for healthcare providers and universities to protect themselves against cyber-attacks during COVID-19, recognizing that a growing number of cyber-criminals are seeking to capitalize on the vulnerabilities of the healthcare sector during this period. This includes a desire to steal intellectual property such as data relating to COVID-19 vaccine development, modelling and experimental therapeutics. It is therefore essential that healthcare providers and universities ensure they are informed, protected and prepared to respond to any cyber-threat. This article outlines key COVID-19 cyber-security principles for both healthcare organizations and academic institutions.


Asunto(s)
/epidemiología , Seguridad Computacional , Salud Global , Sector de Atención de Salud , Terrorismo , Humanos , Pandemias
13.
Methods Mol Biol ; 2195: 263-275, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32852769

RESUMEN

Germ cell tumors (GCTs) are a rare disease, but they account for 15% of all malignancies diagnosed during adolescence. The biological mechanisms underpinning their development are only starting to be explored. Current GCT treatment may be associated with significant toxicity. Therefore, there is an urgent need to understand the molecular basis of GCT and identify biomarkers to tailor the therapy for individual patients. However, this research is severely hamstrung by the rarity of GCTs in individual hospitals/institutes. A publicly available genomic data commons with GCT datasets compiled from different institutes/studies would be a valuable resource to facilitate such research. In this study, we first reviewed publicly available web portals containing GCT genomics data, focusing on comparing data availability, data access, and analysis tools, and the limitations of using these resources for GCT molecular studies. Next, we specifically designed a GCT data commons with a web portal, GCT Explorer, to assist the research community to store, manage, search, share, and analyze data. The goal of this work is to facilitate GCT molecular basis exploration and translational research.


Asunto(s)
Biología Computacional , Bases de Datos Genéticas , Susceptibilidad a Enfermedades , Neoplasias de Células Germinales y Embrionarias/etiología , Biología Computacional/métodos , Seguridad Computacional , Estudios de Asociación Genética/métodos , Genoma , Genómica/métodos , Humanos , Neoplasias de Células Germinales y Embrionarias/metabolismo , Neoplasias de Células Germinales y Embrionarias/patología , Fenotipo , Interfaz Usuario-Computador , Navegador Web
14.
J Healthc Eng ; 2020: 8838390, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33354310

RESUMEN

Background: With the outbreak of COVID-19, large-scale telemedicine applications can play an important role in the epidemic areas or less developed areas. However, the transmission of hundreds of megabytes of Sectional Medical Images (SMIs) from hospital's Intranet to the Internet has the problems of efficiency, cost, and security. This article proposes a novel lightweight sharing scheme for permitting Internet users to quickly and safely access the SMIs from a hospital using an Internet computer anywhere but without relying on a virtual private network or another complex deployment. Methods: A four-level endpoint network penetration scheme based on the existing hospital network facilities and information security rules was proposed to realize the secure and lightweight sharing of SMIs over the Internet. A "Master-Slave" interaction to the interactive characteristics of multiplanar reconstruction and maximum/minimum/average intensity projection was designed to enhance the user experience. Finally, a prototype system was established. Results: When accessing SMIs with a data size ranging from 251.6 to 307.04 MB with 200 kBps client bandwidth (extreme test), the network response time to each interactive request remained at approximately 1 s, the original SMIs were kept in the hospital, and the deployment did not require a complex process; the imaging quality and interactive experience were recognized by radiologists. Conclusions: This solution could serve Internet medicine at a low cost and may promote the diversified development of mobile medical technology. Under the current COVID-19 epidemic situation, we expect that it could play a low-cost and high-efficiency role in remote emergency support.


Asunto(s)
Seguridad Computacional , Diagnóstico por Imagen/instrumentación , Internet , Radiología/métodos , Algoritmos , Redes de Comunicación de Computadores , Computadores , Diagnóstico por Imagen/métodos , Diseño de Equipo , Hospitalización , Hospitales , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Informática Médica , Lenguajes de Programación , Telemedicina
15.
Rev. cuba. inform. méd ; 12(2): e390, graf
Artículo en Español | LILACS, CUMED | ID: biblio-1144467

RESUMEN

La seguridad informática se ha convertido en una necesidad y un derecho de todos los ciudadanos. Los sistemas informáticos empleados en el sector de salud poseen un almacenamiento digital fácil y sostenible que debe garantizar la privacidad e integridad de la información, lo cual constituye cuestión delicada. En Cuba no está definido un esquema PKI (Públic Key Infraestructure) o Infraestructura de Clave Pública, centralizado a nivel nacional que propicie y garantice la seguridad de la información sensible en el sistema de salud pública, lo cual pone en riesgo la autenticidad, integridad y confidencialidad de los datos médicos personales. Este trabajo tiene como objetivo diseñar una estructura de seguridad centrada en la PKI entre las instituciones de salud, a partir de la infraestructura de llave pública nacional como autoridad de certificación raíz. Se realizó un análisis documental sobre la actualidad del tema, se realizaron entrevistas a administrativos, gestores hospitalarios y especialistas en seguridad informática, lo cual permitió crear las bases de la investigación. Se obtuvo un esquema de confianza que propicia el intercambio seguro de los registros médicos de los pacientes entre instituciones de salud. La implementación de una infraestructura PKI en el sector sanitario permite que las instituciones que requieran intercambiar registros médicos, a través de una red, puedan hacerlo con un alto nivel de seguridad(AU)


Computer security has become a necessity and a right for all citizens. The IT systems used in the health sector have much easier and more sustainable digital storage and guarantee the privacy and integrity of information, which are sensitive issues. In Cuba, there is no centralized PKI (Public Key Infrastructure) scheme at the national level that promotes and guarantees the security of sensitive information in the public health system, which puts the authenticity, integrity and confidentiality of personal medical data at risk. The aim of our work was to design a security structure centered on PKI among health institutions, based on the national public key infrastructure as root certificate authority (CA). In order to achieve this, a documentary analysis was carried out on the current state of the art in the subject; as well as interviews with administrative staff, hospital managers and specialists in computer security, which allowed the research bases to be created. As a result, a trust scheme was obtained that promotes the secure exchange of patients' medical records between health institutions. The implementation of a PKI infrastructure in the health sector allows institutions to exchange medical records through a network with a high level of security(AU)


Asunto(s)
Programas Informáticos , Sistemas de Registros Médicos Computarizados , Seguridad Computacional , Cuba
16.
Sensors (Basel) ; 21(1)2020 Dec 25.
Artículo en Inglés | MEDLINE | ID: mdl-33375710

RESUMEN

Ensuring the confidentiality of private data stored in our technological devices is a fundamental aspect for protecting our personal and professional information. Authentication procedures are among the main methods used to achieve this protection and, typically, are implemented only when accessing the device. Nevertheless, in many occasions it is necessary to carry out user authentication in a continuous manner to guarantee an allowed use of the device while protecting authentication data. In this work, we first review the state of the art of Continuous Authentication (CA), User Profiling (UP), and related biometric databases. Secondly, we summarize the privacy-preserving methods employed to protect the security of sensor-based data used to conduct user authentication, and some practical examples of their utilization. The analysis of the literature of these topics reveals the importance of sensor-based data to protect personal and professional information, as well as the need for exploring a combination of more biometric features with privacy-preserving approaches.


Asunto(s)
Privacidad , Telemedicina , Biometría , Seguridad Computacional , Confidencialidad
17.
ACS Appl Mater Interfaces ; 12(52): 57686-57694, 2020 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-33331759

RESUMEN

In recent years, hydrogels as an attractive class of intelligent soft materials have been applied in various advanced fields, including electronic materials, wearable devices, and wound dressing materials. However, it still remains a critical challenge to integrate information encryption transmission capability, antibacterial activity, high mechanical performance, adhesiveness, and self-healable ability into one material and achieve the synergistic characteristics through a simple method. In our study, a facile strategy of a plant-inspired hydrogel was proposed, which provides a novel initiator-free photo-cross-linked hydrogel system by simply mixing the coumarin derivative Pho-CA and the monomer in water, and then obtaining the hydrogel Gel-C-Am under the irradiation of UV light without adding any other cross-linking agents and initiators, and this process is very similar to the growth process of plants in nature. This novel hydrogel presents desirable mechanical properties (including twist, stretchability, and recoverability), which exhibits elongation of approximately 1600%. More interestingly, Gel-C-Am hydrogel displays reversible adhesiveness to various substrates (such as glass, paper, leaves, and rubber), and its adhesion properties can be regulated by water: the viscosity disappears when its surface becomes wet, and the viscosity will recover after the water evaporates. In addition, the developed hydrogel has certain self-healable ability. Two pieces of the Gel-C-Am hydrogel can combine together and reshape into one piece in water, and the fused hydrogel has uniform and interconnected pores under SEM. Based on the characteristic of Pho-CA whose fluorescence get recovery after UV irradiation, the hydrogel can be used in the field of encryption and decryption. Also, the resulting Gel-C-Am hydrogel shows an effective antibacterial activity and can potentially be addressed as antibacterial coatings. Taken together, the formation of the novel fluorescent hydrogel system is just like the growth of a plant in the presence of water and light, Pho-CA and the monomer will form a highly stretchable and recoverable self-healing hydrogel with water-controlled adhesiveness. The developed Gel-C-Am hydrogel shows favorable attributes and is suitable for applications in antibacterial polymeric coatings and information encryption transmission.


Asunto(s)
Biomimética , Seguridad Computacional , Colorantes Fluorescentes/química , Hidrogeles/química , Hidrogeles/farmacología , Plantas , Agua/química , Acrilamida/química , Adhesividad , Antibacterianos/química , Antibacterianos/farmacología , Cumarinas/química , Escherichia coli/efectos de los fármacos , Enlace de Hidrógeno , Propiedades de Superficie
18.
Adv Chronic Kidney Dis ; 27(5): 390-396, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33308504

RESUMEN

The coronavirus (coronavirus disease-2019) pandemic has changed care delivery for patients with end-stage kidney disease. We explore the US healthcare system as it pertains to dialysis care, including existing policies, modifications implemented in response to the coronavirus disease-2019 crisis, and possible next steps for policy makers and nephrologists. This includes policies related to resource management, use of telemedicine, prioritization of dialysis access procedures, expansion of home dialysis modalities, administrative duties, and quality assessment. The government has already established policies that have instated some flexibilities to help providers focus their response to the crisis. However, future policy during and after the coronavirus disease-2019 pandemic can bolster our ability to optimize care for patients with end-stage kidney disease. Key themes in this perspective are the importance of policy flexibility, clear strategies for emergency preparedness, and robust health systems that maximize accessibility and patient autonomy.


Asunto(s)
Política de Salud , Fallo Renal Crónico/terapia , Nefrología , Diálisis Renal/métodos , Telemedicina/métodos , Instituciones de Atención Ambulatoria , Anastomosis Quirúrgica , Arterias/cirugía , Implantación de Prótesis Vascular , Centers for Medicare and Medicaid Services, U.S. , Seguridad Computacional , Prestación de Atención de Salud/métodos , Prestación de Atención de Salud/normas , Planificación en Desastres , Accesibilidad a los Servicios de Salud , Soluciones para Hemodiálisis/provisión & distribución , Hemodiálisis en el Domicilio/métodos , Hemodiálisis en el Domicilio/normas , Humanos , Organización y Administración/normas , Autonomía Personal , Equipo de Protección Personal , Garantía de la Calidad de Atención de Salud , Mecanismo de Reembolso , Diálisis Renal/instrumentación , Diálisis Renal/normas , Telemedicina/normas , Estados Unidos , Venas/cirugía
19.
Sensors (Basel) ; 20(24)2020 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-33322813

RESUMEN

Internet of Things (IoT) technology has recently been integrated with various healthcare devices to monitor patients' health status and share it with their healthcare practitioners. Since healthcare data often contain personal and sensitive information, healthcare systems must provide a secure user authentication scheme. Recently, Adavoudi-Jolfaei et al. and Sharma and Kalra proposed a lightweight protocol using hash function encryption only for user authentication on wireless sensor systems. In this paper, we found some weaknesses in target schemes. We propose a novel three-factor lightweight user authentication scheme that addresses these weaknesses and verifies the security of the proposed scheme using a formal verification tool called ProVerif. In addition, our proposed scheme outperforms other proposed symmetric encryption-based schemes or elliptic curve-based schemes.


Asunto(s)
Internet de las Cosas , Telemedicina , Seguridad Computacional , Confidencialidad , Humanos , Monitoreo Fisiológico
20.
Sensors (Basel) ; 21(1)2020 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-33375512

RESUMEN

With the development of wireless rechargeable sensor networks (WRSNs ), security issues of WRSNs have attracted more attention from scholars around the world. In this paper, a novel epidemic model, SILS(Susceptible, Infected, Low-energy, Susceptible), considering the removal, charging and reinfection process of WRSNs is proposed. Subsequently, the local and global stabilities of disease-free and epidemic equilibrium points are analyzed and simulated after obtaining the basic reproductive number R0. Detailedly, the simulations further reveal the unique characteristics of SILS when it tends to being stable, and the relationship between the charging rate and R0. Furthermore, the attack-defense game between malware and WRSNs is constructed and the optimal strategies of both players are obtained. Consequently, in the case of R0<1 and R0>1, the validity of the optimal strategies is verified by comparing with the non-optimal control group in the evolution of sensor nodes and accumulated cost.


Asunto(s)
Redes de Comunicación de Computadores , Epidemias , Tecnología Inalámbrica , Seguridad Computacional
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