Game Theory-Based Authentication Framework to Secure Internet of Vehicles with Blockchain.

The Internet of Vehicles (IoV) is a new paradigm for vehicular networks. Using diverse access methods, IoV enables vehicles to connect with their surroundings. However, without data security, IoV settings might be hazardous. Because of the IoV's openness and self-organization, they are prone to malevolent attack. To overcome this problem, this paper proposes a revolutionary blockchain-enabled game theory-based authentication mechanism for securing IoVs. Here, a three layer multi-trusted authorization solution is provided in which authentication of vehicles can be performed from initial entry to movement into different trusted authorities' areas without any delay by the use of Physical Unclonable Functions (PUFs) in the beginning and later through duel gaming, and a dynamic Proof-of-Work (dPoW) consensus mechanism. Formal and informal security analyses justify the framework's credibility in more depth with mathematical proofs. A rigorous comparative study demonstrates that the suggested framework achieves greater security and functionality characteristics and provides lower transaction and computation overhead than many of the available solutions so far. However, these solutions never considered the prime concerns of physical cloning and side-channel attacks. However, the framework in this paper is capable of handling them along with all the other security attacks the previous work can handle. Finally, the suggested framework has been subjected to a blockchain implementation to demonstrate its efficacy with duel gaming to achieve authentication in addition to its capability of using lower burdened blockchain at the physical layer, which current blockchain-based authentication models for IoVs do not support.

n-Player Stochastic Duel Game Model with Applied Deep Learning and Its Modern Implications.

This paper provides a conceptual foundation for stochastic duels and contains a further study of the game models based on the theory of stochastic duels. Some other combat assessment techniques are looked upon briefly; a modern outlook on the applications of the theory through video games is provided; and the possibility of usage of data generated by popular shooter-type video games is discussed. Impactful works to date are carefully chosen; a timeline of the developments in the theory of stochastic duels is provided; and a brief literature review for the same is conducted, enabling readers to have a broad outlook at the theory of stochastic duels. A new evaluation model is introduced in order to match realistic scenarios. Improvements are suggested and, additionally, a trust mechanism is introduced to identify the intent of a player in order to make the model a better fit for realistic modern problems. The concept of teaming of players is also considered in the proposed mode. A deep-learning model is developed and trained on data generated by video games to support the results of the proposed model. The proposed model is compared to previously published models in a brief comparison study. Contrary to the conventional stochastic duel game combat model, this new proposed model deals with pair-wise duels throughout the game duration. This model is explained in detail, and practical applications of it in the context of the real world are also discussed. The approach toward solving modern-day problems through the use of game theory is presented in this paper, and hence, this paper acts as a foundation for researchers looking forward to an innovation with game theory.

Low skeletal muscle mass is associated with liver fibrosis in individuals with type 2 diabetes and nonalcoholic fatty liver disease.

BACKGROUND AND AIM: Type 2 diabetes (T2D) and low skeletal muscle mass (SMM) are associated with increased risk of nonalcoholic fatty liver disease (NAFLD). However, data regarding the association between low SMM and NAFLD-related liver fibrosis in individuals with T2D are scarce. Therefore, we aimed to investigate the association between low SMM and liver fibrosis in individuals with T2D and NAFLD. METHODS: Controlled attenuation parameter (CAP) of ≥ 248 dB/m was taken as cutoff suggesting NAFLD. Clinically relevant liver fibrosis and advanced liver fibrosis were defined as liver stiffness measurement (LSM) by transient elastography (TE) of ≥ 8.0 and ≥ 9.6 kPa, respectively. SMM was measured using dual energy X-ray absorptiometry (DEXA). Low SMM was defined as appendicular SMM index of < 7.0 kg/m2 for men and < 5.4 kg/m2 for women. RESULTS: Of the 487 consecutive patients with T2D, 366 (75.1%) had NAFLD. Among individuals with NAFLD, 118 (32.2%) and 64 (17.5%) had clinically relevant liver fibrosis and advanced liver fibrosis, respectively. Low SMM was diagnosed in 78 (21.3%) individuals with NAFLD. Patients with low SMM were older (56.1 vs 52.8 years) and had longer duration of diabetes (10.3 vs 8.1 years). Low SMM was an independent risk factor associated with clinically relevant liver fibrosis (P = 0.002) and advanced liver fibrosis (P ≤ 0.0001). Associations between low SMM and clinically relevant- and advanced liver fibrosis were maintained even after sequential adjustment for confounding variables through the multivariate regression analysis. CONCLUSIONS: Low SMM is independently associated with liver fibrosis in individuals with T2D and NAFLD.

Spectral CT imaging of intranodular hemorrhage in cases with challenging benign thyroid nodules.

While conventional ultrasound and laboratory testing can differentiate most thyroid conditions and malignancies, spectral dual-energy computed tomography (DECT) provides molecular data potentially useful in differential diagnosis of small, complex, and partially obscured hemorrhaged nodules with recent bleeding. To demonstrate that Gemstone Spectral Imaging (GSI) analysis of DECT data differentiates challenging benign thyroid nodule conditions in patients with intranodular hemorrhages. A retrospective study was conducted of 30 intranodular hemorrhage patients from 2010 to 2013, including 18 that underwent surgery and provided thyroid tissues for prospective histological analysis. Iodine and water content were determined in patient CT scans and ex vivo tissue specimen scans by reconstruction of raw CT data at 65 keV (optimal contrast). Slope of spectral curve (λ HU), effective atomic number (Z eff), and final pathological diagnosis were recorded. Iodine content, water content, Z eff, and λ HU significantly varied by region (intranodular hemorrhage, solid thyroid nodule, and adjacent margins) in patients and tissue specimens (P < 0.05). Intranodular hemorrhage exhibited elevated water concentrations (~1100 mg/mL), suggesting a practical threshold of 1075 mg/mL for differentiating intra-plaque hemorrhage and solid nodular regions. Spectral CT provided diagnostic information in 14 thyroid adenomas and four goiters (histologically confirmed in donor specimens), and eight thyroid adenomas and four nodular goiters based on clinical diagnosis. Diagnostically useful regional characteristic of intranodular hemorrhage in the thyroid was visualized via spectral CT employing material decomposition, potentially yielding additional molecular data about complex lesion characteristics no apparent in conventional imaging or laboratory methods.

Improving the prompt identification of the Emergency Severity Index level 2 patient in triage: rapid triage and the registered nurse greeter.

INTRODUCTION: High triage volumes can delay rapid identification of walk in ESI level 2 patients. This concern coupled with persistently increasing volumes prompted the Reading Hospital Emergency Department to move from single-tiered triage to duel-tiered rapid triage in 2008, then brought the addition of the RN Greeter in 2011. The purpose of this study was to assess how rapid triage then the RN Greeter impacted the ability to quickly identify the walk-in ESI 2 patient. METHODS: A retrospective analysis of mini-registration to triage time was conducted on ESI level 2 patients entering the ED by means other than ambulance. Data was collected from three separate time frames: The first representing single-tiered triage, the second duel-tiered rapid triage, and the third duel-tiered triage with the RN Greeter. RESULTS: Data demonstrated despite increasing volumes both rapid triage and the RN Greeter improved the prompt identification of ESI 2 patients. DISCUSSION: While moving from single to duel-tiered triage met little resistance from staff, the RN Greeter role was initially not as well received. However, as empirical data demonstrated the efficacy of the RN Greeter to quickly identify the potential ESI 2 patient, the role ultimately became an integral part of triage.

Impact of improper sample handling on Cobas CT/NG testing platform with dual swab sample collection kit for detecting Chlamydia trachomatis and Neisseria gonorrhoeae.

IMPORTANCE: The importance of this observation lies in its potential to directly impact testing outcomes and patient care. By identifying improper sample handling as a contributing factor to a substantial number of invalid results, we emphasize the need for meticulous adherence to recommended protocols during sample collection. Laboratories that overlook or are unaware of such deviations may inadvertently compromise the reliability and efficacy of their diagnostic processes, leading to misdiagnoses, delayed treatment, and patient dissatisfaction.

Characteristics of potential head injury situations at the FIFA World Cup Qatar 2022TM.

This exploratory video analysis study aimed to review characteristics of potential head injury situations during a men's professional international football tournament. For 64 matches of the FIFA World Cup Qatar 2022™ FIFA analysts used match footage to record all potential head injury situations. A potential head injury situation was defined as a player staying down for more than 5 s and/or requesting medical attention, and where the body impact location included the player's head. Characteristics were further recorded for match, player (i.e. player action including aerial duels), medical assessment, and outcome (e.g. substitution). Descriptive statistics are reported as well as Pearson's Chi-squared test (or Fisher's exact test) to explore potential head injury situations more likely to result in medical attention. In total, 149 potential head injury situations occurred in 56 matches (mean 2.33/match, range 0-6) involving 117 players. Eight matches resulted in no incidents. Aerial duels were the most frequent match characteristic leading to a potential head injury situation. Injury stoppage with on-pitch medical assessment occurred in 35 of the 149 potential head injury situations (23%), with pitch-side assessment also occurring in 15 situations (10%), resulting in four concussion substitutions. Players were more likely to require medical attention for potential head injuries sustained when the ball was loose (χ2 = 6.88; p = 0.038) when the injured player was jumping (FET p = 0.044) and for head-to-head contact (FET p = <0.001). Further exploration of aerial duels during match play which do and do not lead to potential and actual head injuries is recommended.

The role of duel hydrolysis of soybean on functional properties and protein digestibility: a sustainable approach.

Background: Protein hydrolysates derived from food sources contains enormous number of peptides which are composed of amino acid possessess various bioactive properties. However, the use of protein hydrolysates as a nutraceutical is hindered due to their unpleasant flavour. The study aims to enhance the biological activity and palatability of protein hydrolysates. Methodology: In the present study, soybean protein hydrolysate (SPH) was prepared using alcalase for 4 h (control). Modification of hydrolysis (MPH) was carried out by reiterating the hydrolysis of the supernatant obtained after 2 h of hydrolysis using an enzyme to 50% of alcalase during each successive hydrolysis. Samples were characterised by their physio-chemical and functional properties. Furthermore, the effect of modification on the protein digestibility and bitterness intensity using e-tongue was studied. The suppressive effect on retrogradation of corn starch was analysed using texture profile analysis. Results: The results demonstrated increased protein content by 1.6 and 1.9% in MPH compared to SPH and UNH, respectively. MPH showed 1.5- and 1.6-fold higher DH% than SPH before and after gastrointestinal digestion (p < 0.05). A decrease in molecular weight was found in the order of UNH > SPH > MPH. Nevertheless, MPH displayed significantly higher functional properties (p ≤ 0.05). The hardness of retrograded corn starch was significantly reduced in the MPH (1.21N) than SPH (1.55 N) and UNH (1.81N) compared to control (1.71N) during 7-day storage at 4°C (p ≤ 0.05). E-tongue analysis of MPH showed a 4-fold reduction in bitterness than SPH. Conclusion: Modification of hydrolysis of soybean has demonstrated its significance in improved DH% functional properties and palatability. In addition, improved protein digestibility with promising benefits in deferral action on retrogradation of starch over the traditional process of hydrolysis was observed. The outcome of this study contributes to the potential utilisation of MPH as an ingredient in the formulation of nutraceutical products.

A 'worthy disciple of Galen', 'ardent sportsman' and 'expert swordsman': Henry Kipping (1726-1785) apothecary and surgeon at Brighton, England.

Henry Kipping (1726-1785) was an apothecary and surgeon in Brighton, England. Here we present a series of contemporary references to Kipping from newspaper, book, archive and web-based resources. Some relate to his medical practice (resuscitating a 'drowned' elderly physician and a fisherman, bleeding a member of parliament who had fallen from his horse and praising a nostrum for the 'gravel and stone'). Social references include a duel with an army officer whose sword Kipping confiscated. Kipping appears to have been popular, connected with members of Brighton's high society and passionate about traditional past times, e.g. swordsmanship, horse riding and hunting on the Sussex downs. Indeed, Kipping's horse ran in the earliest known horse race in Brighton (1770). He was consulted by notable local residents including the Thrale family of Brighton and Lady Wilhelmina Shelley (the latter evidenced by Kipping partaking in her funeral procession in 1772). Kipping lived and practised at 28 West street, a road most famous for its (now lost) George Inn where King Charles II stayed just prior to his escape to Normandy. Kipping comes across as a colourful and eccentric clinician.

Experiences of grief and moral sentiments in survivors of the armed conflict in Medellín, Colombia.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

Higher thyroid hormone has a negative association with lower limb lean body mass in euthyroid older adults: Analysis from the Baltimore Longitudinal study of aging.

Background: Hyperthyroidism is associated with lower lean body mass, as a result of catabolic actions of thyroid hormone. Therefore, higher thyroid hormone levels could be a factor in the development of sarcopenia and age associated functional decline. The relationship between thyroid hormone and muscle mass in ambulatory, euthyroid older adults is not known. Method: We used mixed-effects models to estimate the cross-sectional relationships (accounting for inter-person variability) between thyroid axis hormone measures and lower limb composition or sarcopenia at visits in the Baltimore Longitudinal Study of Aging (BLSA) at which DEXA scans were available and both thyrotropin (TSH) and free thyroxine (FT4) were in the reference range. Analyses were adjusted for levothyroxine use, age, race, sex, BMI, smoking, alcohol intake, cholesterol, and systolic blood pressure. Results: 1442 euthyroid participants (median age 68, 50% female, and 69% white) contributed to 5306 visits from 2003 to 2019. FT4 was negatively associated with lower limb lean mass (beta: 88.49; 95% Confidence Interval (CI): 122.78, -54.20; p < 0.001) and positively associated with sarcopenia (OR: 1.11%, 95% CI: 1.01, 1.22) in the whole cohort. Additionally, higher FT4 was associated with lower leg lean mass (beta: 66.79; 95% CI: 102.24, -31.33; p < 0.001) and sarcopenia (OR:1.09%, 95% CI:1.01, 1.18) in older adults, but not in younger adults alone. Conclusion: In euthyroid older adults, higher FT4 is associated with lower leg lean mass and higher odds of sarcopenia. Understanding the relationship between thyroid hormone and sarcopenia is needed to improve clinical decision-making and avoid functional decline from excess thyroid hormone use in older adults.

Political Rivalry During America's Founding Fathers Era and the Bullet that Ended Up in Alexander Hamilton's Upper Lumbar Spine.

On the morning of July 11, 1804, Major General Alexander Hamilton, an American statesman and one of the Founding Fathers of the United States, boarded a barge from Manhattan to the New Jersey shore. There, he met his personal and political opponent, Aaron Burr, for a duel during which Burr shot a bullet that entered Hamilton's torso, fractured a false rib, passed through internal organs, and lodged itself in one of his upper lumbar vertebrae. In this unique historical analysis of a pivotal event in American history, we provide a comprehensive discussion of the spinal injuries sustained by Alexander Hamilton, with special consideration of anatomic details and the ballistics of the time. To the authors' knowledge, this is the first thorough examination of the spinal injuries sustained by the prolific Founding Father and great mind behind the American financial system, Alexander Hamilton.

Experiences of Grief and Moral Sentiments in Survivors of the Armed Conflict in Medellín, Colombia. / Experiencias de duelo y sentimientos morales en sobrevivientes del conflicto armado en Medellín, Colombia.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

The Interaction between Phagocytes and Streptococcus agalactiae (GBS) Mediated by the Activated Complement System is the Key to GBS Inducing Acute Bacterial Meningitis of Tilapia.

Streptococcus agalactiae is an important pathogen for tilapia meningitis. Most of the infected tilapia die rapidly in production, when the way to study the pathogenic mechanism of bacteria on host through chronic infection in laboratory is not comprehensive and accurate enough to elucidate the real pathogenic mechanism. The objective of this study was to investigate the mechanism of acute bacterial meningitis of tilapia caused by Streptococcus agalactiae (GBS), and provide a theoretical basis for its prevention and treatment. Duel RNA-seq, proteome analysis, histopathological analysis, plasma biochemical indexes, and blood routine examination were performed on tilapias infected with fish-derived GBS attenuated strain YM001 and its parental virulent strain HN016. The results showed that the contents of white blood cell (WBC), monocytes (MON), and neutrophil (NEU) were significantly lower in the HN016 group compared to that in the YM001 group (p < 0.05). Histopathological examination showed that there were partially lesions in the examined tissues of tilapia infected by HN016, while no obvious histopathological changes occurred in the YM001 group. The differential expressed genes (DEGs) and differential expressed proteins (DEPs) between YM001 and HN016 were mainly enriched in the beta-lactam resistance pathway (oppA1, oppA2, oppB, oppC, oppD, oppF, and mrcA). The DEGs DEPs between YM001-brain and HN016-brain were mainly enriched in the complement and coagulation cascades signaling pathway (C2a, c4b, c3b, c7, CD59, ITGB2, and ITGAX). The present study indicates that the interaction between phagocytes and GBS mediated by the activated complement system is the key to GBS inducing tilapia acute bacterial meningitis. The low survival ability caused by reduced ß-lactam antibiotics resistance is one of the important reasons for why YM001 lost its pathogenicity to tilapia.

D3 -Creatine dilution and the importance of accuracy in the assessment of skeletal muscle mass.

Sarcopenia has been described as the age-associated decrease in skeletal muscle mass. However, virtually every study of sarcopenia has measured lean body mass (LBM) or fat free mass (FFM) rather than muscle mass, specifically. In a number of published sarcopenia studies, LBM or FFM is referred to as muscle mass, leading to an incorrect assumption that measuring LBM or FFM is an accurate measure of muscle mass. As a result, the data on the effects of changes in LBM or FFM in older populations on outcomes such as functional capacity, disability, and risk of injurious falls have been inconsistent resulting in the conclusion that muscle mass is only weakly related to these outcomes. We review and describe the assumptions for the most commonly used measurements of body composition. Dual-energy X-ray absorptiometry (DXA) has become an increasingly common tool for the assessment of LBM or FFM and appendicular lean mass as a surrogate, but inaccurate, measurement of muscle mass. Other previously used methods (total body water, bioelectric impedance, and imaging) also have significant limitations. D3 -Creatine (D3 -Cr) dilution provides a direct and accurate measurement of creatine pool size and skeletal muscle mass. In a recent study in older men (MrOS cohort), D3 -Cr muscle mass was associated with functional capacity and risk of injurious falls and disability, while assessments of LBM or appendicular lean mass by DXA were only weakly or not associated with these outcomes. Inaccurate measurements of muscle mass by DXA and other methods have led to inconsistent results and potentially erroneous conclusions about the importance of skeletal muscle mass in health and disease. The assessment of skeletal muscle mass using the D3 -Cr dilution method in prospective cohort studies may reveal sarcopenia as a powerful risk factor for late life disability and chronic disease.

Randomised trial of the comparison of drug-eluting stents in patients with diabetes: OCT DES trial.

Background: To date, there have been limited comparisons performed between everolimus-eluting stents (EES) and zotarolimus-eluting stents (ZES) in patients with diabetes mellitus (DM). The objectives of this study was to assess the use of second-generation drug-eluting stents in patients with DM, using optical coherence tomography (OCT) to compare the level of stent coverage of Boston Scientific Promus Element EES compared with Medtronic Resolute Integrity ZES.(Clinicaltrials.gov number NCT02060357). Methods: This is a single-centre randomised blinded trials assessing two commercially available stents in 60 patients with diabetes (ZES: n=30, EES: n=30). Patients underwent intracoronary assessment at 6 months with OCT assessing stent coverage, malapposition, neointimal thickness and percentage of in-stent restenosis (ISR). Results: Of the 60 patients randomised, 46 patients underwent OCT analysis. There was no difference in baseline characteristics between the two groups. Both Promus Element and Resolute Integrity had low rates of uncovered struts at 6 months with no significant difference between the two groups (2.44% vs 1.24%, respectively; P=0.17). Rates of malapposition struts (3.9% vs 2.5%, P=0.25) and percentage of luminal loss did not differ between stent types. In addition, there was no significant difference in major adverse cardiovascular events (P=0.24) between the stent types. Conclusions: This study is the first randomised trial to evaluate OCT at 6 months for ZES and EES in patients with diabetes. Both stents showed comparable strut coverage at 6 months, with no difference in ISR rates at 6 months.

[How do quarrels end? on duel]. / Comment termine-T-on les querelles ? À propos du duel Come finiscono le liti ? A proposito del duello.

This essay analyses duels in the early modern period (up until the early part of the nineteenth century), both as the ultimate form of quarrels, their natural conclusion under certain conditions, while duel is itself the object of intense polemics. A duel, which is organised by laws, regulates dissensus at the same time as it exacerbates this dissensus. It is through duels that dissensus in society appears, showing how social intercourses acknowledge disagreements between individuals and regulate ways of solving them. This essay analyses the form of the duel as the end of all quarrels. It then examines the controversies that surrounded duels. Finally, it examines the place of duel in literature, its poetic and dramatic function, in order to underline the ways in which the literary text contributes to a reflection on duels.

Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009-2010.

The possible association between low skeletal muscle mass and cardiovascular disease (CVD) risk factors necessitates estimation of muscle mass even in subjects with normal body mass index (BMI). This study was aimed to investigate optimal cutoffs for skeletal muscle mass reflecting CVD risk factors and to evaluate the relationship between skeletal muscle mass and CVD risk factors in the general population and in subjects with normal BMI using these cutoffs. This cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey 2009-2010. We enrolled 5120 men and 6559 women aged ≥20 years. Skeletal muscle index (SMI) was defined as the weight-adjusted appendicular skeletal muscle mass measured by dual-energy X-ray absorptiometry. Using receiver operating characteristic curve analyses, SMI cutoffs associated with CVD risk factors were determined. Lower SMI was significantly associated with an increased prevalence of CVD risk factors. The first cutoffs in men and women were 32 and 25%, respectively, and the second cutoffs were 30 and 23.5%. Subjects in stage I and stage II SMI categories showed increased prevalence and risk for several CVD risk factors. These tendencies persisted in the association between cardiometabolic characteristics and SMI even in subjects with normal BMI. Using cutoffs of low skeletal muscle mass reflecting CVD risk factors, lower skeletal muscle mass was associated with increased prevalence and risk of several CVD risk factors. A higher prevalence of cardiometabolic abnormalities was observed among subjects with normal BMI but low skeletal muscle mass.

El duelo en tiempos de pandemia: la muerte escrita / Grief in times of pandemic: written death

En tiempos de pandemia los rituales funerarios quedan alterados y en ciertos sitios, suprimidos. los alcances subjetivos de este impedimento no son todavía visibles. No obstante, la formas de despedida y acompañamiento no quedan canceladas. La palabra encuentra los modos de alojar al dolor mostrado su eficacia en el campo de lo humano. Es necesario acentuar estos modos vicarios de la despedida porque de ellos depende el destino del duelo mismo

In times of pandemic, funeral rituals are altered and, in certain places, suppressed. the subjective implications of this impediment are not yet visible. However, the forms of farewell and accompaniment are not canceled. The word finds ways to accommodate pain by showing its effectiveness in the field of the human. It is necessary to accentuate these vicarious ways of parting because the fate of the duel itself depends on them