Patients receiving hemodialysis are at risk of vascular access infections (VAIs) and particularly vulnerable to the opportunistic pathogen Staphylococcus aureus. Hemodialysis patients were also at increased risk of infection during the COVID-19 pandemic. Therefore, this study determined the change in the molecular and antibiotic resistance profiles of S. aureus isolates from VAIs during the pandemic compared with before. 102 S. aureus isolates were collected from VAIs between November 2013 and December 2021. Before the pandemic, 69 isolates were collected, 58%, 39.1%, and 2.9% from arteriovenous grafts (AVGs), tunneled cuffed catheters (TCCs), and arteriovenous fistulas (AVFs), respectively. The prevalence of AVG and TCC isolates changed to 39.4% and 60.6%, respectively, of 33 isolates during the pandemic. Sequence type (ST)59 was the predominant clone in TCC-methicillin-resistant S. aureus (MRSA) and AVG-MRSA before the pandemic, whereas the predominant clone was ST8 in AVG-MRSA during the pandemic. ST59 carrying the ermB gene was resistant to clindamycin and erythromycin. By contrast, ST8 carrying the msrA gene was exclusively resistant to erythromycin. The ST distribution for different VAIs changed from before to during the pandemic. The change in antibiotic resistance rate for different VAIs was closely related to the distribution of specific STs.

With increased vulnerabilities and vast technology landscapes, it is extremely critical to build systems which are highly resistant to cyber-attacks, to break into systems to exploit. It is almost impossible to build 100% secure authentication & authorization mechanisms merely through standard password / PIN (With all combinations of special characters, numbers & upper/lower case alphabets and by using any of the Graphical password mechanisms). The immense computing capacity and several hacking methods used, make almost every authentication method susceptible to cyber-attacks in one or the other way. Only proven / known system which is not vulnerable in spite of highly sophisticated computing power is, human brain. In this paper, we present a new method of authentication using a combination of computer’s computing ability in combination with human intelligence. In fact this human intelligence is personalized making the overall security method more secure. Text based passwords are easy to be cracked ^[6]. There is an increased need for an alternate and more complex authentication and authorization methods. Some of the Methods ^{[7] [8]} in the category of Graphical passwords could be susceptible, when Shoulder surfing/cameras/spy devices are used.

During the last years, significant initiatives have been launched for the dissemination of Open Access as part of the Open Science movement. Nevertheless, the other major pillars of Open Science such as Open Research Data (ORD) and Open Peer Review (OPR) are still in an early stage of development among the communities of researchers and stakeholders. The present study sought to unveil the perceptions of a medical and health sciences community about these issues. Through the investigation of researchers’ attitude, valuable conclusions can be drawn, especially in the field of medicine and health sciences, where an explosive growth of scientific publishing exists. A quantitative survey was conducted based on a structured questionnaire, with 51.8% response rate (215 responses out of 415 electronic invitations). The participants in the survey agreed with the ORD principles However they ignored basic terms like FAIR (Findable, Accessible, Interoperable and Reusable) and appeared incentive to permit the exploitation of their data. Regarding OPR, participants expressed their agreement, implying their interest for a trustworthy evaluation system. Conclusively, researchers urge to receive proper training for both ORD principles and OPR processes which combined with a reformed evaluation system will enable them to take full advantage of the opportunities that arise from the new scholar publishing and communication landscape.

Physical Unclonable Functions (PUFs) based on the retention times of the cells of a Dynamic Random Access Memory (DRAM) can be utilised for the implementation of cost-efficient and lightweight cryptographic protocols. However, as recent work has demonstrated, the times needed in order to generate their responses may prohibit their widespread usage. In order to address this issue, the Row Hammer PUF has been proposed by Schaller et al. [1], which leverages the row hammer effect in DRAM modules to reduce the retention times of their cells and, therefore, significantly speed up the generation times for the responses of PUFs based on these retention times. In this work, we extend the work of Schaller et al. by presenting a run-time accessible implementation of this PUF and further reducing the time required for the generation of its responses. Additionally, we also provide a more thorough investigation of the effects of temperature variations on the the Row Hammer PUF and briefly discuss potential statistical relationships between the cells used to implement it. As our results prove, the Row Hammer PUF could potentially provide an adequate level of security for Commercial Off-The-Shelf (COTS) devices, if its dependency on temperature is mitigated, and, may therefore, be commercially adopted in the near future.

With the proliferating of video surveillance system deployment and related applications, real-time video analysis is very critical to achieve intelligent monitoring, autonomous driving, etc. It is non-trivial to achieve high accuracy and low latency video stream analysis through the traditional cloud computing. In this paper, we propose a non-orthogonal multiple access (NOMA) based edge real-time video analysis framework with one edge server (ES) and multiple user equipments (UEs). A cost minimization problem composed of delay, energy and accuracy is formulated to improve the QoE of UEs. In order to efficiently solve this problem, we propose the joint video frame resolution scaling, task offloading, and resource allocation algorithm based on the Deep Q-Learning Network (JVFRS-TO-RA-DQN), which effectively overcomes the sparsity of the single-layer reward function and accelerates the training convergence speed. JVFRS-TO-RA-DQN consists of two DQN networks to reduce the curse of dimension, which respectively select the offloading and resource allocation action, the resolution scaling action. Experimental results show that JVFRS-TO-RA-DQN can effectively reduce the cost of transmission and computation, and have better performance in convergence compared to other baseline.

The collision avoidance mechanism adopted by the IEEE 802.11 standard is not optimal. The mechanism employs a binary exponential backoff (BEB) algorithm in the medium access control (MAC) layer. Such an algorithm increases the backoff interval whenever a collision is detected to minimize the probability of subsequent collisions. However, the expansion of the backoff interval causes degradation of the radio spectrum utilization (i.e., bandwidth wastage). That problem worsens when the network has to manage the channel access to a dense number of stations, leading to a dramatic decrease in network performance. Furthermore, a wrong backoff setting increases the probability of collisions such that the stations experience numerous collisions before achieving the optimal backoff value. Therefore, to mitigate bandwidth wastage and, consequently, maximize the network performance, this work proposes using reinforcement learning (RL) algorithms, namely Deep Q Learning (DQN) and Deep Deterministic Policy Gradient (DDPG), to tackle such an optimization problem. As for the simulations, the NS-3 network simulator is used along with a toolkit known as NS3-gym, which integrates a reinforcement-learning (RL) framework into NS-3. The results demonstrate that DQN and DDPG have much better performance than BEB for static and dynamic scenarios, regardless of the number of stations. Moreover, the performance difference is amplified as the number of stations increases, with DQN and DDPG showing a 27% increase in throughput with 50 stations compared to BEB. Furthermore, DQN and DDPG presented similar performances.

A new optical steganography scheme is proposed that transmits a stealth optical code-division multiple-access (OCDMA) signal through a public binary phase-shift keying (BPSK) channel. Polarization beam splitters and arrayed waveguide gratings are used to implement a spectral-polarization coding (SPC) system with an incoherent optical source. We employ a Walsh–Hadamard code as the signature code of the user who wants to transmit stealth information using the system. A free space optical link applied to this system maintains the polarization states of light during propagation. The secret data is extracted using correlation detection and balanced subtraction in the OCDMA decoder of the intended receiver, and the other signal from the public channel is reduced by the OCDMA decoder. At the demodulator of the public channel, BPSK demodulation eliminates the stealth signal so that the public channel is not affected by the stealth signal. The two signals cannot interfere with each other. The results of this study show that our proposed optical steganography system is highly secure. The stealth signal can be favorably hidden in the public channel when the average source power of the stealth signal, public noise, and public signal are −5, −3, and 0 dBm, respectively.

Cellular-based machine-to-machine (M2M) communication is expected to facilitate services for the Internet of Things (IoT). However, because cellular networks are designed for human users, they have some limitations. Random access channel (RACH) congestion caused by massive access from M2M devices is one of the biggest factors hindering cellular-based M2M services because the RACH congestion causes random access (RA) throughput degradation and connection failures to the devices. In this paper, we show the possibility exploiting the capture effects, which have been known to have a positive impact on the wireless network system, on RA procedure for improving the RA performance of M2M devices. For this purpose, we analyze an RA procedure using a capture model. Through this analysis, we examine the effects of capture on RA performance and propose a Msg3 power-ramping (Msg3 PR) scheme to increase the capture probability (thereby increasing the RA success probability) even when severe RACH congestion problem occurs. The proposed analysis models are validated using simulations. The results show that the proposed scheme, with proper parameters, further improves the RA throughput and reduces the connection failure probability, by slightly increasing the energy consumption. Finally, we demonstrate the effects of coexistence with other RA-related scheme through simulation result.

Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of chronic disease among vulnerable populations. This study tested a novel food insecurity intervention called FINDING-Food, which stands for Frequent Informational Nudges Directing Individuals to Needed Goods. Informational nudges in the intervention promoted food security through the elimination of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity. The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group at the end of the study. Qualitative findings revealed how the intervention group found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food.

Background and Objectives: C-arm free MIS techniques can offer significantly reduced rates of postoperative complications such as blood loss and hospitalization time. Another advantageous long-term aspect is the notably diminished exposure to radiation which is known to cause ma-lignant changes. This study emphasizes that, in some cases of spinal conditions which require a procedural intervention, C-arm free MIS techniques hold stronger indications than open surgeries guided by image intensifier. Materials and Methods: In this research, a retrospective analysis and review of various cervical and thoracic spinal procedures, performed in our hospital, by applying C-arm free techniques. The course of the study explains the basic steps of the procedures and demonstrating postoperative or intra-operative results. For anterior cervical surgery, we performed OPLL resection, while for posterior cervical surgery, we performed posterior fossa decompression for Chiari malformation, minimally invasive cervi-cal pedicle screw fixation (MICEPS) and modified Goel technique with C1 lateral mass screw for atlantoaxial subluxation. Re-garding the thoracic spine, we performed anterior correction for Lenke type 5 scoliosis, and transdiscal screw fixation for DISH fractures. Results: C-arm free techniques are safe procedures that offer precise and high-quality postoperative results by offering sufficient spine alignment and adequate decompression depending on the case. Blood loss, postoperative pain and wound infection are other important aspects of spine surgery that must be always taken into consideration. Conclusions: Navigated C-arm free techniques are safe and precise procedures implemented in the treatment of surgically demanding conditions. They can significantly increase accuracy while decreasing the operative time. They represent the advancement in the field spine surgery and are hailed as the future of the same

This study evaluates the accessibility of primary care physicians (PCPs) in Eastern Quebec using an enhanced two-step floating catchment area (E2SFCA) methodology. The E2SFCA methodology considers both the population supply of PCPs and the travel time between PCPs and dissemination areas, and was found to be effective in identifying possibly underserved areas. The availability of primary care services is contingent upon the presence of adequate road infrastructure, and populations residing in areas with limited access to main road networks may experience compromised access to primary care. The study concludes that the E2SFCA methodology can facilitate the identification of areas experiencing a shortage of PCPs, and this information can be used to inform the development of regional medical workforce programs and support the establishment of rural residency initiatives.

Adequate public spaces and urban green areas are key criteria for urban development and infrastructure implementation of healthy cities. Latterly, there has been an increasing number of research methods using artificial intelligence (AI) to monitor, quantify, and control the state of these spaces with an aim towards pioneering research in Urban Studies. However, in informal areas, open-data access tends to lack adequate and updated information, making it difficult to use AI methods. Hence, we propose a methodology for restricted open data collection and preparation for future use in machine learning or spatial data science models for similar areas. To that extent, we examine two peripheral and low-income neighborhoods in Quito, Ecuador, La Bota and Toctiuco, to analyze their public spaces, urban green areas, points of interest, and road networks, and how they address healthy cities criteria. We develop an original methodological approach that combines an index of proximity, accessibility, quantity, and quality of these spaces with geospatial and network analysis techniques. Results indicate that the connectivity and structure of these spaces are centralized and nodal, representing exclusion and segregation. This work provides insights on potential healthy spaces, and information to urban planners and policymakers in decision-making for healthy urban infrastructure.

Biocultural heritage preservation relies on ethnobotanical knowledge and the paleoethnobotanical data used in (re)constructing histories of human-biota interactions. Biocultural heritage, defined as the knowledge and practices of Indigenous and Local peoples and their biological relatives, is often guarded information, meant for specific audiences and withheld from other social circles. As such, these forms of heritage and knowledge must also be included in the ongoing data sovereignty discussions and movement. In this paper we share the process and design decisions behind creating an online database for ethnobotanical knowledge and associated paleoethnobotanical data, using a content management system designed to foreground Indigenous and local perspectives. Our main purpose is to suggest the Mukurtu content management system, originally designed for physical items of cultural importance, be considered as a potential tool for digitizing and ethically circulating biocultural heritage, including paleoethnobotanical resources. With this database, we aim to create access to biocultural heritage and paleoethnobotanical considerations for a variety of audiences while also respecting the protected and sensitive natures of Indigenous and local knowledges.

Facing unprecedented global declines in the extent and integrity of ecosystems, the 15^th UN Biodiversity Conference (COP-15) in Kunming, China, presents an opportunity for transformative change. However, a lack of consensus on two key issues – resource mobilization and Access and Benefit Sharing (ABS) associated with Digital Sequence Information (DSI) – risks stalling negotiations for an ambitious ‘Post-2020 Global Biodiversity Framework’ as the next 10-year strategic plan under the Convention on Biological Diversity. We highlight systemic misconceptions concerning the financing of biodiversity and the burden this places on the ABS system. In the context of DSI, we caution that conflating ABS with resource mobilization risks disrupting modern science policy built on open access, with potentially severe ramifications for scientific research and innovation. To resolve these tensions, we call for a recalibration of discussions on ABS in order to maximize the value delivered by biodiversity for all of society, including indigenous peoples and local communities.

In light of the urgency raised by the COVID-19 pandemic, global investment in wildlife virology is likely to increase, and new surveillance programs will identify hundreds of novel viruses that might someday pose a threat to humans. Our capacity to identify which viruses are capable of zoonotic emergence depends on the existence of a technology—a machine learning model or other informatic system—that leverages available data on known zoonoses to identify which animal pathogens could someday pose a threat to global health. We synthesize the findings of an interdisciplinary workshop on zoonotic risk technologies to answer the following questions: What are the prerequisites, in terms of open data, equity, and interdisciplinary collaboration, to the development and application of those tools? What effect could the technology have on global health? Who would control that technology, who would have access to it, and who would benefit from it? Would it improve pandemic prevention? Could it create new challenges?

Tunneled central venous catheters (CVC) are mainly considered as rescue vascular access option in dialysis but still used in about one quarter of prevalent patients worldwide as being associated with poor performances and higher risks. Study design. In this retrospective single-center study, we aimed to report on clinical performances achieved with high-flow tunneled CVC (DualCath, DCath) and compared it with arteriovenous accesses (AVAs; AV fistula, AV graft, Thomas Shunt) in a hospital-based dialysis unit. Methods. Sixty-eight stage 5 chronic kidney disease dialysis dependent patients (CKD5D) receiving high volume hemodiafiltration were followed-up for 30 months. The study consisted of two phases: baseline cross-sectional and longitudinal follow-up of key performance indicators. Clinical performances consisting of effective blood flow and blood volume, recirculation, urea and ionic Kt/V and total Kt, ultrafiltration volume and percent reduction of ß2-M were measured monthly as part of quality control in our unit. Results. At baseline, effective blood flow with DCath was close to 400 ml/min, similar to AVAs. Recirculation with DCath (7%, 6-13%) was higher than AVAs. Diffusive dialysis dose delivered with DCath (spKt and eKt/V) and convective dialysis dose achieved with DCath were slightly lower than AVAs, but still much higher than recommended by guidelines. Percent reduction of ß2-M achieved with DCath was also 4 to 10% lower than AVAs. On longitudinal follow-up, main clinical performance indicators of DCath (total Kt and total ultrafiltration volume, L/session) were maintained very stable over time and close to those achieved with AVAs. Conclusions. As shown in this study, high-flow DualCath tunneled two single lumen silicone catheters may be used to deliver high volume hemodiafiltration in a reliable and consistent manner without compromising clinical performances. These results rely from the specific design of the two silicone cannulas and the strict adherence to best catheter practices.

This study presents a detailed assessment on the impact of the Brazilian legal framework related to the access and benefit sharing provisions of the UN Convention on Biological Diversity. The research is based on a comprehensive dataset that was systematically collected over several years, directly from the official government bodies responsible for its implementation. The aim of the study is to contribute to a fact-based discussion on the effectiveness of national ABS laws, focusing on the Brazilian legal framework, first established in the year 2000 and revised in 2015, as a case example. This study balances the costs and benefits of the Brazilian ABS system and assesses the regulatory challenges it poses to individuals, companies, and institutions that perform research, share knowledge, develop, manufacture or market products derived from Brazilian biodiversity. The study indicates that, after over 22 years of operation, the regulatory challenges are still real and relevant, and that the significant volume of data collected from users on access, prior commercialization and shipment of genetic materials abroad was never systematically assessed by the agencies in charge. Besides, it shows that the costs incurred by the government in managing the policy itself have been higher than the economic benefits it has made possible, and that the institutional mechanisms in place since 2015 have not been able to allocate the monetary benefits contributed by users to the National Benefit Sharing Fund to any projects aimed at developing sustainable uses or preserving Brazilian biodiversity.

Data security in the Internet of things (IoT) is often implemented by means of encryption, which can be burdensome for some entities. We propose in this paper a solution based on routing, by which data are forwarded only to entities that are intended to receive them. An IoT network can be seen as a partial order of equivalence classes of entities, and each entity can be labeled according to the position of its equivalence class in the partial order. The partial order can be constructed according to requirements of secrecy (or confidentiality), integrity and conflicts. Routing tables among entities can be compiled by using the labels. The method is demonstrated in this paper for Software defined networking (SDN) routers and controllers. We propose a centralized IoT architecture with a cloud structure using SDN as networking infrastructure, where storage entities (i.e. cloud servers) are associated with application entities. A small ‘hospital’ example is shown for illustration. Procedures for network reconfigurations are discussed. We also demonstrate the method for the normal case where different partial orders coexist among a set of entities. The method proposed does not impose an overhead on the normal functioning of an SDN network, since it requires calculations only when the network must be reconfigured, because of administrative intervention or policies.

One of today’s most critical challenges is ensuring a sufficient food production and supply for the ever-expanding global population. Recently, many countries around the world, particularly those in Africa, grapple with severe hunger and food insecurity, frequently exacerbated by escalating global prices, persistent insecurity, and the repercussion of the COVID-19 pandemic. However, this study undertook an extensive review of the prevalence and severity of hunger and food insecurity across diverse countries and regions. The review utilised several metrics, including Global Hunger Index (GHI) scores, Global Food Security index (GFSI) scores, 2023 data (related to two Sustainable Development Goal 2 (SDG2) target) from the Food and Agriculture Organization (FAO), and other pertinent sources to assess the current status of the countries included in this study. The 20 countries with 2023 GHI scores below 5 were collectively ranked from 1 to 20, signifying low hunger levels. However, Central African Republic (CAR) received the lowest ranking at 125 out of 125, with a score of 42.3, indicating an alarming level of hunger. Finland achieved the highest GFSI score of 83.7, with Oman showing the most notable GFSI improvement at +13.8, while Syria experienced a significant decline in GFSI score by -10.5. Over time, many countries, particularly the developed ones, witnessed significant improvement in their GHI and GFSI scores. Meanwhile, most countries in sub-Saharan Africa experienced the most deterioration in their GFSI scores and notable increases in their GHI scores. The review documented the significant progress made by countries and regions in reducing levels of hunger and food insecurity, while highlighting the substantial burden borne by sub-Saharan Africa (SSA) in combating global hunger and food insecurity.

The emergence of precision and digital livestock farming presents an opportunity for sustainable animal farming practices that enhance animal welfare and health. However, this transformation of modern animal farming through digital technology has several implications for the technological, social, economic, and environmental aspects of farming. It is crucial to analyze the ethical considerations associated with the digitalization of modern animal farming, particularly in the context of human-animal relationships and potential objectification. This analysis can help develop frameworks for improving animal welfare and promoting sustainability in animal farming.One of the primary ethical concerns of digital livestock farming is the potential for a digital divide between farmers who have access to advanced technologies and those who do not. This could lead to a disparity in animal welfare and health outcomes for different groups of animals. Additionally, the use of artificial intelligence in digital livestock farming may lead to a loss of personal connection between farmers and animals, which could impact the animal's well-being. Another ethical concern of digital livestock farming is the potential for objectification of animals as mere data points. The use of sensors and other monitoring technologies can provide valuable data on animal health and behavior, but it is important to remember that animals are sentient beings with complex emotional and social needs. The use of digital technologies should not lead to neglect of animal welfare or a lack of human responsibility towards animals.Furthermore, social context becomes essential while integrating technologies in the livestock farming to overcome ethics. By considering the cultural and societal norms of different communities, we can ensure that the use of digital technologies does not undermine these values. To address these ethical challenges, the development of standards and codes of conduct for the adoption and implementation of digital livestock farming tools and platforms can help ensure that animal welfare and sustainability are prioritized. This can help alleviate the privacy concerns of stakeholders and improve sustainability in animal farming practices. Additionally, the use of virtual and augmented reality technologies can provide a way to enhance human-animal interactions and provide more personalized care to animals, further promoting animal welfare.

Seniors safety is a compelling need, which necessitates 24/7 real-time monitoring and timely dangerous action recognition. Being able to mirror characteristics of physical objects (PO) to corresponding logical objects (LO) and seamlessly monitor their footprints thus detect anomaly parameters, Digital Twins (DT) has been considered a practical way to provide virtual health services for seniors safety. Meanwhile, widely adopted Internet of Medical Things (IoMT) consisting of wearable sensors and non-contact optical cameras for self and remote health data monitoring also raises concerns on information security and privacy violation. Therefore, security of POs, LOs and reliable data sharing among healthcare professionals are challenging as constructing trust and privacy-preserving virtual health services. Thanks to characteristics of decentralization, traceability and unalterability, Blockchain is promising to enhance security and privacy properties in many areas like data analysis, finance and healthcare. This paper envisions a lightweight authentication framework (LAF) to enable secure and privacy-preserving virtual healthcare services. Leveraging Non-Fungible Token (NFT) technology to tokenize LOs and data streams on blockchain, anyone can certify the authenticity of a digital LO along with its synchronized data between PO without relying on a third-party agency. In addition, the NFT-based tokenization not only allows owners fully control their IoMT devices and data, but it also enables verifiable ownership and traceable transferability during data sharing process. Moreover, NFT only contains references to encrypted raw data that are saved on off-chain storage like local files or distributed databases, such a hybrid storage strategy ensures privacy-preservation for sensitive information. A proof-of-concept prototype is implemented and tests are conducted on a case study of seniors safety. The experimental evaluation shows the feasibility and effectiveness of the proposed LAF solution.

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

This article challenges the assumption that journals and peer review are essential for developing, evaluating and disseminating scientific and other academic knowledge. It suggests a more flexible ecosystem, and examines some of the possibilities this might facilitate. The market for academic outputs should be opened up by encouraging the separation of the dissemination service from the evaluation service. Publishing research in subject-specific journals encourages compartmentalizing research into rigid categories. The dissemination of knowledge would be better served by an open access, web-based repository system encompassing all disciplines. Reviews from peers should be supplemented by reviews from non-peers from a variety of different perspectives: user reviews, statistical reviews, reviews from the perspective of different disciplines, and so on. This should reduce the inevitably conservative influence of relying on two or three peers, and make the evaluation system more critical, multi-dimensional and responsive to the requirements of different audience groups, changing circumstances, and new ideas. Non-peer review might make it easier to challenge dominant paradigms, and expanding the potential audience beyond a narrow group of peers might encourage the criterion of simplicity to be taken more seriously - which is essential if knowledge is to continue to progress.

Cooperative non-orthogonal multi access communication is a promising paradigm for the future wireless networks because of its advantages in terms of energy efficiency, wider coverage and interference mitigating. In this paper, we study the secrecy performance of a downlink cooperative non-orthogonal multi access (NOMA) communication system under the presence of an eavesdropper node. Smart node selection based on feed forward neural networks (FFNN) is proposed in order to improve the physical layer security (PLS) of a cooperative NOMA network. The selected cooperative relay node is employed to enhance the channel capacity of the legal users, where the selected cooperative jammer is employed to degrade the capacity of the wiretapped channel. Simulations of the secrecy performance metric namely the secrecy capacity ($C_S$) are presented and compared with the conventional technique based on fuzzy logic node selection technique. Based on our simulations and discussions the proposed technique outperforms the existing technique in term the of secrecy performance.

The Release of government dataset for public use can potentially strengthen the relationship between the government and its constituents. However, research shows that there are several challenges for open data effectiveness. This paper reviews current determinants and issues associated with the open government data (OGD) procedures. The review concentrates on two ends of the spectrum: First, from the perspective of the preparation by the government, focusing on the organization of traditional governmental datasets and how the recording of the data is administered. Second, from the perspective of the users, focusing on the way in which the data is released to the general public and on human-computer interaction (HCI) issues between end-user and data-consumption interfaces. Following a thorough analysis of these two opposing challenges, the paper proposes approaches to mitigate them. This review and subsequent recommendations contribute and expand current understanding of open government data effectiveness and can lead to public policy changes, development of new procedures and strategies, and ultimately improvements at both ends of the federal open data endeavor.

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical, geographic variables, and neighborhood socio-economic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to patients who received home health care within the recommended first two days, patients who received delayed services (3-7 days after discharge) had higher odds of rehospitalization (OR 1.28, 95% CI 1.25-1.32). Among patients who received late services (8-14 days after discharge), the odds of rehospitalization were four times greater than for patients receiving services within 2 days (OR 4.12, 95% CI 3.97-4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

Recent studies have demonstrated silk fibroin’s ability to extend the shelf life of foods by mitigating the hallmarks of spoilage, namely oxidation and dehydration. Due to the potential for this protein to become more widespread, its safety was evaluated comprehensively. First, a bacterial reverse mutation test (Ames test) was conducted in five bacterial strains. Second, an in vivo erythrocyte test was conducted with Sprague Dawley rats at doses up to 1,000mg/kg-bw/day. Third, a range-finder study was conducted with Sprague Dawley rats at the highest consumption amount given solubility and oral gavage volume constrains (500mg/kg-bw/day). Fourth, a 28-day study in Sprague Dawley rats was conducted at the 500mg/kg-bw/day amount. Fifth, an in vitro pepsin digestion assay was performed to assess the potential for protein allergenicity. Sixth, allergenic potential was further assessed using liquid chromatography-mass spectroscopy for detection of allergenic insect proteins. Seventh, the protein sequences were subjected to bioinformatic analyses. Together, these studies raise no mutagenic, carcinogenic, toxicological, or allergenic concerns with the oral consumption of silk fibroin.

The lexical analysis of seminal policy-to-diplomacy documents from the socio-environmental discourse of the last fifty year agendas allowed examining the evolution of five themes: resources/waste, pollution, social and economic development, justice, and health. Contextual affinities were strongest between resources, pollution, and health and are linked to societal trends and pressures. On those grounds, the central role of resource stewardship according to nature’s physical limits is highlighted, and dedicated concepts, analytical frameworks, and methodologies with different degrees of sustainability are analyzed. To reframe the identified social and economic problems, the work proposes criteria and choices that (1) allow to compare the dynamics of socioecological states across the planet, (2) help matching the pace of socioecological change by addressing path dependencies through participation and engagement of communities, and (3) enable stakeholders to make trade-offs and take decisions in specific social, economic, political, and cultural contexts. The prioritization of resource justice and responsibility becomes a societal project : from Wellfare State to commonfare communities.

The study investigated the usage of open data in public organizations, focusing on the motives, preferences, and governance ideals that determine their quality. The study shed light on how open data platforms are created and improved, as well as their influence on government operations. The primary goal was to understand the motivations behind the usage of open data, evaluate gov-ernance ideals, and examine institutions' efforts to standardize data formats. Hierarchical regres-sion analysis divides variables into core reasons and different preferences, demonstrating a need for "diversification" in order to use open data effectively. Efficiency, accountability, community impact, knowledge, and high-quality service delivery are all emphasized in governance value analysis. The institution's dedication to standardizing open data formats is evidenced by legislative measures and the integration of many technologies. The findings illustrate the institution's dual strategy of em-ploying traditional techniques and new technologies for effective data management. The report suggests increasing data openness and standardization, investing in ongoing training, upgrading alerting and awareness systems, and adopting specific regulations for open data use. Monitoring and feedback techniques are critical for adjusting and refining open data services to satisfy de-velopment needs. This study adds to the scientific knowledge of open data use by highlighting important motives, preferences, and governance ideals. The offered guidelines provide practical insights for public organizations looking to improve their open data platforms by promoting openness, efficiency, and community participation.

(1) Introduction: Every two hours, a Romanian woman is diagnosed with cervical cancer [1] as the country ranks second in Europe in terms of mortality and incidence rate [2]. This paper aims to identify the main reasons that have led to this situation, focusing on the measures taken by the Romanian Ministry of Health for the prevention of this type of cancer national - programs for cervical cancer screening and HPV vaccination. (2) Materials and methods: We performed a study based on available secondary data from the National Statistics Institute, World Health Organization and Bucharest Institute of Oncology in order to assess the burden associated with cervical cancer and placing it in the context of known global and European incidence and mortality rates, thus evaluating the importance of this health issue in Romania. The second component of our study was a cross-sectional study, using a 14 questions questionnaire, applied to the women participating in the National Screening Program for Cervical Cancer, aimed to evaluate the women’s level of knowledge about screening and HPV vaccination and their access cervical cancer specific health-care services. (3) Results: The results of the research shows that a high percentage of women postpone the routine checks due to lack of time and financial resources and indicate that low level of knowledge about the disease and the specific preventive methods determines low participation screening and HPV vaccination programs implemented in Romania contributing to the country’s situation of cervical cancer. (4) Conclusions: The national programs have complicated procedures, are underfunded, and do not motivate enough health care workers. This combined with the lack of information adds up to an extremely low number of women screened and vaccinated. Our conclusion is that the Romanian Ministry of Health must take immediate action by conducting major awareness campaigns, implementing measures to make the programs functional and ensuring coherent funding.

Spinal Cord Stimulation (SCS) is an effective and validated treatment to address chronic refractory neuropathic pain in Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients. Surgical SCS lead placement is traditionally performed under general anesthesia due to its invasiveness. In parallel, recent works have suggested that Awake Anesthesia (AA), consisting in Target Controlled Intra-Veinous Anesthesia (TCIVA), could be an interesting tool to optimize lead anatomical placement using patient intra-operative feedback. We hypothesized that combining AA with Minimal Invasive Surgery (MIS) could improve SCS outcomes. The goal of this study was to evaluate SCS lead performance (defined by the area of pain adequately covered by paraesthesia generated via SCS), using an intraoperative objective quantitative mapping tool, and secondarily to assess pain relief, functional improvement and change in quality of life with a composite score. We analyzed data from a prospective multicenter study (ESTIMET) to compare the outcomes of 115 patients implanted with MIS under AA (MISAA group) or General Anesthesia (MISGA group), or by Laminectomy under General Anesthesia (LGA group). All in all, MISAA appears to show significantly better performance in terms of patient pain coverage, as well as improved secondary outcomes. One step further, our results suggest that MISAA combined with intra-operative hypnosis could potentialize patient intraoperative cooperation and could be proposed as a personalized package offered to PSPS-T2 patients eligible for SCS implantation in highly dedicated neuromodulation centers.

Many academics are critical of the current publishing system, but it is difficult to create a better alternative. This review relates to the Sciences and Social Sciences, and discusses the primary purpose of academic journals as providing a seal of approval for perceived quality, impact, significance, and importance. The key issues considered include the role of anonymous refereeing, continuous rather than discrete frequency of publications, avoidance of time wasting, and seeking adventure. Here we give recommendations about the organization of journal articles, the roles of associate editors and referees, measuring the time frame for refereeing submitted articles in days and weeks rather than months and years, encouraging open access internet publishing, emphasizing the continuity of publishing online, academic publishing as a continuous dynamic process, and how to improve research after publication. Citations and functions thereof, such as the journal impact factor and h-index, are the benchmark for evaluating the importance and impact of academic journals and published articles. Even in the very top journals, a high proportion of published articles are never cited, not even by the authors themselves. Top journal publications do not guarantee that published articles will make significant contributions, or that they will ever be highly cited. The COVID-19 world should encourage academics worldwide not only to rethink academic teaching, but also to re-evaluate key issues associated with academic journal publishing in the future.