Search Results (84)

Efficient and intelligent spectrum access is crucial for meeting the diverse Quality of Service (QoS) demands of Vehicular Internet of Things (V-IoT) systems in next-generation cellular networks. This work proposes a novel reinforcement learning (RL)-based priority-aware spectrum management (RL-PASM) framework, a centralized self-learning priority-aware spectrum management framework operating through Roadside Units (RSUs). RL-PASM dynamically allocates spectrum resources across three traffic classes: high-priority (HP), low-priority (LP), and best-effort (BE), utilizing reinforcement learning (RL). This work compares four RL algorithms: Q-Learning, Double Q-Learning, Deep Q-Network (DQN), and Actor-Critic (AC) methods. The environment is modeled as a discrete-time Markov Decision Process (MDP), and a context-sensitive reward function guides fairness-preserving decisions for access, preemption, coexistence, and hand-off. Extensive simulations conducted under realistic vehicular load conditions evaluate the performance across key metrics, including throughput, delay, energy efficiency, fairness, blocking, and interruption probability. Unlike prior approaches, RL-PASM introduces a unified multi-objective reward formulation and centralized RSU-based control to support adaptive priority-aware access for dynamic vehicular environments. Simulation results confirm that RL-PASM balances throughput, latency, fairness, and energy efficiency, demonstrating its suitability for scalable and resource-constrained deployments. The results also demonstrate that DQN achieves the highest average throughput, followed by vanilla QL. DQL and AC maintain fairness at high levels and low average interruption probability. QL demonstrates the lowest average delay and the highest energy efficiency, making it a suitable candidate for edge-constrained vehicular deployments. Selecting the appropriate RL method, RL-PASM offers a robust and adaptable solution for scalable, intelligent, and priority-aware spectrum access in vehicular communication infrastructures. Full article

The Base Excision Repair (BER) pathway involves a highly coordinated series of protein–protein interactions that facilitate the recognition, excision, and repair of damaged bases. Key enzymes such as DNA glycosylases, apurinic/apyrimidinic endonuclease 1 (APE1), polynucleotide kinase-phosphatase (PNKP), DNA polymerase b (Pol β), ligase IIIα (LigIIIα), poly (ADP-ribose) polymerases PARP1 and PARP2, and X-ray repair cross-complementing protein 1 (XRCC1) catalyze BER in a tightly regulated molecular network. These interactions ensure the seamless handoff of DNA intermediates between the core enzymes of the BER pathway. Understanding the details of protein–protein interactions in BER provides valuable insights into the molecular underpinnings of DNA repair processes. In this review, we focus on protein–protein interactions between the components of the single-nucleotide BER (SN-BER) pathway and other proteins that interact with BER components and regulate the coordination of the pathway. We also briefly discuss the interactions of other proteins that interact with the components of SN-BER based on functional evidence. Full article

Background: Patient safety culture (PSC) is a fundamental aspect of healthcare that significantly impacts care quality and patient outcomes. Examining PSC is vital for identifying areas of improvement and implementing effective, targeted interventions. Objective: This study aimed to evaluate trends in PSC across U.S. hospitals to identify strengths and weaknesses in PSC over time. Methodology: A retrospective descriptive analysis was performed using the Hospital Survey on Patient Safety Culture version 1.0 (HSOPSC 1.0) comparative dataset. This study comprised responses from 1601 hospitals and over 993,000 healthcare providers. Twelve dimensions of PSC, reporting events, and safety grade were analyzed using descriptive statistics to evaluate variations in several indicators, such as means and average positive, negative, and neutral response percentages, across different PSC dimensions and hospital characteristics over time. Considering this study’s exploratory nature, no corrections for multiple testing were applied. Results: The overall PSC scores averaged 65% across years, declining from 67% in 2013 to 64% in 2020, reflecting a moderately positive perception of PSC over time. Key strengths across all years included “Supervisor/Manager Expectations” and “Teamwork within Units”, while persistent weaknesses were observed in “Nonpunitive Response to Error” and “Handoffs and Transitions”. Hospitals in the Southern and Central regions reported the highest positive perceptions. Smaller hospitals and non-teaching hospitals also reported more positive perceptions of PSC. Conclusions: This study underscores the complexities of enhancing PSC and, more importantly, the challenges of sustaining a consistently positive culture over time. The findings highlight the importance of ongoing monitoring and tailored interventions to improve PSC. Promoting a “Just Culture” that prioritizes learning from errors is critical for advancing patient safety in healthcare settings, and enhancing reporting systems is required. Full article

Background/Objectives: Among the factors contributing to medical errors and misdiagnosis, patient handoffs play a significant role. The negative impact of handoffs includes miscommunications, omissions, and information loss. Patient handoffs are inherent to emergency department (ED) patient care and are recognized as high-risk events. The aim of this study was to use a mixed-methods approach, incorporating a retrospective chart review and qualitative analysis, to understand emergency physicians’ perceptions of handoffs, including their impact on patient safety, patient flow, and patient satisfaction, as well as the strategies employed to manage handoffs and their perceived efficacy. Methods: A seven-question online survey was distributed to 120 attending ED physicians employed across a large academic health system comprising six hospitals. Additionally, a 3-year retrospective chart review provided insights into avoidable handoffs in the ED. Results: The survey responses showed that 69% of physicians believed that handoffs reduced patient safety, 55% felt that they reduced patient satisfaction, and 66% perceived them as contributing to longer patient stays. Additionally, 86% of physicians preferred to hand off no more than two patients, while 79% preferred to receive no more than two. Thematic content analysis identified key factors influencing physician preferences, including ownership, patient safety, patient flow, cooperation and colleagueship, and the challenges of continuing workups. To minimize handoffs, ED physicians primarily reported strategies such as staying late after shifts, restricting patient signups, and planning patient disposition toward the end of their shifts. Lastly, retrospective data analysis suggested that implementing one-hour overlapping shifts and restricting patient signups could reduce ED handoffs by 30%. Conclusions: ED physicians perceive handoffs as affecting patient safety, patient satisfaction, and patient flow negatively and prefer fewer handoffs. Overlapping shifts and selective patient signup strategies may reduce handoffs. Full article

Background: ISO certification is widely implemented as a quality assurance tool in healthcare services; however, its impact on patient safety culture (PSC) in public hospitals remains insufficiently explored. Aim: This study aims to assess the effect of ISO certification procedures on different dimensions of PSC in public hospital departments by comparing ISO-certified and non-certified departments across two phases (Phase A: pre-certification; Phase B: 18 months post-certification). Methods: A two-phase cross-sectional study was conducted in a tertiary public hospital in Greece. Healthcare professionals from both ISO-certified and non-certified departments participated. The Hospital Survey on Patient Safety Culture (HSOPSC v1.0) was administered at two time points (Phase A: baseline, pre-certification; Phase B: 18 months post-certification). A repeated measures analysis was performed to assess the changes over time and differences between the two groups. Results: The findings suggest that ISO certification has a mixed impact on the PSC dimensions. A significant improvement was observed in “Supervisor’s/Manager’s Expectations and Actions Promoting Safety” (p = 0.012), while “Teamwork Within Units” (p = 0.026) and “Handoffs and Transitions” (p = 0.037) showed statistically significant changes. These results indicate that certification may enhance structured managerial oversight and interdepartmental collaboration, but at the same time, may negatively impact the teamwork within hospital units. However, no statistically significant changes were observed in “Overall Perception of Safety” (p = 0.135) and “Non-Punitive Response to Error” (p = 0.101), suggesting that while there was a trend towards a stricter safety evaluation, this was not statistically confirmed. Additionally, the staffing perceptions remained unchanged (p = 0.745). Conclusions: ISO certification appears to reinforce managerial safety expectations and interdepartmental teamwork, yet does not significantly improve the overall perceptions of patient safety or non-punitive error responses. The results indicate the need for targeted interventions to ensure that certification processes do not increase administrative burdens or negatively impact staff perceptions. Future research should explore whether these effects persist over time and how hospitals can optimize certification processes to strengthen PSC without unintended consequences. Full article

An intelligent transportation system (ITS) offers commercial and personal movement through the smart city (SC) communication paradigms with hassle-free information sharing. ITS designs and architectures have improved via information and communication technologies in recent years. The information shared through the communication medium in SCs is exposed to adversary risk, resulting in privacy issues. Privacy issues impact the contingent mobility and localization of the ITS path. This paper introduces a novel resilient privacy preserving (RPP) method through presumed secrecy (PS) to provide a robust privacy measure. The privacy of the progressive communication sessions is preserved based on the previous security depletion levels. The interruptions in traffic data-related communication sessions are recurrently identified, and re-handoffs are recommended with dodged transfer learning. The empirical results indicate a 25% reduction in computational overhead and a 30% enhancement in privacy protection over conventional methods, demonstrating the model’s efficacy in secure ITS communication. Compared with existing methods, the proposed approach decreases security depletion rates by 15% across varying traffic densities, underscoring ITS resilience in high-interaction scenarios. Full article

Standardized transfer is an evidence-based framework designed to improve communication between healthcare professionals, reducing risks and ensuring safe, high-quality care. Despite its benefits, implementing this framework in clinical practice poses challenges. Nurses often do not use a systematic guide as a theoretical framework for handovers in daily practice. Objective: To explore nurses’ perceptions regarding the use of standardized transfers. Methodology: This exploratory qualitative cross-sectional study aimed to gain insight into nurses’ experiences and perspectives on pediatric patient transfers. Using purposive sampling, nurses from the pediatric intensive care unit and hospital wards at the hospital institution hosting the study were interviewed. Data were collected through 21 in-depth individual interviews conducted between April and May 2023. The semi-structured interviews, lasting 16 to 28 min, focused on nurses’ views on communication between units during patient transfers. The qualitative approach allowed for a comprehensive understanding of nurses’ perceptions, particularly the barriers they face in practice. The study included 21 nurses: 9 from the pediatric intensive care unit and 12 from pediatric wards. To ensure diverse representation, nurses with varying levels of work experience were included, and at least one nurse from each hospital ward participated. Results: The data were classified into the following main categories: the current state of pediatric patient transfers, attitudes of healthcare professionals, barriers and challenges to implementation, nursing documentation, motivational aspects, and the child-family relationship. The findings revealed significant issues in the communication process during patient transfers, with no systematic guidelines in place. While nurses demonstrated a positive attitude toward the standardization of transfers, they identified numerous practical challenges, particularly those related to the hospital’s nursing documentation system. Conclusions: Nurses view standardized transfers favorably, but they face substantial barriers that limit their practical implementation. Full article

The 5G core network adopts a Control and User Plane Separation (CUPS) architecture to meet the challenges of low-latency business requirements. In this architecture, a balance between management costs and User Experience (UE) is achieved by moving User Plane Function (UPF) to the edge of the network. However, cross-UPF handover during communication between the UE and the remote server will cause TCP/IP session interruption and affect continuity of delay-sensitive real-time communication continuity. Information-Centric Networks (ICNs) separate identity and location, and their ability to route based on identity can effectively handle mobility. Therefore, based on the 5G-ICN architecture, we propose a seamless mobility support method based on router buffered data (BDMM), making full use of the ICN’s identity-based routing capabilities to solve the problem of UE cross-UPF handover affecting business continuity. BDMM also uses the ICN router data buffering capabilities to reduce packet loss during handovers. We design a dynamic buffer resource allocation strategy (DBRAS) that can adjust the buffer resource allocation results in time according to network traffic changes and business types to solve the problem of unreasonable buffer resource allocation. Finally, experimental results show that our method outperforms other methods in terms of average packet delay, weighted average packet loss rate, and network overhead. In addition, our method also has good performance in average handover delay. Full article

The proposed novel algorithm named decision-making algorithm with geographic mobility (DMAGM) includes detailed analysis of decision-making for cognitive radio (CR) that considers a multivariable algorithm with geographic mobility (GM). Scarce research work considers the analysis of GM in depth, even though it plays a crucial role to improve communication performance. The DMAGM considerably reduces latency in order to accurately determine the best communication channels and includes GM analysis, which is not addressed in other algorithms found in the literature. The DMAGM was evaluated and validated by simulating a cognitive radio network that comprises a base station (BS), primary users (PUs), and CRs considering random arrivals and disappearance of mobile devices. The proposed algorithm exhibits better performance, through the reduction in latency and computational complexity, than other algorithms used for comparison using 200 channel tests per simulation. The DMAGM significantly reduces the decision-making process from 12.77% to 94.27% compared with ATDDiM, FAHP, AHP, and Dijkstra algorithms in terms of latency reduction. An improved version of the DMAGM is also proposed where feedback of the output is incorporated. This version is named feedback-decision-making algorithm with geographic mobility (FDMAGM), and it shows that a feedback system has the advantage of being able to continually adjust and adapt based on the feedback received. In addition, the feedback version helps to identify and correct problems, which can be beneficial in situations where the quality of communication is critical. Despite the fact that the FDMAGM may take longer than the DMAGM to calculate the best communication channel, constant feedback improves efficiency and effectiveness over time. Both the DMAGM and the FDMAGM improve performance in practical scenarios, the former in terms of latency and the latter in terms of accuracy and stability. Full article

Named Data Networking (NDN) has emerged as a promising architecture to overcome the limitations of the conventional Internet Protocol (IP) architecture, particularly in terms of mobility, security, and data availability. However, despite the advantages it offers, producer mobility management remains a significant challenge for NDN, especially for moving vehicles and emerging technologies such as Unmanned Aerial Vehicles (UAVs), known for their high-speed and unpredictable movements, which makes it difficult for NDN to maintain seamless communication. To solve this mobility problem, we propose a Distributed Mobility Management Scheme (DMMS) to support UAV mobility and ensure low-latency content delivery in NDN architecture. DMMS utilizes decentralized Anchors to forward proactively the consumer’s Interest packets toward the producer’s predicted location when handoff occurs. Moreover, it introduces a new forwarding approach that combines the standard and location-based forwarding strategy to improve forwarding efficiency under producer mobility without changing the network structure. Using a realistic scenario, DMMS is evaluated and compared against two well-known solutions, namely MAP-ME and Kite, using the ndnSIM simulations. We demonstrate that DMMS achieves better results compared to Kite and MAP-ME solutions in terms of network cost and consumer quality-of-service metrics. Full article

Handoff mechanisms are very important in fifth-generation (5G) mobile networks because of the cellular architecture employed to maximize spectrum utilization. Together with call admission control (CAC) mechanisms, they enable better optimization of bandwidth use. The primary objective of the research presented in this article is to analyze traffic levels, aiming to optimize traffic management and handling. This article considers the two most popular CAC mechanisms: the resource reservation mechanism and the threshold mechanism. It presents an analytical approach to occupancy distribution and blocking probability calculation in 5G mobile networks, incorporating connection handoff and CAC mechanisms for managing multiple traffic streams generated by multi-service sources. Due to the fact that the developed analytical model is an approximate model, its accuracy was also examined. For this purpose, the results of analytical calculations of the blocking probability in a group of 5G cells are compared with the simulation data. This paper is an extended version of our paper published in 17th ConTEL 2023. Full article

(1) Background: Although numerous studies related to communication in a nursing context have been conducted, there is a lack of research considering the effects of personal and organisational communication factors on the self-efficacy for handoffs. This study aimed to identify the impact of communication competence and intra-organisational communication satisfaction on self-efficacy for handoffs among nurses. (2) Methods: This cross-sectional research was conducted between September and October 2018. In total, 203 registered nurses were invited to participate in the study by convenience sampling from five general hospitals in South Korea. Data were analysed using SPSS for t-test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression analysis. (3) Results: In the final regression model, the adjusted R square was significant, explaining 24.2% of the variance in self-efficacy for handoffs (F = 22.43, p = 0.001) when the variable horizontal communication (β = 0.282, p < 0.001) was included in intra-organisational communication satisfaction. In addition, the longer the nurse’s experience in the current unit and the higher the communication competence, the more statistically significant the self-efficacy for handoffs was found to be (β = 0.215, p = 0.001 and β = 0.180, p = 0.008). (4) Conclusions: To enhance the self-efficacy for handoffs, nurse managers should foster an atmosphere that allows their staff nurses to interact freely and establish specific guidelines for handoffs through mutual communication. Full article

The rapid advancement of wireless communication combined with insufficient spectrum exploitation opens the door for the expansion of novel wireless services. Cognitive radio network (CRN) technology makes it possible to periodically access the open spectrum bands, which in turn improves the effectiveness of CRNs. Spectrum sensing (SS), which allows unauthorized users to locate open spectrum bands, plays a fundamental part in CRNs. A precise approximation of the power spectrum is essential to accomplish this. On the assumption that each SU’s parameter vector contains some globally and partially shared parameters, spectrum sensing is viewed as a parameter estimation issue. Distributed and cooperative spectrum sensing (CSS) is a key component of this concept. This work introduces a new component-specific cooperative spectrum sensing model (CSCSSM) in CRNs considering the amplitude and phase components of the input signal including Component Specific Adaptive Estimation (CSAE) for mean squared deviation (MSD) formulation. The proposed concept ensures minimum information loss compared to the traditional methods that consider error calculation among the direct signal vectors. The experimental results and performance analysis prove the robustness and efficiency of the proposed work over the traditional methods. Full article

Background: The utilization of neoadjuvant chemotherapy (NAC) remains highly variable in clinical practice. The implementation of NAC requires coordination of handoffs between a multidisciplinary team (MDT). This study aims to assess the outcomes of an MDT in the management of early-stage breast cancer patients undergoing neoadjuvant chemotherapy at a community cancer center. Methods: We conducted a retrospective case series on patients receiving NAC for early-stage operable or locally advanced breast cancer coordinated by an MDT. Outcomes of interest included the rate of downstaging of cancer in the breast and axilla, time from biopsy to NAC, time from completion of NAC to surgery, and time from surgery to radiation therapy (RT). Results: Ninety-four patients underwent NAC; 84% were White and mean age was 56.5 yrs. Of them, 87 (92.5%) had clinical stage II or III cancer, and 43 (45.8%) had positive lymph nodes. Thirty-nine patients (42.9%) were triple negative, 28 (30.8%) were human epidermal growth factor receptor (HER-2)+, and 24 (26.2%) were estrogen receptor (ER) +HER-2−. Of 91 patients, 23 (25.3%) achieved pCR; 84 patients (91.4%) had downstaging of the breast tumor, and 30 (33%) had axillary downstaging. The median time from diagnosis to NAC was 37.5 days, the time from completion of NAC to surgery was 29 days, and the time from surgery to RT was 49.5 days. Conclusions: Our MDT provided timely, coordinated, and consistent care for patients with early-stage breast cancer undergoing NAC as evidenced by time to treatment outcomes consistent with recommended national trends. Full article

The internet’s future architecture, known as Named Data Networking (NDN), is a creative way to offer content-based services. NDN is more appropriate for content distribution because of its special characteristics, such as naming conventions for packets and methods for in-network caching. Mobility is one of the main study areas for this innovative internet architecture. The software-defined networking (SDN) method, which is employed to provide mobility management in NDN, is one of the feasible strategies. Decoupling the network control plane from the data plane creates an improved programmable platform and makes it possible for outside applications to specify how a network behaves. The SDN is a straightforward and scalable network due to its key characteristics, including programmability, flexibility, and decentralized control. To address the problem of consumer mobility, we proposed an efficient SDPCACM (software-defined proactive caching architecture for consumer mobility) in NDN that extends the SDN model to allow mobility control for the NDN architecture (NDNA), through which the MC (mobile consumer) receives the data proactively after handover while the MC is moving. When an MC is watching a real-time video in a state of mobility and changing their position from one attachment point to another, the controllers in the SDN preserve the network layout and topology as well as link metrics to transfer updated routes with the occurrence of the handoff or handover scenario, and through the proactive caching mechanism, the previous access router proactively sends the desired packets to the new connected routers. Furthermore, the intra-domain and inter-domain handover processing situations in the SDPCACM for NDNA are described here in detail. Moreover, we conduct a simulation of the proposed SDPCACM for NDN that offers an illustrative methodology and parameter configuration for virtual machines (VMs), OpenFlow switches, and an ODL controller. The simulation result demonstrates that the proposed scheme has significant improvements in terms of CPU usage, reduced delay time, jitter, throughput, and packet loss ratio. Full article