Search Results (443)

As medical technology develops and digital demands grow, personal health records (PHRs) are becoming more patient-centered than before based on cloud-based health information exchanges. While enhancing data accessibility and sharing, these systems present privacy and security issues, including data breaches and unauthorized access. We developed a post-quantum, group-oriented encryption scheme using the Crystal-Kyber Key encapsulation mechanism (KEM). Leveraging lattice-based post-quantum cryptography, this scheme ensures quantum resilience and chosen ciphertext attack security for layered cloud PHR environments. It supports four encryption modes: individual, group, subgroup-specific, and authorized subgroup decryption, meeting diverse data access needs. With efficient key management requiring only one private key per user, the developed scheme strengthens the privacy and security of PHRs in a future-proof, flexible, and scalable manner. Full article

Background: More than 1500 genes are associated with developmental delay and intellectual disability, with variants in many of these genes contributing to a shared phenotype. The discovery of variants of uncertain significance (VUS) found in these genes during genetic testing can lead to ambiguity and further delay in diagnosis and medical management. Phenotyping, additional genetic testing, and functional studies can all add valuable information to help reclassify these variants. Here we demonstrate the clinical utility of epigenetic signatures in prioritizing variants of uncertain significance in genes associated with developmental delay (DD) and intellectual disability (ID). Methods: Genome sequencing was performed in a male with developmental delay. He was found to have VUSs in both PHF6 and DDB1 genes, linked with Börjeson–Forssman–Lehmann syndrome (BFLS) and White–Kernohan syndrome (WHIKERS), respectively. These two disorders share a similar phenotype but have distinct inheritance patterns and molecular pathogenic mechanisms. DNA methylation profiling (DNAm) of whole blood was performed using the clinically validated EpiSign assay. Results: The proband’s methylation profile demonstrated a strong correlation with the BFLS methylation signature, supporting the PHF6 variant as a likely cause of his neurodevelopmental disorder. Conclusions: Epigenetic testing for disorders with distinct methylation patterns can provide diagnostic utility when a patient presents with variants of uncertain significance in genes associated with developmental delay. Epigenetic signatures can also guide genetic counselling and family planning. Full article

Background: Aortic stenosis (AS) has long been considered a degenerative disease and is typically diagnosed in older men at an advanced stage. However, accumulating evidence has highlighted the similarities between AS and atherosclerosis, particularly regarding shared risk factors and overlapping pathophysiological mechanisms. This connection has led to a paradigm shift, suggesting that AS may be preventable in its early stages. Methods: This narrative review synthesizes the existing literature exploring the parallels between AS and atherosclerosis, focusing on common risk factors, pathogenic pathways, and evolving therapeutic strategies. Clinical trials and translational studies were examined to assess the effectiveness of atherosclerosis-based treatments for AS. Results: Multiple studies have confirmed the shared inflammatory, lipid-mediated, and calcific mechanisms of AS and atherosclerosis. Despite these similarities, therapeutic strategies effective in atherosclerosis, such as statin therapy, have not consistently shown benefits in AS. New medical approaches aim to delay aortic valve replacement and reduce the associated morbidity. The partially overlapping pathogenesis continues to guide future research. Conclusions: While AS and atherosclerosis share several pathogenic features, their clinical courses and treatment responses diverge. Understanding the limits and potential of their overlap may inform future preventive and therapeutic strategies. Earlier detection and targeted intervention in AS remain key goals, drawing on insights from cardiovascular disease management. Full article

Background: Social media platforms play a crucial role in contemporary healthcare, facilitating patient participation and enabling communication among healthcare workers, as well as serving as a platform for medical awareness and advocacy. Social media use among healthcare workers has increased to 91%, with 65% using it for health promotion purposes. Nonetheless, current studies have not properly and empirically explored its dimensions. Objectives: This study therefore examines social media dimensions and the productivity of healthcare workers. Methods: Leveraging the professional productivity theory and digital engagement theory, the study employs SPSS to analyze the gathered data through a partial least squares (PLS-SEM) approach to explore social media dimensions and productivity among healthcare workers in a Nigerian Tertiary Hospital. Based on a cross-sectional descriptive survey design and stratified random sampling method, 344 medical workers were analyzed. Findings: The study found that fear of missing out, information sharing, social influence, trust, and social media usage have a significant impact on the productivity of healthcare professionals. Conclusions: This research adds to the growing academic research on the capabilities of social media within the circular economic systems aimed at advancing healthcare delivery in developing economies. The research offers a method for maximizing the use of social media within healthcare settings to foster enhanced healthcare outcomes, particularly productivity. Full article

Smart healthcare establishes a safe, reliable, and efficient medical information system for the public with the help of the Internet of Things, cloud storage, and other Internet technologies. To enable secure data sharing and case-matching functions in smart healthcare, we construct a revocable identity-based matchmaking encryption with an equality test (RIBME-ET) scheme for smart healthcare. Our scheme not only ensures the confidentiality and authenticity of messages and protects the privacy of users, but also enables a cloud server to perform equality tests on encrypted ciphertexts from different identities to determine whether they contain the same plaintext and protects the confidentiality of data in the system through a user revocation mechanism. Compared with the existing identity-based encryption with equality test (IBEET) and identity-based matchmaking encryption with equality test (IBME-ET) schemes, we have improved the efficiency of the scheme and reduced communication overhead. In addition, the scheme’s security is proven in the random oracle model under the computational bilinear Diffie–Hellman (CBDH) assumption. Finally, the feasibility and effectiveness of the proposed scheme are verified by performance analysis. Full article

Background/Objectives: Misinformation significantly impacts self-care behaviors and treatment outcomes in patients with type 2 diabetes mellitus (T2DM). We investigated the prevalence and content of diabetes-related misinformation among Thai patients with T2DM, examining the influence on cognitive attitudes and intentions to share such information. Methods: We employed a mixed-methods approach, conducting initial qualitative interviews with healthcare professionals and patients with T2DM to identify key misinformation themes. These themes guided the development of a validated questionnaire that was distributed to 107 patients with T2DM. Spearman’s correlation and multiple linear regression analyses were used to assess the relationships between misinformation exposure, attitudes, and sharing intentions. Results: Misinformation was categorized into four domains: medication side effects, alternative treatments, imbalanced lifestyle, and symptom perception. Exposure to misinformation ranged from 19.6% to 94.4%, with word of mouth identified as the primary source (81.18%). Misconceptions regarding symptom perception and alternative treatments were most prevalent. Information source, especially healthcare providers (β = 0.4); personal attitudes towards misinformation (β = 0.24); and exposure level (β = 0.46) significantly influenced the intention to share misinformation. Conclusions: This study highlights the need for targeted educational interventions to address widespread misconceptions in the management of T2DM, particularly those related to symptom perception and alternative treatments. Addressing these misinformation sources may be associated with improved self-management practices and could inform strategies aimed at enhancing patient outcomes. Full article

In the era of big data, the security of information encryption systems has garnered extensive attention, particularly in critical domains such as financial transactions and medical data management. While traditional Shamir’s Secret Sharing (SSS) ensures secure integer sharing through threshold cryptography, it exhibits inherent limitations when applied to floating-point domains and high-precision numerical scenarios. To address these issues, this paper proposes an innovative algorithm to optimize SSS via type-specific coding for real numbers. By categorizing real numbers into four types—rational numbers, special irrationals, common irrationals, and general irrationals—our approach achieves lossless transmission for rational numbers, special irrationals, and common irrationals, while enabling low-loss recovery for general irrationals. The scheme leverages a type-coding system to embed data category identifiers in polynomial coefficients, combined with Bernoulli-distributed random bit injection to enhance security. The experimental results validate its effectiveness in balancing precision and security across various real-number types. Full article

The healthcare industry is witnessing a rapid rise in the adoption of wearable and implantable medical devices, including advanced electrochemical sensors and other smart diagnostic technologies. These devices are increasingly used to enable real-time monitoring of physiological parameters, allowing for faster diagnosis and more personalized care plans. Their growing presence reflects a broader shift toward smart connected healthcare systems aimed at delivering immediate and actionable insights to both patients and medical professionals. At the same time, the healthcare industry is increasingly targeted by cyberattacks, primarily due to the high value of medical information; in addition, the growing integration of ICT technologies into medical devices has introduced new vulnerabilities that were previously absent in this sector. To mitigate these risks, new international guidelines advocate the adoption of best practices for secure software development, emphasizing a security-by-design approach in the design and implementation of such devices. However, the vast and fragmented nature of the information required to effectively support these development processes poses a challenge for the numerous stakeholders involved. In this paper, we demonstrate how key features of the Malware Information Sharing Platform (MISP) can be leveraged to systematically collect and structure vulnerability-related information for medical devices. We propose tailored structures, objects, and taxonomies specific to medical devices, facilitating a standardized data representation that enhances the security-by-design development of these devices. Full article

Combining a large collection of patient data and advanced technology, healthcare organizations can excel in medical research and increase the quality of patient care. At the same time, health records present serious privacy and security challenges because they are confidential and can be breached through networks. Even traditional methods with federated learning are used to share data, patient information might still be at risk of interference while updating the model. This paper proposes the Privacy-Preserving Federated Learning with Homomorphic Encryption (PPFLHE) framework, which strongly supports secure cooperation in healthcare and at the same time providing symmetric privacy protection among participating institutions. Everyone in the collaboration used the same EfficientNet-B0 architecture and training conditions and keeping the model symmetrical throughout the network to achieve a balanced learning process and fairness. All the institutions used CKKS encryption symmetrically for their models to keep data concealed and stop any attempts at inference. Our federated learning process uses FedAvg on the server to symmetrically aggregate encrypted model updates and decrease any delays in our server communication. We attained a classification accuracy of 83.19% and 81.27% when using the APTOS 2019 Blindness Detection dataset and MosMedData CT scan dataset, respectively. Such findings confirm that the PPFLHE framework is generalizable among the broad range of medical imaging methods. In this way, patient data are kept secure while encouraging medical research and treatment to move forward, helping healthcare systems cooperate more effectively. Full article

Background/Objectives: Men choosing active surveillance (AS) for low- and intermediate risk prostate cancer (PCa) must weigh its harms and benefits against those of active treatment (AT). To understand factors influencing treatment decision-making (TDM) for and adherence to AS, we performed a systematic review. Methods: This systematic review followed the PRISMA guidelines and was registered with PROSPERO (ID CRD42024490427). A comprehensive search strategy from 1990 to 2024 was executed across multiple databases, including Medline and Embase. Studies were included if they examined factors influencing TDM for AS or active monitoring (AM) and adherence to AS/AM. Results: Of the 8316 articles identified, 223 articles were eligible for inclusion. The decision for AS was influenced by different factors, including comprehensive information about treatment options, social support, and wanting to avoid side-effects. Key reasons to choose AT over AS included a lack of information from healthcare professionals about AS and fear of disease progression. Reasons for adhering to the AS protocol included better quality of life and social support. While non-adherence to the AS protocol is prompted by, e.g., biopsy burden and uncertainty, AS discontinuation is generally a results of medical reasons (namely disease upgrading) or from anxiety and family pressure. Conclusions: Numerous factors influence men’s treatment pathway choices. Involving family members in shared decision-making and ensuring that patients have detailed information about AS as a treatment option could help to improve AS uptake. Addressing psychosocial challenges through education and family involvement could improve AS adherence. These insights can help healthcare providers by addressing men’s needs during TDM and AS. Full article

Background: Drones are rapidly establishing themselves as one of the most critical technologies. Robotics, automated machinery, intelligent manufacturing, and other high-impact technological research and applications bring up pressing ethical, social, legal, and political issues. Methods: The present research aims to present the results of a qualitative investigation that looked at perceptions of the growing socio-ethical conundrums surrounding the development of drone applications. Results: According to the obtained results, participants often share similar opinions about whether different drone applications are approved by the public, regardless of their level of experience. Perceptions of drone applications appear consistent across various levels of expertise. The most notable associations are with military objectives (73%), civil protection (61%), and passenger transit and medical purposes (56%). Applications that have received high approval include science (8.70), agriculture (8.78), and disaster management (8.87), most likely due to their obvious social benefits and reduced likelihood of ethical challenges. Conclusions: The study’s findings can help shape the debate on drone acceptability in particular contexts, inform future research on promoting value-sensitive development in society more broadly, and guide researchers and decision-makers on the use of drones, as people’s attitudes, understanding, and usage will undoubtedly impact future advancements in this technology. Full article

Background: The treatment options for HER2-negative metastatic breast cancer include targeted therapies, cytotoxic chemotherapies, and immunotherapy. However, limited specificity and inevitable resistance highlight the need for novel agents. Antibody–drug conjugates (ADCs), such as trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG), represent a breakthrough by selectively delivering cytotoxic agents to tumor cells, potentially improving the therapeutic index. Despite demonstrated efficacy, ADCs present toxicity profiles similar to conventional chemotherapy, alongside unique adverse events. In clinical practice, oncologists may face scenarios where both T-DXd and SG are treatment options in HER2-negative mBC. To enable shared decision-making, it is crucial to present a comprehensive overview that includes both efficacy data and detailed toxicity profiles. Our objective was to provide a pooled and informative synthesis of toxicities from pivotal studies, including graphical representations, to support informed, patient-centered medical decisions. Methods: We reviewed safety data from phase 3 clinical trials in HER2-negative mBC: DESTINY-Breast04/DESTINY-Breast06 for T-DXd and ASCENT/TROPICS-02 for SG. Adverse event (AE) profiles, including frequency and severity, were extracted, and weighted means were calculated. Emerging ADCs such as datopotamab deruxtecan and patritumab deruxtecan were considered to contextualize future therapeutic decisions. Results: Tables, bar plots and radar plots were generated. T-DXd demonstrated high rates of nausea (69.2%), fatigue (47.2%), and neutropenia (35.6%), with 52.7% experiencing grade ≥ 3 AEs. Notably, pneumonitis occurred in 10.7%, with grade ≥ 3 in 2.6%. SG showed a distinct AE profile, with higher incidences of neutropenia (67.1%), with grade ≥ 3 in 51.3%, and diarrhea (60.8%). Conclusions: The choice between ADCs in HER2-negative metastatic BC when both T-DXd and SG are treatment options should consider toxicity profiles to optimize patient-centered treatment strategies. Tailoring ADC selection based on individual tolerance and preferences is critical for shared decision-making, and future research should focus on assessing the utility and acceptability of such clinical tools to guide treatment selection. Full article

Conventional adhesively bonded joints, such as single-lap, curved-lap, wavy-lap, double-lap, stepped-lap, and scarf joints, are widely used for aerospace, automotive, and medical applications. These adhesively bonded joints exhibit different load transfer mechanisms and stress distributions within adhesive layers, which depend primarily on their geometries and mechanical properties of bonded materials. As such, joint geometry and material properties play a critical role in determining the capability of the joints to withstand high loads, resist fatigue, and absorb energy under impact loading. This paper investigates the effects of geometry and material dissimilarity on the performance of both conventional bonded and interlocking joints under tensile loading based on the information available in the literature. In addition, bonding and load transfer mechanisms were analysed in detail. It was found that stress concentration often occurs at free edges of the adhesive layer due to geometric discontinuities, while most of the load is carried by these regions rather than its centre. Sharp corners further intensify resulting stresses, thereby increasing the risk of joint failure. Adhesives typically resist shear loads better than peel loads, and stiffness mismatches between adherents induce an asymmetric stress distribution. Nonetheless, similar materials promote symmetric load sharing. Among conventional joints, scarf joints provide the most uniform load distribution. In interlocking joints such as dovetail, T-slot, gooseneck, and elliptical types, the outward bending of the female component under tension can lead to mechanical failure. Full article

The gender gap in drug use is narrowing in regions where access to criminalized substances, such as opioids, is increasing. While research shows that substance use is gendered, less is known about the cultural norms and values shaping women’s drug use, as most studies focus on men. Cross-national comparisons of cultural models of addiction are needed to better understand how addiction is perceived and to inform culturally responsive treatment approaches for women. This study examined cultural models of addiction among reproductive-aged women receiving treatment for substance misuse in London, Toronto, and Delhi. Participants completed a semi-structured questionnaire with open-ended and free-list prompts. Findings revealed shared cultural models attributing drug use to psychological factors, such as self-medicating to manage negative emotions or enhance positive ones, as well as relational, developmental, and biological influences. In conclusion, the study highlights the importance of incorporating cultural models into research and treatment. By using an inductive approach to explore meanings surrounding drug use among people in recovery, researchers can better understand how interventions are received and interpreted through existing internal frameworks. Full article

Background/Objectives: We aimed to review pediatric patients who underwent surgical treatment for posterior fossa tumors and to share our experience with the various types of dural grafts used in these patients. Methods: We carried out a retrospective study on pediatric patients who received surgical treatment for posterior fossa tumors and underwent duraplasty using either an autograft or a xenograft from January 2018 to December 2022. Data were gathered from patients’ medical records, encompassing demographic details. Additional information included tumor locations and the extent of resection. Factors such as postoperative complications like meningitis, pseudo-meningocele, and hydrocephalus were also noted. Results: Our cohort included 50 patients, 13 of whom underwent surgeries with autografts and 37 had xenografts. The patients’ tumors were in various areas, including intraventricular or those extending into the ventricle (31) and intracerebellar (17) and extra-axial (2) cases. Subtotal resection occurred in 8 cases, near-total resection in 9, and gross-total resection in 33. Postoperatively, meningitis occurred in 12 patients, pseudo-meningocele in 13, and hydrocephalus in 10, with 9 requiring V/P placement. Conclusions: In conclusion, techniques for dural closure hold great significance in neurosurgery, particularly during pediatric posterior fossa surgeries. Although the modest size of the autograft cohort limited statistical power, our epidural onlay fascia lata autograft produced fewer postoperative complications than the bovine xenograft and achieved outcomes comparable to those reported for watertight closure. Full article