Ransomware attacks in healthcare: vulnerabilities and technical countermeasures (Preprint)

2021 ◽  
Author(s):  
Hyeokchan Kwon ◽  
Byungho Chung
Keyword(s):  
Medical Devices ◽  
The United States ◽  
Point Of View ◽  
University Hospital ◽  
Security Technology ◽  
Intrusion Prevention ◽  
Medical Institutions ◽  
Intrusion Prevention System ◽  
The Cost ◽  
The University

UNSTRUCTURED Ransomware attacks, such as Conti, Ryuk, Petya, and Sodinokibi, that target medical institutions are increasing rapidly. In 2020, in the United States., ransomware attacks affected over 600 separate clinics, hospitals, and organizations, and more than 18 million patient records. The cost of these attacks is estimated to be almost $21 billion USD [1]. The first death related to ransomware attacks was reported by the University Hospital of Düsseldorf in Germany in 2020. The aim of this literature is to study vulnerabilities of cybersecurity in medical institutions, characteristics of ransomware aimed at medical institutions, and technical measures to prevent ransomware. From a security point of view, one of the most important targets of hackers against hospitals is medical devices. Many medical devices in hospitals are equipped with outdated software that is vulnerable to security and have many restrictions on security patches/updates. In addition, it is not easy to install even security functions such as antivirus due to the specificity of medical devices where availability is most important. As introduced in the Medjack report issued by TrapX Labs, in many cases, attackers target medical devices that are relatively insecure and then penetrate deep into more critical network infrastructure, such as EMR servers [2]. In this literature, we discuss various considerations to respond to ransomware while ensuring the availability of medical devices, and present AI-MDIPS (AI-based medical device intrusion prevention system) technology, a non-invasive and manageable security technology applicable to medical devices developed by the Korean government

User Evaluation of an Integrated Medical Workstation for Clinical Data Analysis

1993 ◽  
Vol 32 (05) ◽  
pp. 365-372 ◽  
Author(s):  
T. Timmeis ◽  
J. H. van Bemmel ◽  
E. M. van Mulligen
Keyword(s):  
Data Analysis ◽  
Clinical Research ◽  
Clinical Data ◽  
University Hospital ◽  
User Evaluation ◽  
Scientific Staff ◽  
Medical Institutions ◽  
Clinical Data Analysis ◽  
Research Problems ◽  
The University

AbstractResults are presented of the user evaluation of an integrated medical workstation for support of clinical research. Twenty-seven users were recruited from medical and scientific staff of the University Hospital Dijkzigt, the Faculty of Medicine of the Erasmus University Rotterdam, and from other Dutch medical institutions; and all were given a written, self-contained tutorial. Subsequently, an experiment was done in which six clinical data analysis problems had to be solved and an evaluation form was filled out. The aim of this user evaluation was to obtain insight in the benefits of integration for support of clinical data analysis for clinicians and biomedical researchers. The problems were divided into two sets, with gradually more complex problems. In the first set users were guided in a stepwise fashion to solve the problems. In the second set each stepwise problem had an open counterpart. During the evaluation, the workstation continuously recorded the user’s actions. From these results significant differences became apparent between clinicians and non-clinicians for the correctness (means 54% and 81%, respectively, p = 0.04), completeness (means 64% and 88%, respectively, p = 0.01), and number of problems solved (means 67% and 90%, respectively, p = 0.02). These differences were absent for the stepwise problems. Physicians tend to skip more problems than biomedical researchers. No statistically significant differences were found between users with and without clinical data analysis experience, for correctness (means 74% and 72%, respectively, p = 0.95), and completeness (means 82% and 79%, respectively, p = 0.40). It appeared that various clinical research problems can be solved easily with support of the workstation; the results of this experiment can be used as guidance for the development of the successor of this prototype workstation and serve as a reference for the assessment of next versions.

Ultra-resistant schizophrenia and potentiation strategies

2017 ◽  
Vol 41 (S1) ◽  
pp. s834-s834 ◽  
Author(s):  
S. Khouadja ◽  
R. Ben Soussia ◽  
S. Younes ◽  
A. Bouallagui ◽  
I. Marrag ◽  
...  
Keyword(s):  
Treatment Resistance ◽  
Cost Benefit ◽  
Clinical Excellence ◽  
University Hospital ◽  
Dsm Iv ◽  
Competing Interest ◽  
A Prospective Study ◽  
Psychiatric Department ◽  
The Cost ◽  
The University

IntroductionTreatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.ObjectiveThe aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.MethodologyThis is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.Resultswe have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.ConclusionEvery potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Effects of certain disinfectants and antibiotics on biofilm formation by Staphylococcus aureus isolated from medical devices at the University Hospital Center of Sidi Bel Abbes, Algeria

2020 ◽  
Vol 21 (4) ◽  
pp. 304-310
Author(s):  
I. Kara Terki ◽  
H. Hassaine ◽  
A. Kara Terki ◽  
B. Nadira ◽  
N. Kara Terki ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Devices ◽  
Biofilm Formation ◽  
University Hospital ◽  
Centre Hospitalier ◽  
Treatment And Prevention ◽  
Centre Hospitalier Universitaire ◽  
Dispositif Médical ◽  
The University ◽  
Hospital Center

Background: Staphylococcus aureus is one of the species of bacteria most frequently isolated from medical devices. The ability to produce biofilm is an important step in the pathogenesis of these staphylococci infection, and biofilm formation is strongly dependent on environmental conditions as well as antibiotics and disinfectants used in the treatment and prevention of infections.Methodology: In this study, 28 S. aureus isolated from medical devices at the University Hospital Center of Sidi Bel Abbes in Northwestern Algeria were tested for biofilm formation by culture on Red Congo Agar (RCA). The tube method (TM) and tissue culture plate (TCP) techniques were also used to investigate the effect of penicillin, ethanol and betadine on pre-formed biofilm.Results: Nineteen S. aureus isolates produced biofilm on the RCA and 7 produced biofilms by the tube method, 2 of which were high producer. In addition, 9 S. aureus isolates produced biofilm on polystyrene micro-plates, and in the presence of penicillin and ethanol, this number increased to 19 and 11 biofilm producing S. aureus isolates respectively. On the other hand, no biofilm was formed in the presence of betadine.Conclusion: It is important to test for biofilm formation following an imposed external constraint such as disinfectants and antibiotics in order to develop new strategies to combat bacterial biofilms but also to better control their formation. Keywords : Staphylococcus aureus, biofilm, medical device, disinfectant, antibiotic French Title: Effets de certains désinfectants et antibiotiques sur la formation de biofilms par Staphylococcus aureus isolé à partir de dispositifs médicaux au Centre Hospitalier Universitaire de Sidi Bel Abbès, Algérie Contexte: Staphylococcus aureus est l'une des espèces de bactéries les plus fréquemment isolées des dispositifs médicaux. La capacité de produire du biofilm est une étape importante dans la pathogenèse de ces infections à staphylocoques, et la formation de biofilm dépend fortement des conditions environnementales ainsi que des antibiotiques et des désinfectants utilisés dans le traitement et la prévention des infections. Méthodologie: Dans cette étude, 28 S. aureus isolés à partir de dispositifs médicaux au Centre hospitalier universitaire de Sidi Bel Abbès dans le nord-ouest de l'Algérie ont été testés pour la formation de biofilm par culture sur gélose rouge du Congo (RCA). La méthode des tubes (TM) et les techniques de plaques de culture tissulaire (TCP) ont également été utilisées pour étudier l'effet de la pénicilline, de l'éthanol et de la bétadine sur le biofilm préformé. Résultats: Dix-neuf isolats de S. aureus ont produit un biofilm sur le RCA et 7 ont produit des biofilms par la méthode des tubes, dont 2 étaient très productifs. De plus, 9 isolats de S. aureus ont produit du biofilm sur des microplaques en polystyrène, et en présence de pénicilline et d'éthanol, ce nombre est passé à 19 et 11 isolats de S. aureus producteurs de biofilm respectivement. En revanche, aucun biofilm ne s'est formé en présence de bétadine. Conclusion: Il est important de tester la formation de biofilm suite à une contrainte externe imposée comme les désinfectants et les antibiotiques afin de développer de nouvelles stratégies pour lutter contre les biofilms bactériens mais aussi pour mieux contrôler leur formation. Mots-clés: Staphylococcus aureus, biofilm, dispositif médical, désinfectant, antibiotique  

scholarly journals Locked intramedullary nailing technique of the femur without brilliance amplifier at the trauma and orthopedics department of the university hospital of peace series on 35 cases during 1 year

2021 ◽  
Vol 13 (5) ◽  
pp. 95-97
Author(s):  
Augustin Delange Hendrick ◽  
Almenord Pharol ◽  
Khawly Clifford PG ◽  
Augustin Delange ◽  
Pierre Marie Woolley
Keyword(s):  
Hospital Stay ◽  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Patient Morbidity ◽  
Duration Of Hospitalization ◽  
The Cost ◽  
The University

Femoral fractures increase the length of hospital stay for our patients for several reasons such as lack of blood, economic resources, and lack of infrastructure. The use of a C-arm has been shown to reduce patient morbidity due to early functional recovery and reduced hospital stay. Objective: To develop an intramedullary nailing technique without c-arm with a closed focus to reduce the duration of hospitalization of its patients as well as the cost related to the equipment used for follow-up. Methodology: prospective study on 35 patients for 1 year August 2020 to August 2021 Results: We followed 35 patients in which the mean age was 37.83 years with extremes of 18 and 78 years. The male sex predominates 21 against 14 women or 60% against 40% respectively. The sex ratio is 1.5. A total of 19 diaphyseal fractures (54.3%) were nailed, 9 supracondylar (25.7%) and 7 subtrochanteric (20%). Twenty-seven were closed fractures (71.1%), and 8 were open fractures (22.9%). The length of hospitalization was less than 3 days for 30 patients (85.7%), and more than 3 days for 5 patients (14.3%). Conclusion: We recommend that we promote this closed-hearth technique because it improves the postoperative follow-up of patients. Additionally, it would reduce exposure to radiation from c-arm in hospitals that have this equipment.

scholarly journals Contribution to the development of pedagogical learning in international entrepreneurship

2018 ◽  
Author(s):  
Latifa HORR
Keyword(s):  
Training Program ◽  
Small Businesses ◽  
International Entrepreneurship ◽  
The United States ◽  
Point Of View ◽  
Behavioral Models ◽  
Production Technologies ◽  
College Of Business ◽  
The University ◽  
Pedagogical Learning

In order to understand and describe the internationalization behavior of companies, the first research carried out before the 1970s focused on large multinationals whose internationalization strategies were made possible by heavy investments. Other research on the internationalization of SMEs, conducted in the United States and Europe in the early 1980s, has given rise to behavioral models in stages where size is a barrier to internationalization. However, we find that very small businesses (TPE), newly created, inexperienced and with limited resources, internationalize and thwart the classic models of internationalization by scrambling the stages. Age, size and resources are no longer barriers to internationalization. This makes Cavusgil (1980) say that the gradual internationalization of companies has become obsolete. Veilleux and Ferro (2010) confirm that today, between 1 and 2% of new businesses are international when they are created and 76% have export prospects in the first two years. And the majority of research carried out since the 1990s deals with the precocity and rapidity of this internationalization from a point of view external to the company such as the saturation of local and / or national markets, the liberalization of international markets or the aid provided by governments, competitive pressure; and from an internal factors point of view such as the role of the manager and his various experiences, the support of his social networks, the use of new communication and production technologies, the characteristics of the product. However, there are very few works that address the internationalization of these VSEs through pedagogical learning in international entrepreneurship; learning mediated by the University, quickly enabling these companies to position themselves on an international market. The object of this research is precisely the questioning of the relevance of this learning; and this, through our participation in the training "International Entrepreneurship and Development of the Global Enterprise" initiated by the "College of Business" of the University of Indiana (ISU). It is a training program, offered by the ISU "College of Business", bringing together Universities from four other continents: Europe, America, Asia, Africa & l 'Oceania. A mixed group of teacher-researchers and researchers from these different universities benefited from this training program.

scholarly journals SYNTHESIS OF THE ORGANIZATION OF TREATMENT, RESEARCH AND TEACHING (CASE STUDY AT THE UNIVERSITY HOSPITAL IN AACHEN)

2021 ◽  
pp. 349-358
Author(s):  
Maryna Lienkova ◽  
Irina Bulakh
Keyword(s):  
Medical Center ◽  
Multidisciplinary Treatment ◽  
University Hospital ◽  
Survey Analysis ◽  
University Hospitals ◽  
Medical Institutions ◽  
Hospital Patients ◽  
Student Training ◽  
Treatment Research ◽  
The University

The article considers and analyzes the existing in the world, but new for Ukraine, type of healthcare institutions - a university hospital, which today is an example of one of the largest and best university hospitals in Germany - the Medical Center of the University of Aachen. The planning and functional structure of the university hospital and special design approaches that contributed to its design and development are analyzed. The purpose of the article is to illustrate an innovative approach for our state to the organization of medical institutions and to emphasize the importance of their implementation in the domestic healthcare system. The research methodology is based on the systematization and analysis of data from various information sources, as well as on the method of sociological survey (analysis of reviews). The article considers the features of the structure of the University Hospital Aachen, namely the multidisciplinary treatment, research and student training, which are combined in one institution. According to hospital patients, the only drawback of this structure is the frequent long wait for visitors. This is probably due to the significant daily flow of patients of varying complexity and, consequently, the shortcomings of the managerial approach. However, at the same time, the hospital has many advantages, which were highlighted in the article.  

Commentary: An African Perspective on the Doha Round Negotiations

2005 ◽  
Vol 5 (4) ◽  
pp. 1850076
Author(s):  
Kwame Bawuah-Edusei
Keyword(s):  
Medical Center ◽  
The United States ◽  
University Hospital ◽  
Community Leader ◽  
Washington Dc ◽  
Medical Sciences ◽  
Energy Company ◽  
Army Hospital ◽  
Howard University ◽  
The University

An African commentary on the Doha Development Round. Kwame Bawuah-Edusei is Ambassador of Ghana to Switzerland and Austria and Permanent Representative of Ghana to the UN offices and international organizations in Geneva, including the WTO. He obtained his MD degree in 1982 at the University of Science and Technology, School of Medical Sciences, Kumasi Ghana, worked in Ghana for two years, and later studied in the United States. He specialized in Family Medicine at Howard University Hospital, Washington DC, and worked as a physician for the Dewitt Army Hospital in Fort Belvoir, Virginia. He subsequently practiced at Educe Medical Center in Alexandria, Virginia. During this period he was active in promoting business in his native Ghana and extensively involved in humanitarian work in the deprived Northern part of his country. He became a community leader in North America and was instrumental in institutionalizing democracy in Ghana. He became a Director of the EO group, an energy Company, and President of Educe Incorporated in Ghana.

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