Automated Security Assessment Framework for Wearable BLE-enabled Health Monitoring Devices

The growth of IoT technology, increasing prevalence of embedded devices, and advancements in biomedical technology have led to the emergence of numerous wearable health monitoring devices (WHMDs) in clinical settings and in the community. The majority of these devices are Bluetooth Low Energy (BLE) enabled. Though the advantages offered by BLE-enabled WHMDs in tracking, diagnosing, and intervening with patients are substantial, the risk of cyberattacks on these devices is likely to increase with device complexity and new communication protocols. Furthermore, vendors face risk and financial tradeoffs between speed to market and ensuring device security in all situations. Previous research has explored the security and privacy of such devices by manually testing popular BLE-enabled WHMDs in the market and generally discussed categories of possible attacks, while mostly focused on IP devices. In this work, we propose a new semi-automated framework that can be used to identify and discover both known and unknown vulnerabilities in WHMDs. To demonstrate its implementation, we validate it with a number of commercially available BLE-enabled enabled wearable devices. Our results show that the devices are vulnerable to a number of attacks, including eavesdropping, data manipulation, and denial of service attacks. The proposed framework could therefore be used to evaluate potential devices before adoption into a secure network or, ideally, during the design and implementation of new devices.

Clinical and economic benefits of continuous blood glucose monitoring devices

The main intervention to reduce the macro-and microvascular complications of diabetes mellitus (DM) remains to achieve better long-term glycemic control. We have discussed the clinical and economic advantages of using continuous glucose monitoring (CGM) devices for type 1 DM and type 2 DM (T1DM and T2DM) based on data from relevant studies in the literature. Our findings show that using these modalities is associated with remarkable outcomes, including reduced HbA1c levels and enhanced glycemic control among patients with T1DM and T2DM. This can enhance the quality of care and life for diabetic patients and intervene against the development of serious complications and hypoglycemia-related adverse events. The cost of routinely using these devices might seem relatively high. However, the estimated cost benefits are usually higher as they can significantly reduce hospitalization rates due to hypoglycemia and the frequency of diabetic therapy malpractices, which are frequently encountered. However, not many studies have reported these outcomes, indicating the need to conduct future relevant studies.

Remote Patient Monitoring in Diabetes: How to Acquire, Manage, and Use All of The Data

The ability of patients and health care providers to use various forms of technology for general health has significantly increased in the past several years with the expansion of telehealth, digital applications, personal digital devices, smartphones, and other Internet-connected platforms and devices. For individuals with diabetes, this also includes connected blood glucose meters, continuous glucose monitoring devices, and insulin delivery systems. In this article, the authors outline several steps to facilitate the acquisition, management, and meaningful use of digital diabetes data that can enable successful implementation of both diabetes technology and telehealth services in primary care clinics.

Development of Flexible, Conductive and Biocompatible Chitosan-Based Miniaturized Bioelectrodes for Enzymatic Glucose Biofuel Cells

The need for new clean energy sources for portable devices in biomedical, agro-food industry and environmental related sectors boosts scientists towards the development of new strategies for energy harvesting for their application in biodevices development. In this sense, enzymatic biofuel cells (BFCs) have gained much attention in the last years. This work faces the challenge of develop new generation of BFCs able to be adapted to remote and personal monitoring devices within the framework of wearable technologies. To this aim, one of the main challenges consists of the development of conductive and biocompatible electrodes, which constitute a challenge itself due to the non-conductive capabilities of most of the biocompatible supports. Additionally, bioelectrodes may achieve good mechanical properties and resilience in order to be suitable for the envisioned application, which involves exposure to deformation during long-term use. Furthermore, it is desirable that the systems developed are versatile enough to be adapted to miniaturized supports for new personal wearable devices development. In the present work, self-standing chitosan-carbon black membranes have been synthesized and modified with suitable enzymes for the assembly of an enzymatic glucose BFC. The membranes have been adapted to be integrated in miniaturized interdigitated gold electrodes as the step forward to miniaturized systems, modified with enzymes and metallic particles clusters and tested for energy harvesting from glucose solutions. The miniaturized system produces a power density of 0.64 µW/cm2 that is enhanced to 2.75 µW/cm2 in the presence of the metallic clusters, which constitute a 76% incensement. Such preliminary demonstrations highlight the good response of metals in bioelectrode configuration. However, energy harvesting real application of the developed miniaturized electrodes need still improvements but pave the way for the use of BFC as an energy source in wearable technologies due to their good mechanical, electrical and biocompatible properties.

Awareness and use of PPE among radiographic workers working in some selected Government and Private Hospital in Dhaka City

Aim: This was a descriptive cross sectional study with an aim to find out the occurrences of awareness and use of PPE among the radiographic workers. Methods: The study was conducted among 80 radiographic workers working in 30 different X-ray installations in Dhaka city. Data were collected by direct interviewing of the respondents by using structured questionnaires. Result: Out of all respondents, 93.8%were male and 6.2% were female. Fifty two percent were within the age group 31-40 years. Forty-five percent of all the respondents had higher academic qualification on radiography and eighty-six percent of them were trained in radiography. Ninetynine percent of the workers were aware about using personal protective equipments and Ninetyseven percent were aware about using monitoring devices. However PPE was used by ninety-two percent and radiation monitoring devices by only thirty-six percent. Conclusion: Appropriate protective devices and monitoring devices were not available in most the installations. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 114-119

Modeling Digital Healthcare Services Using NLP and IoT in Smart Cities

Smart cities shall have computerized health services to help the treatment of health issues based on a centralized framework. These computerized healthcare services would involve the patient, medical support staff, and doctors. They would have voice recognition clinical staff management, smart health monitoring devices, smart medical reports, and smart medical treatment based on the internet of things (IoT) and natural language processing (NLP). This chapter shall describe the digital healthcare services in the context of NLP and IoT that would help in the improvement of quality of life for people living in smart cities. The authors shall discuss a possible case study on NLP and IoT in digital healthcare in the smart cities.

Digitally enabled flash glucose monitoring for inpatients with COVID-19: Feasibility and pilot implementation in a teaching NHS Hospital in the UK

Background COVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19. Methods Inpatients at University Hospitals Coventry & Warwickshire (UHCW) NHS Trust with COVID-19 and diabetes were considered for digitally enabled flash glucose monitoring during their hospitalization. Glucose monitoring data were analysed, and potential associations were explored between relevant parameters, including time in hypoglycaemia, hyperglycaemia, and in range, glycated haemoglobin (HbA1c), average glucose, body mass index (BMI), and length of stay. Results During this pilot, digital flash glucose monitoring devices were offered to 25 inpatients, of whom 20 (type 2/type 1: 19/1; mean age: 70.6 years; mean HbA1c: 68.2 mmol/mol; mean BMI: 28.2 kg/m2) accepted and used these (80% uptake). In total, over 2788 h of flash glucose monitoring were recorded for these inpatients with COVID-19 and diabetes. Length of stay was not associated with any of the studied variables (all p-values >0.05). Percentage of time in hyperglycaemia exhibited significant associations with both percentage of time in hypoglycaemia and percentage of time in range, as well as with HbA1c (all p-values <0.05). The average glucose was significantly associated with percentage of time in hypoglycaemia, percentage of time in range, and HbA1c (all p-values <0.05). Discussion We report the first pilot inpatient use of digital flash glucose monitors in an NHS hospital to support care of inpatients with diabetes and COVID-19. Overall, there are strong arguments for the inpatient use of these devices in the COVID-19 setting, and the findings of this pilot demonstrate feasibility of this digitally enabled approach and support wider use for inpatients with diabetes and COVID-19.