Secure and Flexible Key Protected Identity Framework for Mobile Devices

Mobile or IOT based applications are emerging rapidly across the globe and there is a massive digital transformation happening within each country. It is a need of an hour to improve and protect digital identity during online transactions through handheld devices. This paper proposes a Mobile ID solution based on Mobile-originated PKI without the need for the actual identity card or a card reader. The solution proposed focuses on security, privacy, and usability using open standards which will protect Personally Identifiable Information (PII) over handheld devices. The proposed mobile ID solution has better cost-efficacy and privacy than today’s scenario. It also explicates the Mobile ID solution with established secure identity among users, authorities, other organizations of public, and private sectors.

The Costs of Complications and Unplanned Readmissions after Pancreatoduodenectomy for Pancreatic and Periampullary Tumors: Results from a Single Academic Center

Background/Objectives: Complications after pancreatoduodenectomy (PD) lead to unplanned readmissions (UR), with a two- to threefold increase in admission costs. In this study, we aimed to create an understanding of the costs of complications and UR in this patient group. Furthermore, we aimed to generate a detailed cost overview that can be used to build a theoretical model to calculate the cost efficacy for prehabilitation. Methods: A retrospective cohort analysis was performed using the Dutch Pancreatic Cancer Audit (DPCA) database of patients who underwent a PD at our institute between 2013 and 2017. The total costs of the index hospital admission and UR related to the PD were collected. Results: Of the 160 patients; 35 patients (22%) had an uncomplicated course; 87 patients (54%) had minor complications, and 38 patients (24%) had severe complications. Median costs for an uncomplicated course were EUR 25.682, and for a complicated course, EUR 32.958 (p = 0.001). The median costs for minor complications were EUR 30.316, and for major complications, EUR 42.664 (p = 0.001). Costs were related to the Comprehensive Complication Index (CCI). The median costs of patients with one or more UR were EUR 41.199. Conclusions: Complications after PD led to a EUR 4.634–EUR 16.982 (18–66%) increase in hospital costs. A UR led to a cost increase of EUR 12.567 (44%). Since hospital costs are directly related to the CCI, reduction in complications will lead to cost-effectiveness.

Joint Preservation Using Orthobiologic Therapies in Osteoarthritis

Osteoarthritis is estimated to be the most prevalent musculoskeletal disorder in the world. Estimates show that the disease is prevalent in 18% and 10% in women and men that are aged >60 years old. The quality of life of the affected patients can also be significantly impacted due to the associated morbidities and functional loss. Many interventions have been proposed to preserve the joint and enhance the functional outcomes in patients with osteoarthritis. In the present literature review, we have discussed the different orthobiologic therapies for patients with osteoarthritis for joint preservation and subsequent improvement in the functional and pain outcomes. Variable modalities that have been proposed in the literature include Bone Marrow Aspirate Concentrate (BMAC), gene therapy and platelet rich plasma (PRP). All of these modalities were reported with favorable outcomes and minimal complications. PRP has been reported to have a clinical efficacy that is boosed when co-administered with hyaluronic acid. However, it should be noted that the clinical efficacy is limited in the long term, and administration is continuously required. On the other hand, gene therapy is a promising technique that offers maintained favorable outcomes with no adverse events. However, further studies are still needed to indicate the effectiveness and cost-efficacy of this approach.

Multiple Methods of Monitoring Cats at a Landscape-scale

Feral cats are both difficult to manage and harder to monitor. We analysed the cost-efficacy of monitoring the pre- and post-bait abundance of feral cats via camera-traps or track counts using four years of data from the Matuwa Indigenous protected Area. Additionally, we report on the recovery of the feral cat population and the efficacy of subsequent Eradicat® aerial baiting programs following 12 months of intensive feral cat control in 2019 that consisted of aerial baiting and leg-hold trapping. Significantly fewer cats were captured in 2020 (n = 8) compared to 2019 (n = 126). Pre-baiting surveys for 2020 and 2021 suggested that the population of feral cats on Matuwa was very low, at 5.5 and 4.4 cats/100 km respectively, which is well below our target threshold of 10 cats/100 km. Post-baiting surveys then recorded 3.6 and 3.0 cats/100 km respectively, which still equates to a 35% and 32% reduction in cat activity. Track counts recorded significantly more feral cats than camera traps and were cheaper to implement. We recommend that at least two methods of monitoring cats be implemented to prevent erroneous conclusions.

Comparing the clinical performance and cost efficacy of [68Ga]Ga-PSMA-11 and [18F]PSMA-1007 in the diagnosis of recurrent prostate cancer: a Markov chain decision analysis

Purpose Amongst others, [68Ga]Ga-PSMA-11 and [18F]PSMA-1007 are available for the detection of recurrent prostate cancer (rPC). There are currently limited data comparing the performance of these two radioligands with respect to clinical outcomes or their cost efficacy, which this study aims to address. Methods Two hundred and forty-four patients undergoing PSMA PET/CT for rPC were retrospectively analysed for this study (one hundred and twenty two with each radiopharmaceutical) to generate rates of PET positivity, negativity and unclear findings. Patients underwent follow-up to determine the rate of additional examinations and to confirm PET findings. A Markov chain decision analysis was implemented to model clinical decision-making processes and to analyse clinical performance of the two tracers. We determine their clinical cost efficacies using cost data from several countries where both radiotracers are in routine use. Results The PET positivity rate was non-significantly higher for [18F]PSMA-1007 compared to [68Ga]Ga-PSMA-11 (91.8% vs. 86.9%, p = 0.68), whereas the rate of uncertain findings was significantly greater (17.2% vs. 8.25%, p = 0.02). The probability of a true positive finding was higher for [68Ga]Ga-PSMA-11 (0.90, 95% CI 0.70-0.98) vs. [18F]PSMA-1007 (0.81, 95% CI 0.66–0.91). A significantly (p < 0.0001) higher PPV for [68Ga]Ga-PSMA-11 (0.99, 95% CI 0.99–1.0 vs. 0.86) was found compared to [18F]PSMA-1007 (0.86, 95% CI 0.82–1.00). Intervention efficacy analysis favoured [68Ga]Ga-PSMA-11, where the number needed to image (to achieve a true positive finding) was 10.58 and the number needed to image to harm (to achieve a false positive finding) was − 8.08. A cost efficacy analysis favours [68Ga]Ga-PSMA-11 in three of the four jurisdictions analysed where health economic data was available (Switzerland, Israel, Australia) and [18F]PSMA-1007 in one jurisdiction (Denmark). Conclusion The analysis reveals a non-significantly higher PET positivity rate for [18F]PSMA-1007, but finds significantly greater rates of uncertain findings and false positive findings when compared to [68Ga]Ga-PSMA-11. We find differences in the two tracers in terms of clinical performance and cost efficacy. The method presented herein is generalisable and can be used with clinical or cost data for other countries or tracers.

Retrospective study of Parajump injuries in Indian Armed Forces

Introduction: A number of studies on military and civil parachuting injuries have been published in the past. Most of the studies place the incidence of parachuting injuries to vary between 0.22% and 0.89%. The profile of injuries sustained during jumps by Indian paratroopers from Paratrooper Training School (PTS), Agra, between 2013 and 2019 was analyzed. Material and Methods: A retrospective analysis of Indian military parachuting injuries was done to assess injury patterns from the records of static line and combat free fall jumps, available at the PTS. The data pertaining to 270 injuries sustained from 256 jumps were analyzed in terms of number of jumps by each paratrooper, type of course/ mission, age, time of the of jump (day/ night), type of parachute used, wind speed at the time of drop, terrain on which the paratrooper landed, the location / part of body injured, the diagnosis, and finally the possible modality of injury using descriptive statistics. Results: The incidence of injuries ascertained from the records varied from 0.054% to 0.10% with a mean incidence of 0.083% from 306,986 jumps recorded over 7 years. Most injuries were related to refresher jumps and static line jumps. There were three fatalities recorded in this period, all due to failure of main and standby parachutes. Most of the injuries were sustained at the time of landing (218, 86.17%). Lower limb injuries accounted for maximum injuries (109, 40.37%), followed by truncal injuries 95 (35.19%) and upper limb injuries 33 (12.22%). Conclusion: The study brings out an interesting aspect of significantly less military parachuting injuries seen in the present study vis-à-vis reported in literature. A high degree of physical fitness and rigorous training are probably responsible for this low incidence. Increasing the duration of refresher training and physical conditioning may further reduce the occurrence of injuries. A cost-efficacy analysis of the same may be done before effecting changes in the training programme.

A Critical Review on Pulsed Electric Field: A Novel Technology for the Extraction of Phytoconstituents

Different parts of a plant (seeds, fruits, flower, leaves, stem, and roots) contain numerous biologically active compounds called “phytoconstituents” that consist of phenolics, minerals, amino acids, and vitamins. The conventional techniques applied to extract these phytoconstituents have several drawbacks including poor performance, low yields, more solvent use, long processing time, and thermally degrading by-products. In contrast, modern and advanced extraction nonthermal technologies such as pulsed electric field (PEF) assist in easier and efficient identification, characterization, and analysis of bioactive ingredients. Other advantages of PEF include cost-efficacy, less time, and solvent consumption with improved yields. This review covers the applications of PEF to obtain bioactive components, essential oils, proteins, pectin, and other important materials from various parts of the plant. Numerous studies compiled in the current evaluation concluded PEF as the best solution to extract phytoconstituents used in the food and pharmaceutical industries. PEF-assisted extraction leads to a higher yield, utilizes less solvents and energy, and it saves a lot of time compared to traditional extraction methods. PEF extraction design should be safe and efficient enough to prevent the degradation of phytoconstituents and oils.

Systematic treatment and prevention of cardiac digoxin toxicity

Digoxin has a narrow therapeutic index, such as complicated pharmacokinetics and dynamics. Many drug interactions may occur when the administration of one drug alters the clinical effects of another. As a result, digoxin toxicity can be a common condition within clinical settings that might lead to the development of many morbidities and even mortality. Many studies were published to investigate the efficacy and safety of different management modalities to enhance the outcomes that follow digoxin administration. The aim of the study was to discuss the approaches to systematically treat and prevent the development of cardiac digoxin toxicity. The findings are based on evidence from previous studies in the literature. To be specific, Fab fragments are the most effective modalities that can be used to treat severe cases within ideal periods. However, evidence regarding their administration for asymptomatic or mild cases is still poor regarding the cost-efficacy and the development of serious adverse events. Physicians should primarily care for a better intervention as it is usually associated with a significantly more enhanced prognosis and clinical outcomes. Nevertheless, adequate monitoring of the patients and evaluation of their personal and medical history are important steps in the process, and further approaches are still needed. Also, detailed information about our intended outcomes is furtherly discussed within the manuscript.

The Additional Value of Lung Cancer Screening Program in Identifying Unrecognized Diseases

Background: A systematic examination of low-dose CT (LDCT) scan, beside lung nodules, may disclose the presence of undiagnosed diseases, improving the efficacy and the cost/efficacy of these programs. The study was aimed at evaluating the association between LDCT scan findings and non-oncologic and oncologic diseases.Methods: The LDCT scan of participants to the “Un Respiro per la vita”® lung cancer screening program were checked and abnormal findings, beside lung nodules, recorded. First admission to the acute care because of cardiovascular (CD), respiratory (RD) and oncological diseases (OD) in the following three years were retrieved. The association of LDCT scan abnormal findings with CD, RD and OD was assessed through univariable and multivariable logistic regression models.Results: Mean age of 746 participants was 62 years (SD:5), 62% were male. 11 (1.5%) received a diagnosis of lung cancer. 16.1% participants were admitted to the acute care in the following three years: 8.6% for CD, 4.3% for RD and 5.2% for OD. Valve calcification (OR 2.02, p:0.02) and mucus plugs (OR 3.37, p:0.04) were positively associated with CD, while sub-pleural fibrosis had a protective role (OR 0.47, p:0.01). Lung nodules >8 mm (OR 5.54, p:<0.01), tracheal deviation (OR 6.04, p:0.01) and mucus plugs (OR 4.00, p:0.04) were positively associated with OD admissions. Centrilobular emphysema OR for RD admissions was 1.97 (p:0.06).Conclusions: Selected LDCT scan findings are harbingers of undiagnosed CD, RD and OD, even different from lung cancer, whom knowledge might improve the efficacy and cost/efficacy of lung cancer screening programs.