Medicine and Health Sciences Commons^™

An Efficient Lightweight Provably Secure Authentication Protocol For Patient Monitoring Using Wireless Medical Sensor Networks, Garima Thakur, Sunil Prajapat, Pankaj Kumar, Ashok Kumar Das, Sachin Shetty

VMASC Publications

The refurbishing of conventional medical network with the wireless medical sensor network has not only amplified the efficiency of the network but concurrently posed different security threats. Previously, Servati and Safkhani had suggested an Internet of Things (IoT) based authentication scheme for the healthcare environment promulgating a secure protocol in resistance to several attacks. However, the analysis demonstrates that the protocol could not withstand user, server, and gateway node impersonation attacks. Further, the protocol fails to resist offline password guessing, ephemeral secret leakage, and gateway-by-passing attacks. To address the security weaknesses, we furnish a lightweight three-factor authentication framework employing the …

Architectural Design Of A Blockchain-Enabled, Federated Learning Platform For Algorithmic Fairness In Predictive Health Care: Design Science Study, Xueping Liang, Juan Zhao, Yan Chen, Eranga Bandara, Sachin Shetty

VMASC Publications

Background: Developing effective and generalizable predictive models is critical for disease prediction and clinical decision-making, often requiring diverse samples to mitigate population bias and address algorithmic fairness. However, a major challenge is to retrieve learning models across multiple institutions without bringing in local biases and inequity, while preserving individual patients' privacy at each site.

Objective: This study aims to understand the issues of bias and fairness in the machine learning process used in the predictive health care domain. We proposed a software architecture that integrates federated learning and blockchain to improve fairness, while maintaining acceptable prediction accuracy and minimizing overhead …

The Use Of Artificial Intelligence To Detect Students Sentiments And Emotions In Gross Anatomy Reflections, Krzysztof J. Rechowicz, Carrie A. Elzie

VMASC Publications

Students' reflective writings in gross anatomy provide a rich source of complex emotions experienced by learners. However, qualitative approaches to evaluating student writings are resource heavy and timely. To overcome this, natural language processing, a nascent field of artificial intelligence that uses computational techniques for the analysis and synthesis of text, was used to compare health professional students' reflections on the importance of various regions of the body to their own lives and those of the anatomical donor dissected. A total of 1365 anonymous writings (677 about a donor, 688 about self) were collected from 132 students. Binary and trinary …

The Shortfalls Of Vulnerability Indexes For Public Health Decision-Making In The Face Of Emergent Crises: The Case Of Covid-19 Vaccine Uptake In Virginia, Lydia Cleveland Sa, Erika Frydenlund

VMASC Publications

Equitable and effective vaccine uptake is a key issue in addressing COVID-19. To achieve this, we must comprehensively characterize the context-specific socio-behavioral and structural determinants of vaccine uptake. However, to quickly focus public health interventions, state agencies and planners often rely on already existing indexes of "vulnerability." Many such "vulnerability indexes" exist and become benchmarks for targeting interventions in wide ranging scenarios, but they vary considerably in the factors and themes that they cover. Some are even uncritical of the use of the word "vulnerable," which should take on different meanings in different contexts. The objective of this study is …

Design Of Robust Blockchain-Envisioned Authenticated Key Management Mechanism For Smart Healthcare Applications, Siddhant Thapiyal, Mohammad Wazid, Devesh Pratap Singh, Ashok Kumar Das, Sachin Shetty

VMASC Publications

The healthcare sector is a very crucial and important sector of any society, and with the evolution of the various deployed technologies, like the Internet of Things (IoT), machine learning and blockchain it has numerous advantages. However, in this section, the data is much more vulnerable than others, because the data is strictly private and confidential, and it requires a highly secured framework for the transmission of data between entities. In this article, we aim to design a blockchain-envisioned authentication and key management mechanism for the IoMT-based smart healthcare applications (in short, we call it SBAKM-HS). We compare the various …

Estimating The Health Effects Of Adding Bicycle And Pedestrian Paths At The Census Tract Level: Multiple Model Comparison, Ross J. Gore, Christopher Lynch, Craig Jordan, Andrew Collins, R. Michael Robinson, Gabrielle Fuller, Pearson Ames, Prateek Keerthi, Yash Kandukuri

VMASC Publications

Background: Adding additional bicycle and pedestrian paths to an area can lead to improved health outcomes for residents over time. However, quantitatively determining which areas benefit more from bicycle and pedestrian paths, how many miles of bicycle and pedestrian paths are needed, and the health outcomes that may be most improved remain open questions.

Objective: Our work provides and evaluates a methodology that offers actionable insight for city-level planners, public health officials, and decision makers tasked with the question “To what extent will adding specified bicycle and pedestrian path mileage to a census tract improve residents’ health outcomes over time?” …

Ascp-Iomt: Ai-Enabled Lightweight Secure Communication Protocol For Internet Of Medical Things, Mohammad Wazid, Jaskaran Singh, Ashok Kumar Das, Sachin Shetty, Muhammad Khurram Khan, Joel J.P.C. Rodrigues

VMASC Publications

The Internet of Medical Things (IoMT) is a unification of smart healthcare devices, tools, and software, which connect various patients and other users to the healthcare information system through the networking technology. It further reduces unnecessary hospital visits and the burden on healthcare systems by connecting the patients to their healthcare experts (i.e., doctors) and allows secure transmission of healthcare data over an insecure channel (e.g., the Internet). Since Artificial Intelligence (AI) has a great impact on the performance and usability of an information system, it is important to include its modules in a healthcare information system, which will be …

Healthcare 5.0 Security Framework: Applications, Issues And Future Research Directions, Mohammad Wazid, Ashok Kumar Das, Noor Mohd, Youngho Park

VMASC Publications

Healthcare 5.0 is a system that can be deployed to provide various healthcare services. It does these services by utilising a new generation of information technologies, such as Internet of Things (IoT), Artificial Intelligence (AI), Big data analytics, blockchain and cloud computing. Due to the introduction of healthcare 5.0, the paradigm has been now changed. It is disease-centered to patient-centered care where it provides healthcare services and supports to the people. However, there are several security issues and challenges in healthcare 5.0 which may cause the leakage or alteration of sensitive healthcare data. This demands that we need a robust …

Short-Range Forecasting Of Covid-19 During Early Onset At County, Health District, And State Geographic Levels Using Seven Methods: Comparative Forecasting Study, Christopher Lynch, Ross Gore

VMASC Publications

BACKGROUND:

Forecasting methods rely on trends and averages of prior observations to forecast COVID-19 case counts. COVID-19 forecasts have received much media attention, and numerous platforms have been created to inform the public. However, forecasting effectiveness varies by geographic scope and is affected by changing assumptions in behaviors and preventative measures in response to the pandemic. Due to time requirements for developing a COVID-19 vaccine, evidence is needed to inform short-term forecasting method selection at county, health district, and state levels.

OBJECTIVE:

COVID-19 forecasts keep the public informed and contribute to public policy. As such, proper understanding of forecasting purposes …

Application Of One-, Three-, And Seven-Day Forecasts During Early Onset On The Covid-19 Epidemic Dataset Using Moving Average, Autoregressive, Autoregressive Moving Average, Autoregressive Integrated Moving Average, And Naïve Forecasting Methods, Christopher J. Lynch, Ross Gore

VMASC Publications

The coronavirus disease 2019 (COVID-19) spread rapidly across the world since its appearance in December 2019. This data set creates one-, three-, and seven-day forecasts of the COVID-19 pandemic's cumulative case counts at the county, health district, and state geographic levels for the state of Virginia. Forecasts are created over the first 46 days of reported COVID-19 cases using the cumulative case count data provided by The New York Times as of April 22, 2020. From this historical data, one-, three-, seven, and all-days prior to the forecast start date are used to generate the forecasts. Forecasts are created using: …

Emergency Department Frequent Utilization For Non-Emergent Presentments: Results From A Regional Urban Trauma Center Study, Joshua G. Behr, Rafael Diaz

VMASC Publications

Objectives
First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model.

Data Source
Primary data collection over an eight week period within a level-1 trauma urban hospital's emergency department.

Study Design
Representative randomized sample of 1,443 adult patients triaged ESI levels 4'5. Physicians …

Health Service Utilization And Poor Health Reporting In Asthma Patients, Joshua G. Behr, Rafael Diaz, Muge Akpinar-Elci

VMASC Publications

The management and treatment of adult asthma has been associated with utilization of health services. Objectives: First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data …

Framework For Classifying Compliance And Medical Immediacy Among Low-Acuity Presentations At An Urban Trauma Center, Joshua G. Behr, Rafael Diaz, Barry Knapp, Cynthia Kratzke

VMASC Publications

Background: This research offers two exploratory frameworks for medical regimen compliance and medical immediacy. The first classifies compliance awareness, compliance mitigation, and financial limitation for those patients that exhibit nonadherence with a medical regimen. The second classifies medical immediacy and characterizes avoidable utilization.

Methods: Representative sampling of adult patients presenting at an emergency department (62,000/ppy) triaged as low acuity; emergency department physician assessment of noncompliance with medical regimen for those patients with a complaint related to a chronic condition; and emergency department physician assessment of medical immediacy and avoidable utilization.

Results: Physicians report 48.3% (95% confidence interval (CI) 43.5% to …

You Are What You Tweet: Connecting The Geographic Variation In America's Obesity Rate To Twitter Content, Ross J. Gore, Saikou Diallo, Jose Padilla

VMASC Publications

We conduct a detailed investigation of the relationship among the obesity rate of urban areas and expressions of happiness, diet and physical activity on social media. We do so by analyzing a massive, geo-tagged data set comprising over 200 million words generated over the course of 2012 and 2013 on the social network service Twitter. Among many results, we show that areas with lower obesity rates: (1) have happier tweets and frequently discuss (2) food, particularly fruits and vegetables, and (3) physical activities of any intensity. Additionally, we provide evidence that each of these results offer different and unique insight …

Measuring Sense Of Presence And User Characteristics To Predict Effective Training In An Online Simulated Virtual Environment, Gianluca De Leo, Leigh A. Diggs, Elena Radici, Thomas W. Mastaglio

VMASC Publications

Introduction: Virtual-reality solutions have successfully been used to train distributed teams. This study aimed to investigate the correlation between user characteristics and sense of presence in an online virtual-reality environment where distributed teams are trained. A greater sense of presence has the potential to make training in the virtual environment more effective, leading to the formation of teams that perform better in a real environment. Being able to identify, before starting online training, those user characteristics that are predictors of a greater sense of presence can lead to the selection of trainees who would benefit most from the online simulated …

Disparate Health Implications Stemming From The Propensity Of Elderly And Medically Fragile Populations To Shelter In Place During Severe Storm Events, Joshua G. Behr, Rafael Diaz

VMASC Publications

Chronic conditions, disability limitations (mobility, cognitive, and sensory), and the need for assistance with activities of daily living are characteristics of elderly and medically fragile populations. Theory suggests that households with these vulnerability attributes are more likely to suffer storm-induced adverse and prolonged health consequences and, therefore, ought to evidence an increased propensity to evacuate prior to a severe storm event. Yet despite being more sensitive to storm disruption, the elderly and medically fragile populations are only slightly more likely to evacuate in the face of impending storms. This suggests, for these groups, there may be other factors such as …

A System Dynamics Model For Simulating Ambulatory Health Care Demands, Rafael Diaz, Joshua G. Behr, Mandar Tulpule

VMASC Publications

Introduction: This article demonstrates the utility of the system dynamics approach to model and simulate US demand for ambulatory health care service both for the general population and for specific cohort subpopulations over the 5-year period, from 2003 to 2008. A system dynamics approach that is shown to meaningfully project demand for services has implications for health resource planning and for generating knowledge that is critical to assessing interventions.

Methods: The study uses a cohort-component method in combination with structural modeling to simulate ambulatory health care utilization. Data are drawn from the National Ambulatory Medical Care Survey and the National …

Theoretically-Driven Infrastructure For Supporting Health Care Teams Training At A Military Treatment Facility, T. Robert Turner Jr., V. Andrea Parodi

VMASC Publications

Designated a Department of Defense Team Resource Center (TRC) in 2008, Naval Medical Center Portsmouth (NMCP) currently hosts three tri-service health care teams training courses annually. Each consists of didactic learning coupled with simulation-based training exercises to provide an interactive educational experience for health care professionals. Simulated cases are developed to reinforce specific teamwork skills and behaviors, and to incorporate a variety of technologies including standardized patients, manikins, and virtual reality. The course is also the foundation of a research program designed to explore applications of modeling and simulation for enhanced team training in health care. The TRC has adopted …

Analyzing The Effects Of Policy Options To Mitigate The Effect Of Sea Level Rise On The Public Health And Medically Fragile Population: A System Dynamics Approach, Rafael Diaz, Joshua Behr, Anna Jeng, Hua Liu, Franceso Longo

VMASC Publications

A critical question related to climate change concerns to how rising sea level will affect underserved populations and medically fragile population in coastal zones and floodplains. As sea levels rise, coastal waters will regain near-tidal areas and co-mingle with human-made pollutants, resulting from decades of industrial and commercial activity. This poses potential threat and risks to public health and the environment. It is critical that decision makers will initiate a process of parsing resources to the mitigation and management of these issues. The purpose of this research is to model the inherent dynamics of this process and understand how near-term …