An Effective Threat Detection Framework for Advanced Persistent Cyberattacks

Recently, with the normalization of non-face-to-face online environments in response to the COVID-19 pandemic, the possibility of cyberattacks through endpoints has increased. Numerous endpoint devices are managed meticulously to prevent cyberattacks and ensure timely responses to potential security threats. In particular, because telecommuting, telemedicine, and tele-education are implemented in uncontrolled environments, attackers typically target vulnerable endpoints to acquire administrator rights or steal authentication information, and reports of endpoint attacks have been increasing considerably. Advanced persistent threats (APTs) using various novel variant malicious codes are a form of a sophisticated attack. However, conventional commercial antivirus and anti-malware systems that use signature-based attack detection methods cannot satisfactorily respond to such attacks. In this paper, we propose a method that expands the detection coverage in APT attack environments. In this model, an open-source threat detector and log collector are used synergistically to improve threat detection performance. Extending the scope of attack log collection through interworking between highly accessible open-source tools can efficiently increase the detection coverage of tactics and techniques used to deal with APT attacks, as defined by MITRE Adversarial Tactics, Techniques, and Common Knowledge (ATT&CK). We implemented an attack environment using an APT attack scenario emulator called Carbanak and analyzed the detection coverage of Google Rapid Response (GRR), an open-source threat detection tool, and Graylog, an open-source log collector. The proposed method expanded the detection coverage against MITRE ATT&CK by approximately 11% compared with that conventional methods. © 2023 Tech Science Press. All rights reserved.

Verification of the Performance of the Panbio COVID-19 Ag Rapid Test Device for Implementation in the Clinical Laboratory

Objectives: The Panbio COVID-19 Ag Rapid Test Device (Panbio COVID-19 Ag, Abbott Rapid Diagnostics) is a lateral flow immunochromatographic assay targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein in nasopharyngeal specimens for the diagnosis of coronavirus disease 2019 (COVID-19). This study aimed to verify the performance of the Panbio COVID-19 Ag for implementation in clinical laboratories. Method(s): Sixty nasopharyngeal swab specimens (30 positive and 30 negative) dipped in transport medium, and COVID-19 was confirmed using real-time RT-PCR using Allplex SARS-CoV-2 assay (Seegene), were tested using the Panbio COVID-19 Ag. Reproducibility was evaluated using positive and negative control materials. Sensitivity and specificity were calculated based on the results of realtime RT-PCR as the standard test method. Result(s): Reproducibility was confirmed by the consistent results of repeated tests of the quality control materials. The overall sensitivity and specificity of Panbio COVID-19 Ag were 50.0% and 100.0%, respectively. Panbio COVID-19 Ag demonstrated high sensitivity (88.2%) in analyzing the detection limit cycle threshold (Ct) value of 26.67 provided by the manufacturer as a positive criterion, and the sensitivity was 100.0% for the positive criterion of Ct values <25, although it was less sensitive for Ct > 25. Conclusion(s): Considering the high sensitivity for positive samples with Ct values <25 and the rapid turnaround of results, Panbio COVID-19 Ag can be used in clinical laboratories to diagnose COVID-19 in limited settings. Copyright © 2023 Ewha Womans University College of Medicine and Ewha Medical Research Institute.

Effect of the COVID-19 Pandemic on Headache in Pediatric Migraine Patients at a Single Tertiary Center

Purpose: The aim of this study was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on children and adolescents with migraine. Method(s): This longitudinal cohort study enrolled children and adolescents with migraine from the Department of Pediatric Neurology at our hospital from January 2017 to June 2021. Self-re-ported data from individual headache diaries were used. The patients were questioned about their headache frequency and intensity, stress, physical activity, changes in mood and sleep, and their school and home lives during the COVID-19 pandemic. The Pediatric Migraine Disability Assessment (Ped-MIDAS) scoring system was applied to assess headache-related disability. Result(s): In total, 325 pediatric migraine patients (mean age 12.8+/-5.6 years, 62.5% female) were included in this study. The average monthly frequency of migraine headaches was 2.17+/-1.32 and 4.62+/-3.29 before and during the COVID-19 pandemic (P<0.001), respectively. The Ped-MIDAS score was obtained for 207 patients both before and during the pandemic, and the total score slightly increased from 13.8 to 14.7 points (P=0.295). Sixty patients (18.5%) showed significantly worsening migraine headaches. Younger age (P=0.017), mood deterioration (P<0.001), sleep problems (P<0.001), increased acute medication use (P=0.010), and larger changes in the Ped-MIDAS score (P=0.002) were significantly associated with worsening headache in the logis-tic regression analysis. Conclusion(s): Headache attacks in children and adolescents with migraine were more frequent during the COVID-19 pandemic than before it. Worsening headaches could be independently at-tributed to younger age, mood deterioration, and poor sleep during the COVID-19 pandemic.Copyright © 2022 Korean Child Neurology Society.

International Students' Satisfaction with Online Learning during the COVID-19 at a South Korean University

Previous research has emphasised the importance of online learning during COVID-19 for local students. However, previous research has not fully explored how international students in higher education perceive online learning. To fill the gap in the literature, this research specifically focuses on international students' satisfaction level with online learning during COVID-19 at a South Korean university. In the present study, international student satisfaction with online learning was assessed utilising a research instrument previously employed by Almusharraf and Khahro (2020). A total of 44 undergraduate and 215 graduate students participated in the survey via convenience sampling, and structural equation modeling was used to analyse the data. The study results indicated that gender played a significant role in satisfaction with online learning, that previous online learning experience did not predict satisfaction, that undergraduate and graduate students were satisfied with online learning, but that only graduate students perceived school support as important. In addition, the results showed that international students were satisfied with their online learning regarding instructors' online teaching methods and school support. Finally, the implications of providing effective online education for international students are discussed. © Authors.

Comparison of Adverse Events of SARS-CoV-2 Vaccination between Patients with Inflammatory Bowel Disease and Healthcare Workers

Background: This study aimed to investigate the adverse events (AEs) after SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD) and to compare them with healthcare workers (HCWs). Method(s): We conducted a web-based survey on the local and systemic AEs experienced within 7 days of SARS-CoV-2 vaccination (BNT162b2, mRNA-1273, or ChAdOx1 nCoV-19) in IBD patients and HCWs between October 2021 and February 2022. The frequency of all AEs was compared between IBD patients and HCWs, and propensity score matching method was used to control confounding factors. Result(s): A total of 336 IBD patients (139 Crohn's disease [CD] and 197 ulcerative colitis [UC]) and 288 HCWs who completed the questionnaire had received the same type of vaccine for their first and second doses. Common local AEs in patients with IBD were injection site pain (78.9% and 70.8% after receiving first and second vaccine doses, respectively), swelling (35.4% and 31.5%), and induration (35.1% and 26.5%), and systemic AEs were fatigue (44.6% and 42.0%), myalgia (42.6% and 37.2%), and fever or febrile sense (29.5% and 32.1%). All severe AEs were rarely observed (0-3.9%). Hospital visits or hospitalizations associated with AEs were observed in 16 (4.8%) and 18 (5.4%) patients, respectively. A small number of patients reported deterioration of bowel frequency (CD: 10.1% and 12.2%, UC: 8.1% and 11.7%), abdominal pain (CD: 5.0% and 7.9%), and rectal bleeding (UC: 5.1% and 7.6%). About 30% of IBD patients reported a worsening of their sense of well-being. After propensity score matching, there was no significant increase in the frequency of AEs in IBD patients except for diarrhea (14.5% vs 4.8%, P = 0.005) and dyspepsia (15.2% vs 5.5%, P= 0.007) after first vaccination. Conclusion(s): SARS-CoV-2 vaccination in patients with IBD was generally well-tolerated and severe AEs occurred rarely. Compared with HCWs, the frequency of AEs does not seem to increase except for diarrhea and dyspepsia.

Getting Ready for Teaching in the Pandemic Era: Action Research on Integrating ICT Course with Training and Online Teaching Practice

The purpose of this action study was to identify problems of pre-service English teachers within the context of the COVID-19 pandemic, initiate appropriate actions, and measure impacts. As the lack of teacher training and practice was noted as a problem, actions of providing long-term training and online teaching practice were initiated. Eighteen pre-service English teachers took an ICT course to receive training and taught students online. Their responses in regular group conferences, a final conference, and a survey questionnaire were analyzed through observing and reflecting. They perceived all topics and contents covered for the training as very useful. They also reported online teaching practice enabled them to improve various abilities such as managing Zoom classes, creating video content, managing an app, etc. Finally, they experienced difficulty, particularly in keeping students motivated, and holding online mentoring. However, working collaboratively enabled them to become more responsible. Actions initiated in this study were confirmed to be successful. Implications for the future are presented. © 2022 The Korea Association of Teachers of English (KATE)

An Exploratory Study on Current Nursing Issues in the COVID-19 era through Newspaper Articles: The Application of Text Network Analysis

Purpose: This study was explored the current nursing issues in the COVID-19 era by analyzing newspaper articles. Methods: The search term "nurse"was used to collect newspaper articles from 2020. Pre-processing and semantic network analysis and topic group clustering were conducted using the NetMiner program to analyze the collected articles. Results: A total of 256 articles were identified, and four topics were extracted. The core keywords were "medical care", "hospital", "COVID-19"and "medical workforce". The extracted topics were "work environment related to response to infectious diseases", "utilization of nursing resources", "excessive nursing work", and "shortage of nursing workforce". Conclusion: Our findings provide useful information for understanding social perspectives of critical nursing issues in the COVID-19 era. Most of the extracted topics are the actual problems that nurses have faced for a long time. Now, nurses must proactively address current nursing issues to respond to national disasters and provide quality nursing care. © 2022 Korean Academy of Nursing Administration.

Implementing Synchronous Online Flipped Learning for Pre-service Teachers During COVID-19

Most research has examined flipped learning within the context of face-to-face (F2F) instruction. However, previous research has not effectively explored the possibility of how online synchronous flipped learning influences pre-service teachers (PSTs) in teacher education programs during Coronavirus disease (COVID-19). Recognizing the gap in the literature, this paper explored three aspects of online synchronous flipped learning by understanding 1) PSTs' learner engagement, 2) self-directed learning, and 3) learner satisfaction in a Korean university. The data was collected from Korean PST's interviews, reflection notes, and course evaluations. The thematic analysis was used to analyze qualitative data sources. The study findings showed that PSTs favored a synchronous online FL because it encouraged them to engage in various collaborative activities through Zoom breakout sessions. Also, pre-class materials from online FL can positively enhance the PSTs' self-directed learning process. Based on these findings, this study provides suggestions on how to effectively implement online synchronous flipped learning in teacher education programs. © 2022 The Author(s).

Adverse reactions to coronavirus disease 2019 vaccines in children and adolescents

The incidence of coronavirus diseases 2019 (COVID-19), including severe cases, has been increasing in both children and adolescents with the spread of the delta variant. COVID-19 vaccines have been identified to be effective in the prevention of COVID-19 transmission in children and adolescents and keeping schools open. However, adverse reactions associated with COVID-19 vaccination in children and adolescents contribute to parents' hesitation to proceed with vaccination, especially due to serious, albeit rare, reactions. The results from COVID-19 vaccine clinical trials on the safety and efficacy of COVID-19 vaccines in children and adolescents are promising in terms of their effects on COVID-19 infection prevention. In the present study, we summarize the adverse reactions of COVID-19 vaccines in children and adolescents, based on the clinical trials, mainly including Pfizer-BioNTech and Moderna COVID-19 vaccines. In the Pfizer-BioNTech COVID-19 clinical trials, the most common local adverse reaction was pain at the injection site in 74.1%-86%, depending on age, and the most common systemic adverse reaction was fatigue, followed by headache, myalgia, diarrhea, and fever with differences in the distribution according to age. There was no severe adverse reaction related to any COVID-19 vaccine in children and adolescents during the study period. In the mass vaccination program of COVID-19 in children and adolescent, myocarditis has rarely been diagnosed after COVID-19 vaccination, which most commonly occurred in boys after the second dose. Currently, Pfizer-BioNTech COVID-19 vaccines can be safely recommended in children and adolescents for the prevention of COVID-19 infection and the reduction in COVID-19 severity.

Service Quality, Customer Satisfaction and Behavioral Intention in Shanghai Hospital Choice during the COVID-19 Pandemic

The purpose of this study is to analyze how service quality and customer satisfaction impact behavioral intention, an indicator of hospital choice, in Shanghai during the COVID-19 pandemic. A total of 311 responses were collected through a convenience sampling on social media;however, only 281 responses are accepted due to some responses not being relevant in the context of Shanghai hospital choice. Factor analysis and structural equation model were then conducted to analyze how service quality and customer satisfaction impact behavioral intention. While service quality has a direct impact on both customer satisfaction and behavioral intention, there is no significant impact of customer satisfaction on behavioral intention. Findings can help hospital administrators better adjust prevention policies and healthcare practices during the COVID-19 pandemic to improve service quality and increase hospital visits. © 2021 ACM. Copyright held by the owner/author(s). Publication rights licensed to ACM.

Does oil price variability affect the long memory and weak form efficiency of stock markets in top oil producers and oil Consumers? Evidence from an asymmetric MF-DFA approach

This study examines the asymmetric multifractality and the market efficiency of the stock markets in the countries that are the top crude oil producers (USA, KSA, Canada and Russia) and consumers (Brazil, China, India, and Japan) using an asymmetric multifractal detrended fluctuation analysis (A-MF-DFA) method. The results show evidence of an asymmetric multifractal nature for all markets. Moreover, the multifractality is stronger in the upward movement of the market returns, except in China. The degree of efficiency of the stock markets is shown to be time-varying and experienced a decrease during the 2008 global financial crisis (GFC), but an upside trend occurred during the recent oil price crash followed a significant decline during COVID-19. The stock markets have an anti-persistent feature during GFC and COVID-19, whereas they exhibit a long-term persistent feature during oil price crash. More interestingly, the efficiency of the stock markets of crude oil producers is lower in general than that of oil consumers. Furthermore, the efficiency of the stock market is lower in the downward movement of the market returns than in the upward movement. Asymmetry and oil price uncertainty index are the key driver of the stock markets and can serve as predictor of the stock market dynamics of top oil producers and top oil consumers particularly during COVID-19 and oil price crash. © 2021 Elsevier Inc.

Characterization of Severe Acute Respiratory Syndrome Coronavirus 2 Stability in Multiple Water Matrices

The advent of the global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) necessitates a thorough study of the stability and transmissibility in the environment. We characterized the stability of SARS-CoV-2 in three water matrices: fresh, tap, and seawater. The minimum infective dose of SARS-CoV-2 in Vero cells was confirmed to be 10³ PFU/mL. The stability of SARS-CoV-2 varied according to the water matrix: infective SARS-CoV-2 was undetectable after treatment with fresh water and seawater, but remained detectable for 2 days in tap water, when starting with an initial concentration of 10⁴ PFU/mL. When the starting concentration was increased to 10⁵ PFU/mL, a similar trend was observed. In addition, viral RNA persisted longer than infectious virus in all water matrices. This study was conducted in stagnant water containing a significantly high titer of virus, thus, human-to-human transmission of SARS-CoV-2 through the actual aquatic environment is expected to be rare.

Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy.

BACKGROUND: Identifying the extent of environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection control and prevention. The extent of environmental contamination has not been fully investigated in the context of severe coronavirus disease (COVID-19) patients. AIM: To investigate environmental SARS-CoV-2 contamination in the isolation rooms of severe COVID-19 patients requiring mechanical ventilation or high-flow oxygen therapy. METHODS: Environmental swab samples and air samples were collected from the isolation rooms of three COVID-19 patients with severe pneumonia. Patients 1 and 2 received mechanical ventilation with a closed suction system, while patient 3 received high-flow oxygen therapy and non-invasive ventilation. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) was used to detect SARS-CoV-2; viral cultures were performed for samples not negative on rRT-PCR. FINDINGS: Of the 48 swab samples collected in the rooms of patients 1 and 2, only samples from the outside surfaces of the endotracheal tubes tested positive for SARS-CoV-2 by rRT-PCR. However, in patient 3's room, 13 of the 28 environmental samples (fomites, fixed structures, and ventilation exit on the ceiling) showed positive results. Air samples were negative for SARS-CoV-2. Viable viruses were identified on the surface of the endotracheal tube of patient 1 and seven sites in patient 3's room. CONCLUSION: Environmental contamination of SARS-CoV-2 may be a route of viral transmission. However, it might be minimized when patients receive mechanical ventilation with a closed suction system. These findings can provide evidence for guidelines for the safe use of personal protective equipment.

COVID-19: Initial experience of an international group of hand surgeons.

The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.