Single-Gate In-Transistor Readout of Current Superposition and Collapse Utilizing Quantum Tunneling and Ferroelectric Switching.

In nanostructure assemblies, the superposition of current paths forms microscopic electric circuits, and different circuit networks produce varying results, particularly when utilized as transistor channels for computing applications. However, the intricate nature of assembly networks and the winding paths of commensurate currents hinder standard circuit modeling. Inspired by the quantum collapse of superposition states for information decoding in quantum circuits, the implementation of analogous current path collapse to facilitate the detection of microscopic circuits by modifying their network topology is explored. Here, the superposition and collapse of current paths in gate-all-around polysilicon nanosheet arrays are demonstrated to enrich the computational resources within transistors by engineering the channel length and quantity. Switching the ferroelectric polarization of Hf0.5 Zr0.5 O2 gate dielectric, which drives these transistors out-of-equilibrium, decodes the output polymorphism through circuit topological modifications. Furthermore, a protocol for the single-electron readout of ferroelectric polarization is presented with tailoring the channel coherence. The introduction of lateral path superposition results into intriguing metal-to-insulator transitions due to transient behavior of ferroelectric switching. This ability to adjust the current networks within transistors and their interaction with ferroelectric polarization in polycrystalline nanostructures lays the groundwork for generating diverse current characteristics as potential physical databases for optimization-based computing.

Developing the "Healthcare CEO App" for patients with type 1 diabetes transitioning from adolescence to young adulthood: A mixed-methods study.

AIM: To develop and test a mobile application that supports the disease self-management of adolescents with type 1 diabetes during their transition to early adulthood. DESIGN: A sequential mixed-methods design was employed. METHODS: The application content was designed according to previously identified care needs and expectations, followed by application development on the Android operating system. From the outpatient clinic of the Department of Paediatric Endocrinology and Metabolism at a medical centre in northern Taiwan, 35 individuals aged between 16-25 years participated in application testing. RESULTS: The overall median score of the QUIS was 4-5, most of the 25% quartile was 4-5, and all of the 75% quartile was 5, indicating adequate user interaction satisfaction.

Privacy Concerns and Information Sharing: The Perspective of the U-Shaped Curve.

Privacy concerns are a key predictor of information sharing, yet some critical issues remain unclear. Based on social capital theory, this study argues that the relationship between privacy concerns and information sharing is a U-shaped curve. Users with privacy concerns would not share their private information; however, such users would eventually share their information as long as they trust the website and its members. Furthermore, this study provides a contingency perspective, suggesting that the curvilinear relationship between privacy concerns and information sharing varies with the system evaluation perception and personal motivation levels. The results show that at a high level of system evaluation, the relationship between privacy concerns squared and information sharing is non-significant. In contrast, at a low level of system evaluation, there is a U-shaped relationship between privacy concerns and information sharing. Regarding motivation, the results were congruent with our expectations.

A Smartcard-Based User-Controlled Single Sign-On for Privacy Preservation in 5G-IoT Telemedicine Systems.

Healthcare is now an important part of daily life because of rising consciousness of health management. Medical professionals can know users' health condition if they are able to access information immediately. Telemedicine systems, which provides long distance medical communication and services, is a multi-functional remote medical service that can help patients in bed in long-distance communication environments. As telemedicine systems work in public networks, privacy preservation issue of sensitive and private transmitted information is important. One of the means of proving a user's identity are user-controlled single sign-on (UCSSO) authentication scheme, which can establish a secure communication channel using authenticated session keys between the users and servers of telemedicine systems, without threats of eavesdropping, impersonation, etc., and allow patients access to multiple telemedicine services with a pair of identity and password. In this paper, we proposed a smartcard-based user-controlled single sign-on (SC-UCSSO) for telemedicine systems that not only remains above merits but achieves privacy preservation and enhances security and performance compared to previous schemes that were proved with BAN logic and automated validation of internet security protocols and applications (AVISPA).

An Autonomous Log Storage Management Protocol with Blockchain Mechanism and Access Control for the Internet of Things.

As the Internet of Things (IoT) has become prevalent, a massive number of logs produced by IoT devices are transmitted and processed every day. The logs should contain important contents and private information. Moreover, these logs may be used as evidences for forensic investigations when cyber security incidents occur. However, evidence legality and internal security issues in existing works were not properly addressed. This paper proposes an autonomous log storage management protocol with blockchain mechanism and access control for the IoT. Autonomous model allows sensors to encrypt their logs before sending it to gateway and server, so that the logs are not revealed to the public during communication process. Along with blockchain, we introduce the concept "signature chain". The integration of blockchain and signature chain provides efficient management functions with valuable security properties for the logs, including robust identity verification, data integrity, non-repudiation, data tamper resistance, and the legality. Our work also employs attribute-based encryption to achieve fine-grained access control and data confidentiality. The results of security analysis using AVSIPA toolset, GNY logic and semantic proof indicate that the proposed protocol meets various security requirements. Providing good performance with elliptic curve small key size, short BLS signature, efficient signcryption method, and single sign-on solution, our work is suitable for the IoT.

Three-Factor Fast Authentication Scheme with Time Bound and User Anonymity for Multi-Server E-Health Systems in 5G-Based Wireless Sensor Networks.

The fifth generation (5G) mobile network delivers high peak data rates with ultra-low latency and massive network capacity. Wireless sensor network (WSN) in Internet of Thing (IoT) architecture is of prominent use in 5G-enabled applications. The electronic healthcare (e-health) system has gained a lot of research attention since it allows e-health users to store and share data in a convenient way. By the support of 5G technology, healthcare data produced by sensor nodes are transited in the e-health system with high efficiency and reliability. It helps in reducing the treatment cost, providing efficient services, better analysis reports, and faster access to treatment. However, security and privacy issues become big concerns when the number of sensors and mobile devices is increasing. Moreover, existing single-server architecture requires to store a massive number of identities and passwords, which causes a significant database cost. In this paper, we propose a three-factor fast authentication scheme with time bound and user anonymity for multi-server e-health systems in 5G-based wireless sensor networks. In our work, the three-factor authentication scheme integrating biometrics, password, and smart card ensures a high-security sensor-enabled environment for communicating parties. User anonymity is preserved during communication process. Besides, time bound authentication can be applied to various healthcare scenarios to enhance security. The proposed protocol includes fast authentication, which can provide a fast communication for participating parties. Our protocol is also designed with multi-server architecture to simplify network load and significantly save database cost. Furthermore, security proof and performance analysis results show that our proposed protocol can resist various attacks and bear a rational communication cost.

Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke.

Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagnosed with acute ischemic stroke and treated for rt-PA at Chang Gung Memorial Hospitals from 2006 to 2016. In-hospital death, intensive care unit (ICU) stay, or prolonged hospitalization were defined as unfavorable treatment outcomes. Medical history variables and laboratory test results were considered variables of interest to determine risk factors. Among 643 eligible patients, 537 (83.5%) and 106 (16.5%) patients had favorable and poor outcomes, respectively. In the multivariable analysis, risk factors associated with poor outcomes were female gender, higher stroke severity index (SSI), higher serum glucose levels, lower mean corpuscular hemoglobin concentration (MCHC), lower platelet counts, and anemia. The risk factors found in this research could help us study the treatment strategy for ischemic stroke.

The effectiveness of a nurse-led exercise and health education informatics program on exercise capacity and quality of life among cancer survivors after esophagectomy: A randomized controlled trial.

BACKGROUND: Esophagectomy is the primary surgical treatment for esophageal cancer. However, patients often experience a decrease in physical activity, poor nutrition, and a reduction in quality of life following surgery. OBJECTIVES: The aim of this study was to examine the effects of an exercise and nursing education health informatics program on quality of life, exercise capacity, and nutrition among patients following esophagectomy for esophageal cancer. DESIGN: A randomized controlled trial. SETTINGS AND METHODS: Patients who had undergone an esophagectomy for cancer were recruited by purposive sampling from a medical center in Taiwan. Patients who met inclusion criteria and agreed to participate (N = 88) were randomly assigned to an exercise informatics program (intervention group, n = 44) or usual post-surgery care (control group, n = 44). Quality of life was assessed at baseline and 1, 3, and 6 months after discharge. Secondary outcomes of nutrition (albumin, body mass index), and exercise capacity (maximal oxygen uptake, the six-minute walking test) were conducted at baseline and 3 months following discharge. Differences in quality of life, nutrition and exercise capacity between the two groups were analyzed using generalized estimating equations. RESULTS: Analysis demonstrated significant improvements in outcome measures following hospital discharge for the intervention group compared to controls. Measures of quality of life were significantly better for the intervention group and varied with time following discharge. Functional scores for physical (1 and 3 months), role (1, 3, and 6 months), emotional (1 month), social (3 months) and global health (3 months) were significantly higher than controls. Cancer-related subscales improved for insomnia (1 and 3 months) and nausea/vomiting (3 and 6 months). Esophageal cancer-specific symptoms improved for dry mouth (1 month), dysphagia (3 months), and loss of taste (1 and 6 months). Three months following discharge, levels of albumin were significantly higher for the intervention group compared to controls (ß=0.32, 95% CI 0.09, 0.54, p < .01); body mass index did not differ between groups. Exercise capacity was also significantly better; the intervention group had higher maximal oxygen consumption (ß=2.61, 95% CI 1.54, 3.69, p < .001) and greater distance on the six-minute walking test (ß=83.30, 95% CI 52.60, 113.99, p < .001). CONCLUSION: The intervention group experienced significant improvements in nutrition, exercise capacity, and variables related to quality of life. These findings suggest a nurse-led exercise and health education informatics program should be implemented for survivors of esophagectomy prior to hospital discharge.

The Usage Behavior and Intention Stability of Nurses: An Empirical Study of a Nursing Information System.

BACKGROUND: Many prior studies of technology adoption treat user intention as the single predictor of actual usage behavior. However, as many researchers of behavioral science have pointed out, multiple factors mediate the relationship between user intention and usage behavior. PURPOSE: The present article explores the factors that mediate the relationship between intention and actual behavior. We develop a conceptual framework that is based on the Technology Acceptance Model III and behavior theory to further elicit system usage behavior and to confirm "intention stability" and "past experience" as two significant mediating factors in this relationship. METHODS: The target system was a nursing information system that had been recently adopted by a medical center in central Taiwan. Data were collected using a questionnaire survey conducted in two rounds. Two hundred forty-five valid questionnaires were returned (response rate: 49%). Mediated moderation was analyzed to explore the presence of mediators or moderators between intention and behavior. RESULTS: The results support that intention stability is a mediated moderator and that prior experience is a moderator of the relationship between intention and behavior. These two factors increased by over 13.6% the explanatory power of intention on actual behavior. Furthermore, this study expanded the scope of prior research by confirming intention stability as a moderating variable between intention and behavior. Finally, this study identified the moderating effect of past experience on the intention-behavior relationship, indicating that past experience enhances the predictive power of intention on behavior. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study may assist hospital managers to better understand the nursing information system usage behaviors of nursing staff and to develop ways to enhance the intention stability of these staff. Managers may improve the familiarity of nursing staff with the system by increasing their system-related practice time. More experience should enhance staff system skills and resolve problems such as the need for extra work hours or overtime because of initial system unfamiliarity. Improved work efficiency should then allow nurses to divert more time from administrative work to patient care and training. This positive circle of support is expected to increase the willingness of nurses to accept and take advantage of the system.

Designing an intelligent health monitoring system and exploring user acceptance for the elderly.

Recently, many healthcare or health monitoring systems are proposed to improve life quality of the elderly in the aging process. The elderly are generally with poor health and low information literacy. Low information literacy might be an obstacle of using such systems. This research considered the characteristics and the needs of the elderly and developed an intelligent health monitoring system for the elderly with low information literacy living in the nursing home. The system is intelligent since it can monitor the health status of the elderly based on clinical and medical knowledge, provide an easy-to-understand and easy-to-use user interface for the elderly, and automatically send important or emergency feedback to caregivers. Finally, we explored the user acceptance for the elderly using our proposed system based on the unified theory of acceptance and user of technology model. The experimental results indicate the developed system is highly accepted by the elderly in terms of performance expectation, endeavor expectation, social influence, and facilitating condition.

The role of privacy protection in healthcare information systems adoption.

Privacy protection is an important issue and challenge in healthcare information systems (HISs). Recently, some privacy-enhanced HISs are proposed. Users' privacy perception, intention, and attitude might affect the adoption of such systems. This paper aims to propose a privacy-enhanced HIS framework and investigate the role of privacy protection in HISs adoption. In the proposed framework, privacy protection, access control, and secure transmission modules are designed to enhance the privacy protection of a HIS. An experimental privacy-enhanced HIS is also implemented. Furthermore, we proposed a research model extending the unified theory of acceptance and use of technology by considering perceived security and information security literacy and then investigate user adoption of a privacy-enhanced HIS. The experimental results and analyses showed that user adoption of a privacy-enhanced HIS is directly affected by social influence, performance expectancy, facilitating conditions, and perceived security. Perceived security has a mediating effect between information security literacy and user adoption. This study proposes several implications for research and practice to improve designing, development, and promotion of a good healthcare information system with privacy protection.

Research on a community-based platform for promoting health and physical fitness in the elderly community.

This study aims to assess the acceptability of a fitness testing platform (iFit) for installation in an assisted living community with the aim of promoting fitness and slowing the onset of frailty. The iFit platform develops a means of testing Bureau of Health Promotion mandated health assessment items for the elderly (including flexibility tests, grip strength tests, balance tests, and reaction time tests) and integrates wireless remote sensors in a game-like environment to capture and store subject response data, thus providing individuals in elderly care contexts with a greater awareness of their own physical condition. In this study, we specifically evaluated the users' intention of using the iFit using a technology acceptance model (TAM). A total of 101 elderly subjects (27 males and 74 females) were recruited. A survey was conducted to measure technology acceptance, to verify that the platform could be used as intended to promote fitness among the elderly. Results indicate that perceived usefulness, perceived ease of use and usage attitude positively impact behavioral intention to use the platform. The iFit platform can offer user-friendly solutions for a community-based fitness care and monitoring of elderly subjects. In summary, iFit was determined by three key drivers and discussed as follows: risk factors among the frail elderly, mechanism for slowing the advance frailty, and technology acceptance and support for promoting physical fitness.

The iFit: an integrated physical fitness testing system to evaluate the degree of physical fitness of the elderly.

This paper presents an integrated physical fitness testing system (iFit) that evaluates the physical fitness of older adults. The intent of the test is to help them manage and promote their health and mitigate the effects of aging. National protocols of physical fitness were implemented to support the assessment. The proposed system encompasses four modules of physical fitness assessment for both users and medical professionals. The test information will be recorded and managed through a wireless sensor network that will enable a better understanding of users' fitness states. Furthermore, the iFit has been validated by a test session attended by elderly participants. The results show that there is a significant correlation between iFit use in the test of flexibility, grip strength, and balance, compared to conventional methods.

A security and privacy preserving e-prescription system based on smart cards.

In 2002, Ateniese and Medeiros proposed an e-prescription system, in which the patient can store e-prescription and related information using smart card. Latter, Yang et al. proposed a novel smart-card based e-prescription system based on Ateniese and Medeiros's system in 2004. Yang et al. considered the privacy issues of prescription data and adopted the concept of a group signature to provide patient's privacy protection. To make the e-prescription system more realistic, they further applied a proxy signature to allow a patient to delegate his signing capability to other people. This paper proposed a novel security and privacy preserving e-prescription system model based on smart cards. A new role, chemist, is included in the system model for settling the medicine dispute. We further presented a concrete identity-based (ID-based) group signature scheme and an ID-based proxy signature scheme to realize the proposed model. Main property of an ID-based system is that public key is simple user's identity and can be verified without extra public key certificates. Our ID-based group signature scheme can allow doctors to sign e-prescription anonymously. In a case of a medical dispute, identities of the doctors can be identified. The proposed ID-based proxy signature scheme can improve signing delegation and allows a delegation chain. The proposed e-prescription system based on our proposed two cryptographic schemes is more practical and efficient than Yang et al.'s system in terms of security, communication overheads, computational costs, practical considerations.