Pre-transjugular-intrahepatic-portosystemic-shunt measurement of hepatic venous pressure gradient and its clinical application: A comparison study.

BACKGROUND: It is controversial whether transjugular intrahepatic portosystemic shunt (TIPS) placement can improve long-term survival. AIM: To assess whether TIPS placement improves survival in patients with hepatic-venous-pressure-gradient (HVPG) ≥ 16 mmHg, based on HVPG-related risk stratification. METHODS: Consecutive variceal bleeding patients treated with endoscopic therapy + nonselective ß-blockers (NSBBs) or covered TIPS placement were retrospectively enrolled between January 2013 and December 2019. HVPG measurements were performed before therapy. The primary outcome was transplant-free survival; secondary endpoints were rebleeding and overt hepatic encephalopathy (OHE). RESULTS: A total of 184 patients were analyzed (mean age, 55.27 years ± 13.86, 107 males; 102 in the EVL+NSBB group, 82 in the covered TIPS group). Based on the HVPG-guided risk stratification, 70 patients had HVPG < 16 mmHg, and 114 patients had HVPG ≥ 16 mmHg. The median follow-up time of the cohort was 49.5 mo. There was no significant difference in transplant-free survival between the two treatment groups overall (hazard ratio [HR], 0.61; 95% confidence interval [CI]: 0.35-1.05; P = 0.07). In the high-HVPG tier, transplant-free survival was higher in the TIPS group (HR, 0.44; 95%CI: 0.23-0.85; P = 0.004). In the low-HVPG tier, transplant-free survival after the two treatments was similar (HR, 0.86; 95%CI: 0.33-0.23; P = 0.74). Covered TIPS placement decreased the rate of rebleeding independent of the HVPG tier (P < 0.001). The difference in OHE between the two groups was not statistically significant (P = 0.09; P = 0.48). CONCLUSION: TIPS placement can effectively improve transplant-free survival when the HVPG is greater than 16 mmHg.

Toward an Applied Cyber Security Solution in IoT-Based Smart Grids: An Intrusion Detection System Approach.

We present an innovative approach for a Cybersecurity Solution based on the Intrusion Detection System to detect malicious activity targeting the Distributed Network Protocol (DNP3) layers in the Supervisory Control and Data Acquisition (SCADA) systems. As Information and Communication Technology is connected to the grid, it is subjected to both physical and cyber-attacks because of the interaction between industrial control systems and the outside Internet environment using IoT technology. Often, cyber-attacks lead to multiple risks that affect infrastructure and business continuity; furthermore, in some cases, human beings are also affected. Because of the traditional peculiarities of process systems, such as insecure real-time protocols, end-to-end general-purpose ICT security mechanisms are not able to fully secure communication in SCADA systems. In this paper, we present a novel method based on the DNP3 vulnerability assessment and attack model in different layers, with feature selection using Machine Learning from parsed DNP3 protocol with additional data including malware samples. Moreover, we developed a cyber-attack algorithm that included a classification and visualization process. Finally, the results of the experimental implementation show that our proposed Cybersecurity Solution based on IDS was able to detect attacks in real time in an IoT-based Smart Grid communication environment.

An IoT-Based Anonymous Function for Security and Privacy in Healthcare Sensor Networks.

In the age of the Internet of Things, connected devices are changing the delivery system in the healthcare communication environment. With the integration of IoT in healthcare, there is a huge potential for improvement of the quality, safety, and efficiency of health care in addition to promising technological, economical, and social prospects. Nevertheless, this integration comes with security risks such as data breach that might be caused by credential-stealing malware. In addition, the patient valuable data can be disclosed when the perspective devices are compromised since they are connected to the internet. Hence, security has become an essential part of today's computing world regarding the ubiquitous nature of the IoT entities in general and IoT-based healthcare in particular. In this paper, research on the algorithm for anonymizing sensitive information about health data set exchanged in the IoT environment using a wireless communication system has been presented. To preserve the security and privacy, during the data session from the users interacting online, the algorithm defines records that cannot be revealed by providing protection to user's privacy. Moreover, the proposed algorithm includes a secure encryption process that enables health data anonymity. Furthermore, we have provided an analysis using mathematical functions to valid the algorithm's anonymity function. The results show that the anonymization algorithm guarantees safety features for the considered IoT system applied in context of the healthcare communication systems.

Study on effective extraction of chicken feather keratins and their films for controlling drug release.

We report the fabrication of keratin films with porosity using keratin, for controlled drug delivery systems. Feathers are currently an important waste product from the poultry industry, however abandoned down products cause an environmentally difficult disposal problem as they are not efficiently extracted and applied. In this paper, feather keratin was extracted using a high-efficiency method. The yield of pure keratin was up to 90%. Its molecular weight was 20 kDa with low dispersity. The films, based on the extracted keratin, were prepared using a simple method, and showed good mechanical properties. Furthermore, the feather keratin films were used to load and release drugs. The resultant feather keratin biopolymer films were pH-responsive and showed controllable drug-release behavior. In summary, we achieved a simple method to reutilize disused feathers. It could be an attractive candidate for applications in the biomedical field.