The interaction of a high-current, relativistic electron beam with a plasma

Imperial Users onl

Risk Assessment Framework for Evaluation of Cybersecurity Threats and Vulnerabilities in Medical Devices

Medical devices are vulnerable to cybersecurity exploitation and, while they can provide improvements to clinical care, they can put healthcare organizations and their patients at risk of adverse impacts. Evidence has shown that the proliferation of devices on medical networks present cybersecurity challenges for healthcare organizations due to their lack of built-in cybersecurity controls and the inability for organizations to implement security controls on them. The negative impacts of cybersecurity exploitation in healthcare can include the loss of patient confidentiality, risk to patient safety, negative financial consequences for the organization, and loss of business reputation. Assessing the risk of vulnerabilities and threats to medical devices can inform healthcare organizations toward prioritization of resources to reduce risk most effectively. In this research, we build upon a database-driven approach to risk assessment that is based on the elements of threat, vulnerability, asset, and control (TVA-C). We contribute a novel framework for the cybersecurity risk assessment of medical devices. Using a series of papers, we answer questions related to the risk assessment of networked medical devices. We first conducted a case study empirical analysis that determined the scope of security vulnerabilities in a typical computerized medical environment. We then created a cybersecurity risk framework to identify threats and vulnerabilities to medical devices and produce a quantified risk assessment. These results supported actionable decision making at managerial and operational levels of a typical healthcare organization. Finally, we applied the framework using a data set of medical devices received from a partnering healthcare organization. We compare the assessment results of our framework to a commercial risk assessment vulnerability management system used to analyze the same assets. The study also compares our framework results to the NIST Common Vulnerability Scoring System (CVSS) scores related to identified vulnerabilities reported through the Common Vulnerability and Exposure (CVE) program. As a result of these studies, we recognize several contributions to the area of healthcare cybersecurity. To begin with, we provide the first comprehensive vulnerability assessment of a robotic surgical environment, using a da Vinci surgical robot along with its supporting computing assets. This assessment supports the assertion that networked computer environments are at risk of being compromised in healthcare facilities. Next, our framework, known as MedDevRisk, provides a novel method for risk quantification. In addition, our assessment approach uniquely considers the assets that are of value to a medical organization, going beyond the medical device itself. Finally, our incorporation of risk scenarios into the framework represents a novel approach to medical device risk assessment, which was synthesized from other well-known standards. To our knowledge, our research is the first to apply a quantified assessment framework to the problem area of healthcare cybersecurity and medical networked devices. We would conclude that a reduction in the uncertainty about the riskiness of the cybersecurity status of medical devices can be achieved using this framework

Implication of an Environmentally Induced Hamartoma in Commercial Shrimps

An overgrowth of muscle protruded through the ventral portion of the sixth abdominal segment of Penaeus aztecus and P. setiferus. This hamartoma was observed in 33 postlarval shrimp and is the first reported from a crustacean. Even though afflicted individuals represented a small proportion of the shrimp examined, nearly all such individuals were collected from the presumed most heavily polluted site. We suggest an unidentified pollutant as the cause of the abnormality

Molecular phylogeny and diversification history of Prosopis (Fabaceae: Mimosoideae)

The genus Prosopis is an important member of arid and semiarid environments around the world. To study Prosopis diversification and evolution, a combined approach including molecular phylogeny, molecular dating, and character optimization analysis was applied. Phylogenetic relationships were inferred from five different molecular markers (matK-trnK, trnL-trnF, trnS-psbC, G3pdh, NIA). Taxon sampling involved a total of 30 Prosopis species that represented all Sections and Series and the complete geographical range of the genus. The results suggest that Prosopis is not a natural group. Molecular dating analysis indicates that the divergence between Section Strombocarpa and Section Algarobia plus Section Monilicarpa occurred in the Oligocene, contrasting with a much recent diversification (Late Miocene) within each of these groups. The diversification of the group formed by species of Series Chilenses, Pallidae, and Ruscifoliae is inferred to have started in the Pliocene, showing a high diversification rate. The moment of diversification within the major lineages of American species of Prosopis is coincident with the spreading of arid areas in the Americas, suggesting a climatic control for diversification of the group. Optimization of habitat parameters suggests an ancient occupation of arid environments by Prosopis species.Fil: Catalano, Santiago Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; ArgentinaFil: Vilardi, Juan Cesar. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; ArgentinaFil: Tosto, Daniela Sandra. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas; ArgentinaFil: Saidman, Beatriz Ofelia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; Argentin

The TViews Table Role-Playing Game

The TViews Table Role-Playing Game (TTRPG) is a digital tabletop role-playing game that runs on the TViews table, bridging the separate worlds of traditional role-playing games with the growing area of massively multiplayer online role-playing games. The TViews table is an interactive tabletop media platform that can track the location of multiple tagged objects in real-time as they are moved around its surface, providing a simultaneous and coincident graphical display. In this paper we present the implementation of the first version of TTRPG, with a content set based on the traditional Dungeons & Dragons rule-set. We also discuss the results of a user study that used TTRPG to explore the possible social context of digital tabletop role-playing games

Safe Opioid Prescribing at Discharge

Safe Opioid Prescribing at Discharge Taylor Goodman, PharmD; Elva Van Devender, PharmD; Luetta Jones, PharmD; Courtney Barber Background/Purpose: The opioid epidemic has led to devastating consequences, especially in Oregon, with an average of five Oregonians dying each week from opioid overdose. Opioid prescriptions at discharge are correlated with future continued opioid use. United States providers prescribe more opioids both inpatient and at discharge than other countries, and Oregon providers wrote more opioid prescriptions per person than the national average. Oversupplying prescription opioids can lead to reservoirs of unused medication, creating opportunities for non-medical use and overdose. Pharmacy interventions have shown significant improvement in safe opioid prescribing practices at hospital discharge. However, inpatient discharges still represent a major source of high-volume opioid prescriptions. The purpose of this study is to evaluate hospital discharge opioid prescriptions and to assess the impact of data sharing and education on subsequent discharge prescribing practices. Methods: This was a retrospective review of discharge opioid prescriptions for adult hospitalist patients discharged from two, large, tertiary hospitals during July 2018, September 2019, and either February 2020 or February 18th thru March 18th, 2020 depending on the location. Eligible patients’ data elements including discharge opioid, quantity of opioid tablets (QTY), morphine milligram equivalence (MME), concomitant benzodiazepine prescription, ordering provider, and ordering department were evaluated for pre and post intervention implementation analysis. Data was collected through a review of orders in the electronic health record (EHR). Further investigation into charts was completed for necessary additional information if needed. The primary outcome is hospitalist group opioid discharge prescribing practices pre and post multiple interventions (EHR changes to default quantity on new orders, addition of MME daily calculation and provider education) and provider education alone presented on either January 21st or February 11th, 2020. Secondary outcomes include department and individual provider prescribing practices. This study has been approved by the institutional review board. Results: At Hospital A, both the average quantity of tablets and MME per discharge decreased post EHR and education interventions, then increased (25.8 to 23 to 25 and 198.3 to 177.5 to 195.6 respectively) post education only intervention. At Hospital B, a similar trend in both the average quantity of tablets and MME per discharge post interventions (34.9 to 23.3 to 25.8 and 303.5 to 191 to 212 respectively) was seen. The percentage of(62% to 62.7% to 67.5% at Hospital A and 50.6% to 70.2% to 66.5% at Hospital B). Conclusion: Results comparison prior to intervention (2018) to post intervention (2019 and 2020) indicate that it was effective in promoting safer prescribing practices however education/data sharing only intervention may be more effective when combined with more system orientated interventions. While longer term monitoring and individual provider follow up is needed to elicit the true impact of provider education and data sharing intervention, future efforts should combine multiple interventions. These should target the individual via continued education/data sharing and system processes via workflow adjustments such as encouraging utilizing new opioid orders upon discharge. Targeting specific service lines could help identify more opportunities to promote safer prescribing practices going forward.https://digitalcommons.psjhealth.org/pharmacy_PGY1/1001/thumbnail.jp

NA

A Montecarlo simulation is conducted to ascertain performance of the ATIGS system in a proposed air-launched cruise missile configuration. The simulation is conducted within a local-level inertial frame consisting of down-range, cross-range and up as primary reference vectors. Efforts are made to measure the relative effects associated with the intended pure position reset provided by a MICRAD sensor as compared with those effects which could be expected from a linear suboptimal Kalman filtering scheme used in conjuction with the MICRAD sensorhttp://archive.org/details/kalmanfilterappl00vandNANAU.S. Navy (U.S.N.) author

Attack Modeling and Mitigation Strategies for Risk-Based Analysis of Networked Medical Devices

The escalating integration of network-enabled medical devices raises concerns for both practitioners and academics in terms of introducing new vulnerabilities and attack vectors. This prompts the idea that combining medical device data, security vulnerability enumerations, and attack-modeling data into a single database could enable security analysts to proactively identify potential security weaknesses in medical devices and formulate appropriate mitigation and remediation plans. This study introduces a novel extension to a relational database risk assessment framework by using the open-source tool OVAL to capture device states and compare them to security advisories that warn of threats and vulnerabilities, and where threats and vulnerabilities exist provide mitigation recommendations. The contribution of this research is a proof of concept evaluation that demonstrates the integration of OVAL and CAPEC attack patterns for analysis using a database-driven risk assessment framework