Medical Security Research Articles

Cryptographic Encryption and Optimization for Internet of Things Based Medical Image Security

The expansion of the Internet of Things is expected to lead to the emergence of the Internet of Medical Things (IoMT), which will revolutionize the health-care industry (IoT). The Internet of Things (IoT) revolution is outpacing current human services thanks to its bright mechanical, economical, and social future. Security is essential because most patient information is housed on a cloud platform in the hospital. The security of medical images in the Internet of Things was investigated in this research using a new cryptographic model and optimization approaches. For the effective storage and safe transfer of patient data along with medical images, a separate framework is required. The key management and optimization will be chosen utilizing the Rivest–Shamir–Adleman-based Arnold map (RSA-AM), hostile orchestration (HO), and obstruction bloom breeding optimization (OBBO) to increase the encryption and decryption processes’ level of security. The effectiveness of the suggested strategy is measured using peak signal-to-noise ratio (PSNR), entropy, mean square error (MSE), bit error rate (BER), structural similarity index (SSI), and correlation coefficient (CC). The investigation shows that the recommended approach provides greater security than other current systems.

Public health insurance and the risk of cancer-specific mortality in patients with cervical cancer: A Chinese prospective cohort study.

Cervical cancer has one of the highest incidence and mortality rates of any malignant tumor of the female reproductive tract, and its longer treatment period will place significant financial strain on patients and their families. Little is known about how health insurance policies influence cervical cancer prognosis, particularly in developing countries. The relationship between cervical cancer specific death and cervical cancer all-cause mortality with public health insurance, self-payment rate, and the combined effect of public health insurance and self-payment rate was investigated in this study. From 2015 to 2019, a prospective longitudinal cohort study on cervical cancer was carried out in Chongqing, China. We chose 4,465 Chongqing University Cancer Hospital patients who had been diagnosed with cervical cancer between 2015 and 2019. The self-payment rate and public health insurance are taken into account in our subgroup analysis. After applying the inclusion and exclusion criteria, we describe the demographic and clinical traits of patients with various insurance plans and self-payment rates using the chi-square test model. The relationship between cervical cancer patients with various types of insurance, the self-payment rate, and treatment modalities is examined using the multivariate logistic regression model. After applying the inclusion and exclusion criteria, we summarize the demographic and clinical traits of patients with various insurance plans and self-payment rates using the chi-square test model. The association between cervical cancer patients with various types of insurance, the self-payment rate, and treatment modalities is examined using the multivariate logistic regression model. The cumulative hazard ratio of all-cause death and cervical cancer-specific mortality for various insurance types and self-payment rates was then calculated using the Cox proportional hazard model and the competitive risk model. This study included a total of 3,982 cervical cancer patients. During the follow-up period (median 37.3 months, 95% CI: 36.40-38.20), 774 deaths were recorded, with cervical cancer accounting for 327 of them. Patients who obtained urban employee-based basic medical insurance (UEBMI) had a 37.1% lower risk of all-cause death compared to patients who received urban resident-based basic medical insurance (URBMI) (HRs = 0.629, 95% CI: 0.508-0.779, p = 0.001). Patients with a self-payment rate of more than 60% had a 26.9% lower risk of cervical cancer-specific mortality (HRs = 0.731, 95% CI: 0.561-0.952, p <0.02). The National Medical Security Administration should attempt to include the more effective self-paid anti-tumor medications into national medical insurance coverage within the restrictions of restricted medical insurance budget. This has the potential to reduce not only the mortality rate of cervical cancer patients, but also their financial burden. High-risk groups, on the other hand, should promote cervical cancer screening awareness, participate actively in the state-led national cancer screening project and enhance public awareness of HPV vaccine. This has the potential to reduce both cervical cancer patient mortality and the financial burden and impact.

Impact of COVID-19 on the national development of countries: Implications for the public health.

The article focuses on measuring the fluctuations in countries' development as a result of the COVID-19 pandemic. The obtained measures make it possible to predict the extent of the impact of risks to public health on the economy, financial-budgetary, political-institutional development of states in the future, as well as the social determinants of public health. This assessment represents a new paradigm that makes it possible to effectively evaluate the manifestations of the consequences of COVID-19 and to identify the relevant determinants of the lack of resilience of the medical and social security systems to the coronavirus pandemic around the world. We picked the determinant of national development indicators of the 59 countries in order to measure the fluctuations in their economic development. In addition, we applied the binary response model for identifying the economic, financial-budgetary, and political-institutional development change with the happiness index of the countries being the dependent variable. The analysis of our empirical model made it possible for us to conclude that economic and financial-budgetary components have significantly increased the influence on well-being during the COVID-19 pandemic. In contrast, we observed the decrease in the impact of political and institutional indicators during the same period.

Lightweight certificateless privacy-preserving integrity verification with conditional anonymity for cloud-assisted medical cyber–physical systems

Cloud-assisted medical cyber–physical systems (MCPSs) leverage the power of cloud computing for scalable storage and management of outsourced medical data. Based on the crucial outsourced medical data, guardians could know patient’s health condition timely, doctors can make accurate diagnoses of patients, and medical research centers could also conduct medical big data analysis. However, medical data is highly sensitive and demands strong protection. Meanwhile, the integrity of outsourced medical data is vulnerable to hardware failures, software bugs or human errors. To date, a large number of data privacy-preserving integrity auditing schemes have been presented, but most of them suffer from the burden of complex public key certificate management or the key escrow problem of identity-based cryptography. In this paper, we propose a lightweight certificateless privacy-preserving integrity verification scheme (LCPPIV) with conditional anonymity for cloud-assisted MCPSs by developing an elliptic-curve digital signature and a key exchange mechanism, which can achieve the functionalities of medical data privacy protection, integrity verification of outsourced medical data, conditional anonymity, batch auditing, and secure compensation mechanism, simultaneously. Theoretical security analysis demonstrates that our scheme is provably secure in the random oracle model, with resistance to the public key replacement attack, malicious-but-passive-KGC attack, and response auditing proofs forgery. The performance evaluations indicate that LCPPIV is much more practical for cloud-assisted MCPSs compared with state-of-art data auditing schemes.

A Study of the Impact of Population Aging on Fiscal Sustainability in China

China has entered a deeply aging society, and the aging population poses a significant public risk to fiscal sustainability. In this regard, researchers have conducted a large number of studies, but the fiscal sustainability indicators used in the existing literature are not scientific enough, the sample data are too macro, and the heterogeneity analysis is not comprehensive enough. This paper innovatively constructs fiscal sustainability indicators based on data from 4 municipalities directly under the central government, 8 provincial capitals, and 88 prefecture-level cities in China from 2010–2019, and analyzes the impact of population aging on fiscal sustainability in eastern, central, western, and multi-level cities in China, using methods such as two-way fixed-effects models. The study finds that (1) fiscal sustainability is significantly hampered by population aging; that is, the more aging there is, the less fiscal sustainability there is. (2) The inhibitory effect of population aging on fiscal sustainability is greater in developed regions compared to backward regions. Compared to prefecture-level cities, provincial cities (including municipalities and provincial capitals) are much more negatively impacted by population aging on fiscal sustainability. (3) The paths through which population aging inhibits fiscal sustainability are healthcare expenditures and social security employment expenditures. The policy recommendations put forward in this paper are to raise the fertility rate, protect the fiscal expenditures of developed regions and provincial capitals to deal with population aging, and increase the effectiveness of the use of funds for medical and health expenditures and social security employment expenditures. The conclusions and policy recommendations drawn in this paper have a positive effect on China’s response to the fiscal sustainability problems caused by an aging population.

Blockchain, Information Security, Control, and Integrity: Who Is in Charge?

Blockchain technology has attracted substantial interest in recent years, most notably for its effect on global economics through the advent of cryptocurrency. Within the health care domain, blockchain technology has been actively explored as a tool for improving personal health data management, medical device security, and clinical trial management. Despite a strong demand for innovation and cutting-edge technology in plastic surgery, integration of blockchain technologies within plastic surgery is in its infancy. Recent advances and mainstream adoption of blockchain are gaining momentum and have shown significant promise for improving patient care and information management. In this article, the authors explain what defines a blockchain and discuss its history and potential applications in plastic surgery. Existing evidence suggests that blockchain can enable patient-centered data management, improve privacy, and provide additional safeguards against human error. Integration of blockchain technology into clinical practice requires further research and development to demonstrate its safety and efficacy for patients and providers.

Research on the Effect of Commercial Health Insurance Development on Economic Efficiency.

In the process of comprehensively promoting the construction of a multi-level medical security system in China, it is very important to clarify the impact of commercial health insurance. In order to better promote the development of commercial health insurance, we explore the effect of commercial health insurance development on economic efficiency. Theoretical analysis shows that, in addition to providing health risk protection for residents, commercial health insurance can also promote the coordinated development of the health industry chain, promote risk reduction, accumulate capital, and contribute to high-quality economic development. Empirically, this study indexes a commercial health insurance development index that is more in line with China's development reality. In addition, this study compiles the economic efficiency index from the three dimensions of economic development basis, social benefits and industrial changes. We measure the commercial health insurance development index and economic efficiency index in 31 regions from 2007 to 2019, and further econometric analysis is carried out on this basis. It is found that the development of commercial health insurance can promote economic efficiency, and this result is robust. Meanwhile, the impact of commercial health insurance on economic efficiency is restricted by the economic environment itself, and the more developed the economy is, the more obvious this effect will be. Therefore, the development of commercial health insurance will significantly benefit the construction of China's multi-level medical security system and promote regional economic efficiency.

Evolutions of extracorporeal membrane oxygenator (ECMO): perspectives for advanced hollow fiber membrane.

Hollow fiber membrane is incorporated into an extracorporeal membrane oxygenator (ECMO), and the function of the membrane determines the ECMO's functions, such as gas transfer rate, biocompatibility, and durability. In Japan, the membrane oxygenator to assist circulation and ventilation is approved for ECMO support. However, in all cases, the maximum use period has been only 6h, and so-called 'off-label use' is common for ECMO support of severely ill COVID-19 patients. Under these circumstances, the HLS SET Advanced (Getinge Group Japan K.K.) was approved in 2020 for the first time in Japan as a membrane oxygenator with a two-week period of use. Following this membrane oxygenator, it is necessary to establish a domestic ECMO system that is approved for long-term use and suitable for supporting patients. Looking back on the evolution of ECMO so far, Japanese researchers and manufacturers have also contributed to the developments of ECMO globally. Currently, excellent membrane oxygenators and systems have been marketed by Japanese manufacturers and some of them are globally acclaimed, but in fact, most of the ECMO membranes are not made in Japan. Fortunately, Japan has led the world in the fields of membrane separation technology and hollow fiber membrane production. In the wake of this pandemic, from the perspective of medical and economic security, the practical use of purely domestic hollow fiber membranes and membrane oxygenators for long-term ECMO is imperative in anticipation of the next pandemic.

Evaluation of the Medical Resource Allocation: Evidence from China.

Medical resource allocation is an increasingly crucial issue. It is vital to understand residents' (people living in the local area) evaluation of it. This study explores residents' evaluation of medical resource allocation and its determinants with the dimensions of medical resource adequacy, balance, publicness, and accessibility. We used data from the China General Social Survey (CGSS). Binary logistic regression models were constructed from the four dimensions separately, and we compared the differences among them. The study's results showed that accessibility and publicness are the highest and lowest dimensions of residents' evaluation, respectively. The high evaluation of social equity may be a positive contributor to a higher evaluation of publicness and accessibility. The central region residents had the lowest evaluation of adequacy (OR = 0.697, p = 0.010) and balance (OR = 0.642, p = 0.008). To sum up, perceived social equity, social trust, and social class are crucial factors. Based on the results, the government should strengthen the supervision of the medical market, increase financial support for the health field in the central region, and establish a multi-level medical security system that may help optimize the allocation.

Copper Organometallic Iodide Arrays for Efficient X-ray Imaging Scintillators.

Lead-free organic metal halide scintillators with low-dimensional electronic structures have demonstrated great potential in X-ray detection and imaging due to their excellent optoelectronic properties. Herein, the zero-dimensional organic copper halide (18-crown-6)2Na2(H2O)3Cu4I6 (CNCI) which exhibits negligible self-absorption and near-unity green-light emission was successfully deployed into X-ray imaging scintillators with outstanding X-ray sensitivity and imaging resolution. In particular, we fabricated a CNCI/polymer composite scintillator with an ultrahigh light yield of ∼109,000 photons/MeV, representing one of the highest values reported so far for scintillation materials. In addition, an ultralow detection limit of 59.4 nGy/s was achieved, which is approximately 92 times lower than the dosage for a standard medical examination. Moreover, the spatial imaging resolution of the CNCI scintillator was further improved by using a silicon template due to the wave-guiding of light through CNCI-filled pores. The pixelated CNCI-silicon array scintillation screen displays an impressive spatial resolution of 24.8 line pairs per millimeter (lp/mm) compared to the resolution of 16.3 lp/mm for CNCI-polymer film screens, representing the highest resolutions reported so far for organometallic-based X-ray imaging screens. This design represents a new approach to fabricating high-performance X-ray imaging scintillators based on organic metal halides for applications in medical radiography and security screening.

Non-Contact Human Vital Signs Extraction Algorithms Using IR-UWB Radar: A Review

The knowledge of heart and respiratory rates (HRs and RRs) is essential in assessing human body static. This has been associated with many applications, such as survivor rescue in ruins, lie detection, and human emotion detection. Thus, the vital signal extraction from radar echoes after pre-treatments, which have been applied using various methods by many researchers, has exceedingly become a necessary part of its further usage. In this review, we describe the variety of techniques used for vital signal extraction and verify their accuracy and efficiency. Emerging approaches such as wavelet analysis and mode decomposition offer great opportunities to measure vital signals. These developments would promote advancements in industries such as medical and social security by replacing the current electrocardiograms (ECGs), emotion detection for survivor status assessment, polygraphs, etc.

Impact of China's Aging Population on Economic Development and Possible Solutions

China's economic structure has been unbalanced for a long time, and now it faces the severe challenge of the aging population. This article will deeply analyze the impact of population aging from the aspects of social impact, labor force and medical security. With the unexpected arrival of an aging society, the government, society, and individuals should remain calm. They should recognize the negative and positive aspects of its effect on social development. The reduction of cheap labor will undoubtedly harm the development of labor-intensive enterprises. However, it can force these businesses to increase their labor productivity rate, move into the field of high technology and high added value, and increase the employment rate of college students and another high-quality talent. Moreover, the aging population will drive the growth of the elderly economy and related service industries such as home Economy. In this article, we will also list several ways to solve the economic crisis caused by the aging population

An Intelligent Classification Diagnosis Based on Blood Oxygen Saturation Signals for Medical Data Security Including COVID-19 in Industry 5.0

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is gradually valued due to its high prevalence, high risk, and high mortality. Alternative to the polysomnography (PSG) diagnosis, the proposed method assesses the subject's degree of illness considering the supply chain and Industry 5.0 requirement efficiently and accurately. This article uses the blood oxygen saturation (SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) signal count of the number of apnea or hypoventilation events during the sleep of the subject, calculating the apnea-hypopnea index (AHI) and the subject's disease level. SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> signals are used to extract 35-D features based on the time domain, including approximate entropy, central tendency measure, and Lempel–Ziv complexity to accelerate the diagnosis process in supply chains. The feature selection process is reduced from 35 to 7 dimensions that benefits to the implementation in the practical supply chains in Industry 5.0 by extracting the extracted features. This article applies Pearson correlation coefficient selection, based on minimum redundancy-maximum correlation algorithm selection, and a wrapper based on the backward search algorithm. The accuracy rate is 86.92%, and the specificity is 90.7% under the selected random forest classifier. A random forest classifier was used to calculate the AHI index, and a linear regression analysis was performed with the AHI index obtained from the PSG. The result reaches a 92% accuracy rate in assessing the prevalence of OSAHS, satisfying the industrial deployment.

Research on Big Data Audit Practice based on Medical Insurance Fund Audit

The rapid development of information technology makes the national audit data base and audit method change accordingly. In recent years, China's medical insurance reform and development is remarkable. The framework of the medical insurance system covering urban and rural residents has been basically formed, and the management service system has been completely informationized and digitized. Medical security audit in the new era must adapt to the changes in the new era and step into the practice of big data audit. Based on the audit practice in the field of medical security, this paper analyzes the current situation of the big data environment faced by the current medical security fund audit, discusses the existing problems of medical insurance audit based on big data, and puts forward suggestions to promote the deepening development of big data audit.

Internet of Medical Things Privacy and Security: Challenges, Solutions, and Future Trends from a New Perspective

The Internet of Medical Things (IoMT), an application of the Internet of Things (IoT) in the medical domain, allows data to be transmitted across communication networks. In particular, IoMT can help improve the quality of life of citizens and older people by monitoring and managing the body’s vital signs, including blood pressure, temperature, heart rate, and others. Since IoMT has become the main platform for information exchange and making high-level decisions, it is necessary to guarantee its reliability and security. The growth of IoMT in recent decades has attracted the interest of many experts. This study provides an in-depth analysis of IoT and IoMT by focusing on security concerns from different points of view, making this comprehensive survey unique compared to other existing studies. A total of 187 articles from 2010 to 2022 are collected and categorized according to the type of applications, year of publications, variety of applications, and other novel perspectives. We compare the current studies based on the above criteria and provide a comprehensive analysis to pave the way for researchers working in this area. In addition, we highlight the trends and future work. We have found that blockchain, as a key technology, has solved many problems of security, authentication, and maintenance of IoT systems due to the decentralized nature of the blockchain. In the current study, this technology is examined from the application fields’ points of view, especially in the health sector, due to its additional importance compared to other fields.

Development and x-ray imaging performance of Tb-doped GdAlO3-αAl2O3 submicron-diameter phase-separated scintillator fibers

Scintillators are key components in high-energy x-ray detectors for x-ray computed tomography, which are applied in medical diagnosis, nondestructive testing, and security inspection. Scintillators in x-ray imaging are required to have both high spatial resolution and sensitivity; however, a trade-off between spatial resolution and sensitivity exists. To improve the sensitivity of a scintillator, its thickness must be increased; however, spatial resolution deteriorates with increasing thickness. Here, we developed a well-aligned Tb-doped GdAlO3-αAl2O3 phase-separated scintillator fiber (PSSF) with a diameter of 1.25-μm by a micro-pulling-down method. The luminescence, scintillation, and imaging performances of a grown PSSF sample were evaluated. X-ray-induced radioluminescence measurements of the sample showed Tb3+ 4f–4f emissions in the wavelength range of 470–700 nm, and the maximum emission peak was at 550 nm. The contrast transfer function at 10 lp/mm was 82% for both 270 and 500 μm-thick PSSF samples. We calculated the luminescence index, which is the product of the scintillator’s light yield and sensitivity, of the samples and compared their values with commercially available conventional CsI:Tl columnar scintillators. The Tb-doped GdAlO3-αAl2O3 PSSF exhibits higher contrast transfer function and luminescence index values at above 60 keV x-ray region compared with the tested conventional scintillators.

Blockchain Technology: Security Issues, Healthcare Applications, Challenges and Future Trends

Blockchain technology provides a data structure with inherent security properties that include cryptography, decentralization, and consensus, which ensure trust in transactions. It covers widely applicable usages, such as in intelligent manufacturing, finance, the Internet of things (IoT), medicine and health, and many different areas, especially in medical health data security and privacy protection areas. Its natural attributes, such as contracts and consensus mechanisms, have leading-edge advantages in protecting data confidentiality, integrity, and availability. The security issues are gradually revealed with in-depth research and vigorous development. Unlike traditional paper storage methods, modern medical records are stored electronically. Blockchain technology provided a decentralized solution to the trust-less issues between distrusting parties without third-party guarantees, but the “trust-less” security through technology was easily misunderstood and hindered the security differences between public and private blockchains appropriately. The mentioned advantages and disadvantages motivated us to provide an advancement and comprehensive study regarding the applicability of blockchain technology. This paper focuses on the healthcare security issues in blockchain and sorts out the security risks in six layers of blockchain technology by comparing and analyzing existing security measures. It also explores and defines the different security attacks and challenges when applying blockchain technology, which promotes theoretical research and robust security protocol development in the current and future distributed work environment.

The status of emotional labour and its influence on job burnout among village doctors during the COVID-19 pandemic in China: a cross-sectional study

BackgroundVillage doctors in China are not only the gatekeepers of rural residents' health but also the net bottom of the medical security system. However, emotional labour is increasingly threatening the stability of the rural primary medical system. In addition, the ongoing coronavirus disease 2019 (COVID-19) pandemic has further exposed the vulnerability of human resources in China's rural health system. This study aims to evaluate the current situation of emotional labour among village doctors and explore the impact of emotional labour on job burnout during the COVID-19 pandemic in China.MethodsA cross-sectional survey was conducted in December 2021 in Shandong Province. We used structured questionnaires to collect data, including sociodemographic characteristics, emotional labour, and job burnout. Data were analysed by t test, analysis of variance (ANOVA), Pearson correlation analysis, and hierarchical multiple linear regression.ResultsA total of 1,093 village doctors from Shandong Province participated in the study. More than half of the participants were male (62.40%) and were between 41 and 50 years old (53.43%). The total mean score of emotional labour was 3.17 ± 0.67, of which the surface acting (SA) score was 2.28 ± 0.90, and the deep acting (DA) score was 3.91 ± 0.93. There were significant differences in SA according to gender and work content (P < 0.05) and in DA according to gender, age, education level, and work content (P < 0.05). Pearson correlation analysis showed that SA was positively correlated with job burnout (P < 0.001), and DA was negatively correlated with job burnout (P < 0.001). Hierarchical multiple linear regression analysis revealed that 29% of the variance in job burnout is attributable to SA (β = 0.530, P < 0.001) and DA (β = -0.154, P < 0.001).ConclusionVillage doctors in Shandong Province performed moderate levels of emotional labour during the COVID-19 pandemic. SA had a significant positive effect on job burnout, while DA had a significant negative effect on job burnout among village doctors. Administrators should enhance training on emotional labour for village doctors to play a positive role in alleviating their job burnout.

Implementation of a block cipher algorithm for medical information security on cloud environment: using modified advanced encryption standard approach

Implementation of a block cipher algorithm for medical information security on cloud environment: using modified advanced encryption standard approach

Regional disparities and influencing factors of high quality medical resources distribution in China

BackgroundWith the gradual increase of residents’ income and the continuous improvement of medical security system, people’s demand for pursuing higher quality and better medical and health services has been released. However, so far little research has been published on China's high quality medical resources (HQMR). This study aims to understand the spatiotemporal variation trend of HQMR from 2006 to 2020, analyze regional disparity of HQMR in 2020, and further explore the main factors influencing the distribution of HQMR in China.MethodsThe study selected Class III level A hospitals (the highest level medical institutions in China) to represent HQMR. Descriptive statistical methods were used to address the changes in the distribution of HQMR from 2006 to 2020. Lorentz curve, Gini coefficient (G), Theil index (T) and High-quality health resource density index (HHRDI) were used to calculate the degree of inequity. The geographical detector method was used to reveal the key factors influencing the distribution of HQMR.ResultsThe total amount of HQMR in China had increased year by year, from 647 Class III level A hospitals in 2006 to 1580 in 2020. In 2020, G for HQMR by population was 0.166, while by geographic area was 0.614. T was consistent with the results for G, and intra-regional contribution rates were higher than inter-regional contribution rates. HHRDI showed that Beijing, Shanghai, and Tianjin had the highest allocated amounts of HQMR. The results of the geographical detector showed that total health costs, government health expenditure, size of resident populations, GDP, number of medical colleges had a significant impact on the spatial distribution of HQMR and the q values were 0.813, 0.781, 0.719, 0.661, 0.492 respectively. There was an interaction between the influencing factors.ConclusionsChina's total HQMR is growing rapidly but is relatively inadequate. The distribution of HQMR by population is better than by geography, and the distribution by geography is less equitable. Population size and geographical area both need to be taken into account when formulating policies, rather than simply increasing the number of HQMR.