Preserving Patient Privacy Research Articles

An Anonymous Authenticated Key Agreement Scheme for Telecare Medical Information Systems

With the rapid development of information technology from one side and the experience of the COVID-19 pandemic from the other side, people presently prefer to access healthcare services remotely. Telecare Medical Information System (TMIS) provides more flexible, faster, and more convenient e-healthcare services available to all people, particularly those who lack access to physicians due to their geographical restrictions. However, due to the sensitivity of medical information, preventing unauthorized access to patient data and preserving patient privacy is crucial. In this paper, we propose an authenticated key agreement scheme for TMIS to preserve the privacy of the patient’s identity from all internal (even the health server and the physician) and external entities. Moreover, the physician’s identity is kept secret from all external entities. Formal and informal security analysis of the proposed scheme indicates that it is secure against all attacks in the context.

Artificial Intelligence-based Enhanced Brain Tumor Prediction: A Comprehensive Investigation of Machine Learning and Deep Learning

Brain tumors pose a significant threat to patients’ quality of life and survival rates, with traditional diagnostic methods often falling short due to their time-consuming nature and susceptibility to high misdiagnosis rates. Recent progress in Artificial Intelligence (AI), especially in Machine Learning (ML) and Deep Learning (DL), offer promising alternatives for the prediction and diagnosis of brain tumors. AI models, including Support Vector Machine (SVM), Random Forests, Logistic Regression, Artificial Neural Network (ANN), Convolutional Neural Network (CNN), and Long Short-Term Memory (LSTM) models networks, have demonstrated superior performance in processing complex medical data, thereby enhancing predictive accuracy and aiding clinical decision-making. This review systematically evaluates the application of these AI techniques in brain tumor prediction, highlighting their strengths and limitations, as well as the challenges faced in terms of model interpretability, data applicability, and patient privacy. Furthermore, this paper explored future prospects for improving model interpretability, transfer learning and domain adaptation for enhancing model applicability, and federated learning for preserving patient privacy. By addressing these issues, Artificial Intelligence can significantly advance brain tumor diagnosis and treatment, ultimately improving patient outcomes.

Daymet and DeGAUSS: Development of a Novel Method that Links High Spatial Resolution Gridded Meteorological Data with Geocoded Healthcare Encounters

ObjectiveDue to human-caused climate change, extreme temperature-related morbidity/mortality are increasing global public health concerns. To better understand the burdens of heat exposure, researchers must merge accurate/granular environmental data with clinical data. We developed a privacy-preserving method that links high-spatial-resolution continuous, gridded, meteorological data to geocoded healthcare encounters. ApproachIn an R environment, we developed code that links geocoded healthcare encounters to publicly-available Daymet data via the corresponding Daymet raster cell number and healthcare encounter date. Daymet provides daily 1km x 1km surface meteorological data over North America since 1980. User specifications include the bounding box latitude/longitude of Daymet data download, which Daymet environmental variables are linked, and the day-lag of Daymet data matching to healthcare encounter date. ResultsLinking 500,000 healthcare encounters over a 7-day lag with 7 years of Daymet data comprising minimum/maximum temperature over a bounding box encompassing Cook County, Illinois (5,670 1km raster cells) took 11.92 minutes with 4 CPUs and 8GB RAM. Thirteen years of Daymet data took 23.85 minutes. Linking 7.5 million encounters with 7 years of data took 28.49 minutes. ConclusionsOur newly-developed method for linking Daymet data to geocoded healthcare encounters preserves patient privacy, and processes the data efficiently over a minimal timespan. ImplicationsDaymet data linked to healthcare encounters allows for accurate assessment of the association between environmental variable exposure and any clinical outcome over North America. Packaging the code allows for public distribution within the Decentralized Geomarker Assessment for Multi-Site Studies (DeGAUSS) universe of geoanalytic tools.

Healthcare Provider's Preferences on Open Versus Restricted Visiting Hours in Surgical Intensive Care Unit.

The increasing consideration of open visiting hours in intensive care units (ICUs) has presented implementation challenges. Recognizing the invaluable insights of healthcare providers, this study aimed to assess their perspectives on the potential impact of altering ICU visiting policies on patient care. In a single-institution, cross-sectional study, a five-point Likert survey was administered to healthcare providers working in a surgical ICU to assess their perceptions of open and restricted visiting hours. Descriptive statistics were used to analyze the responses. Ninety-three healthcare providers participated, including nurses (53%), resident physicians (23%), and other healthcare professionals. The majority (81%) did not believe that open ICU visiting hours would enhance patient-centered care. Providers expressed concerns that open visitation could lead to increased provider stress (89%), physical barriers to patient access (80%), disruption in workflow (90%), and provider burnout (76%). Conversely, they perceived that restricted visitation would preserve patient privacy (87%), promote better healing for patients (64%), reduce provider stress (81%), and improve workflow (95%). Nurses were more likely than resident physicians to perceive that open ICU hours would alleviate familial stress (p=0.022). Additionally, both nurses and other healthcare providers recognized the potential for open ICU hours to improve communication between patient families and healthcare teams (p<0.05). Notably, there were no significant differences among providers in perceptions of the impact of open versus restricted visitation on provider stress, workflow, or other factors (p>0.05). This survey reveals a negative perception of open ICU visiting hours among healthcare providers in a surgical ICU, with concerns that such a change could increase stress for both patients and providers. These findings underscore the potential challenges and negative impacts of implementing open visiting hours in this setting, emphasizing the need for careful consideration and further research to inform policy decisions and visitation practices.

Quality Assessment of Brain MRI Defacing Using Machine Learning.

Defacing of brain magnetic resonance imaging (MRI) scans is a crucial process in medical imaging research aimed at preserving patient privacy while maintaining data integrity. However, existing defacing algorithms are prone to errors, potentially compromising patient anonymity. This paper investigates the feasibility and efficacy of automated quality assessment for defaced brain MRIs using machine learning (ML). Our findings demonstrate the promising capability of ML models in accurately distinguishing between properly and inadequately defaced MRI scans.

The role of blockchain to secure internet of medical things

This study explores integrating blockchain technology into the Internet of Medical Things (IoMT) to address security and privacy challenges. Blockchain’s transparency, confidentiality, and decentralization offer significant potential benefits in the healthcare domain. The research examines various blockchain components, layers, and protocols, highlighting their role in IoMT. It also explores IoMT applications, security challenges, and methods for integrating blockchain to enhance security. Blockchain integration can be vital in securing and managing this data while preserving patient privacy. It also opens up new possibilities in healthcare, medical research, and data management. The results provide a practical approach to handling a large amount of data from IoMT devices. This strategy makes effective use of data resource fragmentation and encryption techniques. It is essential to have well-defined standards and norms, especially in the healthcare sector, where upholding safety and protecting the confidentiality of information are critical. These results illustrate that it is essential to follow standards like HIPAA, and blockchain technology can help ensure these criteria are met. Furthermore, the study explores the potential benefits of blockchain technology for enhancing inter-system communication in the healthcare industry while maintaining patient privacy protection. The results highlight the effectiveness of blockchain’s consistency and cryptographic techniques in combining identity management and healthcare data protection, protecting patient privacy and data integrity. Blockchain is an unchangeable distributed ledger system. In short, the paper provides important insights into how blockchain technology may transform the healthcare industry by effectively addressing significant challenges and generating legal, safe, and interoperable solutions. Researchers, doctors, and graduate students are the audience for our paper.

Exploiting 2D-SDMCHM and matching embedding driven by flag-shaped hexagon prediction for visually meaningful medical image cryptosystem

With the proliferation of advanced medical technologies and smart wearable devices, a considerable volume of patient data and medical images is being generated and stored, leading to an escalating concern over patient privacy violations and manipulation. Therefore, safeguarding the secrecy and integrity of medical images is paramount for preserving patient privacy and ensuring accurate medical diagnostics. To tackle this challenge, this paper introduces a novel approach, the Visually Meaningful Medical Image Cryptosystem (VMMIC), leveraging a 2-Dimensional Sinusoidal Discrete Memristor Coupled Hyperchaotic Map (2D-SDMCHM) to protect the privacy of medical images. The innovation of this study is primarily reflected in three aspects: Firstly, a novel Discrete Memristor (DM) model is proposed, upon which a new 2D-SDMCHM is constructed. Comparative analysis showcases its superior chaos robustness, as evidenced by evaluations through bifurcation diagrams, phase trajectories, Lyapunov exponents, and Shannon entropy. Secondly, we introduce a measurement matrix optimization algorithm based on Optimal Matrix Arrangement (OMA) for Compressive Sensing (CS), aimed at minimizing the coherence of the measurement matrix, thereby enhancing reconstruction accuracy. Lastly, a Matching Embedding Method Driven by Flag-Shaped Hexagon Prediction (MEMFHP) is introduced to ensure lossless concealment of confidential information. Experimental findings and comparative evaluations affirm the VMMIC's capability to meet high standards of reconstruction quality, steganography, and efficiency in handling medical images, while also demonstrating robustness against various attacks. Consequently, the proposed VMMIC holds significant promise for practical implementation in engineering applications.

Federated Active Learning Framework for Efficient Annotation Strategy in Skin-Lesion Classification

Federated Learning (FL) enables multiple institutes to train models collaboratively without sharing private data. Current FL research focuses on communication efficiency, privacy protection, and personalization and assumes that the data of FL have already been ideally collected. In medical scenarios, however, data annotation demands both expertise and intensive labor, which is a critical problem in FL. Active learning (AL), has shown promising performance in reducing the number of data annotations in medical image analysis. We propose a federated AL (FedAL) framework in which AL is executed periodically and interactively under FL. We exploit a local model in each hospital and a global model acquired from FL to construct an ensemble. We use ensemble-entropy-based AL as an efficient data-annotation strategy in FL. Therefore, our FedAL framework can decrease the amount of annotated data and preserve patient privacy while maintaining the performance of FL. To our knowledge, this FedAL framework applied to medical images has not been previously reported. We validated our framework on real-world dermoscopic datasets. Using only 50% of samples, our framework was able to achieve state-of-the-art performance on a skin-lesion classification task. Our framework performed better than several state-of-the-art AL methods under FL and achieved comparable performance to full-data FL.

Smart Defense: How Self-Learning AI Can Shield Bangladeshi Medical Records

The digitalization of healthcare records in Bangladesh presents both opportunities and challenges, particularly concerning the security and protection of sensitive patient information. As electronic health records (EHRs) become increasingly prevalent, the threat of cyberattacks targeting medical data escalates, necessitating innovative solutions to fortify the country's healthcare cybersecurity infrastructure. This paper investigates the efficacy of self-learning artificial intelligence (AI) systems in safeguarding Bangladeshi medical records against cyber threats. The traditional methods of securing medical records, such as firewalls and antivirus software, are proving inadequate against the evolving tactics of cybercriminals. Bangladesh faces unique challenges in this regard, including limited resources, lack of cybersecurity awareness among healthcare professionals, technological fragmentation, and an increasingly sophisticated threat landscape. To address these challenges, there is a growing imperative to explore novel approaches that can adapt and evolve in real-time to counter emerging cyber threats. Self-learning AI systems represent a promising frontier in healthcare cybersecurity. By leveraging advanced machine learning algorithms, these systems can analyze vast amounts of data to detect patterns indicative of cyber threats. Unlike static security measures, self-learning AI continuously learns from new information and adjust their defense strategies, accordingly, enabling them to stay ahead of evolving threats. Key functionalities of self-learning AI include anomaly detection, threat prediction, and adaptive defense mechanisms, all of which are essential for safeguarding medical records in Bangladesh's healthcare landscape. The implications of integrating self-learning AI into Bangladesh's healthcare cybersecurity framework are significant. Not only can these technologies enhance the detection and prevention of cyber threats, but they can also alleviate resource constraints and technical challenges faced by healthcare organizations. However, successful implementation requires comprehensive training, adherence to data privacy regulations, and ongoing monitoring to ensure the effectiveness and reliability of AI-driven security measures. The protection of medical records is paramount as Bangladesh continues its digital transformation in healthcare. Self-learning AI offers a dynamic and proactive approach to cybersecurity, empowering healthcare organizations to mitigate risks and preserve patient privacy in an increasingly digitized landscape. Embracing these innovative technologies is crucial for building a resilient healthcare ecosystem that prioritizes data security and patient trust.

A protocol for annotation of total body photography for machine learning to analyze skin phenotype and lesion classification.

Artificial Intelligence (AI) has proven effective in classifying skin cancers using dermoscopy images. In experimental settings, algorithms have outperformed expert dermatologists in classifying melanoma and keratinocyte cancers. However, clinical application is limited when algorithms are presented with 'untrained' or out-of-distribution lesion categories, often misclassifying benign lesions as malignant, or misclassifying malignant lesions as benign. Another limitation often raised is the lack of clinical context (e.g., medical history) used as input for the AI decision process. The increasing use of Total Body Photography (TBP) in clinical examinations presents new opportunities for AI to perform holistic analysis of the whole patient, rather than a single lesion. Currently there is a lack of existing literature or standards for image annotation of TBP, or on preserving patient privacy during the machine learning process. This protocol describes the methods for the acquisition of patient data, including TBP, medical history, and genetic risk factors, to create a comprehensive dataset for machine learning. 500 patients of various risk profiles will be recruited from two clinical sites (Australia and Spain), to undergo temporal total body imaging, complete surveys on sun behaviors and medical history, and provide a DNA sample. This patient-level metadata is applied to image datasets using DICOM labels. Anonymization and masking methods are applied to preserve patient privacy. A two-step annotation process is followed to label skin images for lesion detection and classification using deep learning models. Skin phenotype characteristics are extracted from images, including innate and facultative skin color, nevi distribution, and UV damage. Several algorithms will be developed relating to skin lesion detection, segmentation and classification, 3D mapping, change detection, and risk profiling. Simultaneously, explainable AI (XAI) methods will be incorporated to foster clinician and patient trust. Additionally, a publicly released dataset of anonymized annotated TBP images will be released for an international challenge to advance the development of new algorithms using this type of data. The anticipated results from this protocol are validated AI-based tools to provide holistic risk assessment for individual lesions, and risk stratification of patients to assist clinicians in monitoring for skin cancer.

PPPCT: Privacy-Preserving framework for Parallel Clustering Transcriptomics data

Single-cell transcriptomics data provides crucial insights into patients’ health, yet poses significant privacy concerns. Genomic data privacy attacks can have deep implications, encompassing not only the patients’ health information but also extending widely to compromise their families’. Moreover, the permanence of leaked data exacerbates the challenges, making retraction an impossibility. While extensive efforts have been directed towards clustering single-cell transcriptomics data, addressing critical challenges, especially in the realm of privacy, remains pivotal. This paper introduces an efficient, fast, privacy-preserving approach for clustering single-cell RNA-sequencing (scRNA-seq) datasets. The key contributions include ensuring data privacy, achieving high-quality clustering, accommodating the high dimensionality inherent in the datasets, and maintaining reasonable computation time for big-scale datasets. Our proposed approach utilizes the map-reduce scheme to parallelize clustering, addressing intensive calculation challenges. Intel Software Guard eXtension (SGX) processors are used to ensure the security of sensitive code and data during processing. Additionally, the approach incorporates a logarithm transformation as a preprocessing step, employs non-negative matrix factorization for dimensionality reduction, and utilizes parallel k-means for clustering. The approach fully leverages the computing capabilities of all processing resources within a secure private cloud environment. Experimental results demonstrate the efficacy of our approach in preserving patient privacy while surpassing state-of-the-art methods in both clustering quality and computation time. Our method consistently achieves a minimum of 7% higher Adjusted Rand Index (ARI) than existing approaches, contingent on dataset size. Additionally, due to parallel computations and dimensionality reduction, our approach exhibits efficiency, converging to very good results in less than 10 seconds for a scRNA-seq dataset with 5000 genes and 6000 cells when prioritizing privacy and under two seconds without privacy considerations.Availability and implementationCode and datasets availability: https://github.com/University-of-Windsor/PPPCT.

Insurechain : Empowering You with Block Chain Insurance

The integration of blockchain technology into health insurance represents a transformation towards a secure, efficient, and patient-centered system. This content introduces a novel approach to insurance by utilizing blockchain data distribution, smart contracts, and privacy measures. The primary objective is to enhance application efficiency while safeguarding health information. The system operates on a permissioned blockchain network and employs smart contracts to enforce rules and ensure the verification process. The decentralized nature of blockchain guarantees data integrity, fraud prevention, and preserves patient privacy through encryption technology. Collaboration is facilitated through information systems that enable effective communication among stakeholders. Proof of concept demonstrates superior data security, accelerated data processing, and increased patient control over medical data. These findings underscore the immense potential of blockchain to revolutionize health insurance in alignment with the global trend towards digital transformation and patient empowerment.

Fast and Lightweight Image Cryptosystem for IoMT Applications

This paper presents a fast and lightweight image encryption technique founded on a new concept of progressive and selective diffusion. We make use of modified chaotic systems like the sine-logistic system, sine-tangent system, and tent-logistic system to generate key blocks for diffusion. The encryption procedure comprises three stages: column diffusion, permutation, and row diffusion, which collectively contribute to the overall encryption mechanism. In the first stage, progressive and selective column substitution of the input image is conducted employing key-blocks D1 and D2, in a manner that each substituted column data is a function of previously diffused data. In the second stage, the column-substituted image goes through an adaptive permutation operation realized using an improved sin-logistic system. The last stage incorporates two distinct mappings based on key arrays and key blocks to ensure selective and progressive inter-row substitution/diffusion. The experimental results suggest that the proposed image system exhibits rapid performance as it reports an average encryption time of 0.03 seconds for an image of the size 256×256. Besides, the use of 1-D chaotic maps together with simple yet effective confusion and diffusion processes make it lightweight. Furthermore, it provides better security performance shown by various parameters like Information Entropy Analysis (IE), Correlation Coefficient analysis (CC), Histogram analysis, Differential Attacks Analysis (NPCR and UACI), key sensitivity assessment, and fidelity analysis. The suggested system has the capability to meet the cryptographic objectives as it reports average values of IE = 7.9974, CC =0.0035, NPCR =99.61%, UACI = 33.48%, and an enormously large key space compared to the state-of-art. The proposed technique offers enhanced data security, preserving patient privacy and preventing unauthorized access, while ensuring efficient encryption performance to assure the security and immediate transmission and storage of medical images. The better security performance together with computational efficiency and lightweight nature makes it an ideal candidate to be used in IoMT systems.

Leveraging semantic context to establish access controls for secure cloud-based electronic health records

With the continuous growth of cloud-based Electronic Health Record (EHR) systems and medical data, medical organizations are particularly concerned about storing patient data to provide fast services while adhering to privacy and security concerns. Existing EHR systems often face challenges in handling heterogeneous data and maintaining good performance with data growth. These systems mostly use relational databases or partially store data in a knowledge graph, making it challenging to handle big data and allowing flexible schema expansion. Hence, there is a need to address these problems. This paper provides a solution by proposing a novel graph-based EHR system integrating Attribute-Based Encryption and Semantic Web Technologies to ensure fine-grained EHR field-level security of patient records. Our approach leverages semantic context to query through a knowledge graph that stores encrypted medical data in the nodes, making it possible to handle heterogeneous data while ensuring optimal performance and preserving patient privacy.

Enhancing accuracy and privacy in speech-based depression detection through speaker disentanglement

Speech signals are valuable biomarkers for assessing an individual’s mental health, including identifying Major Depressive Disorder (MDD) automatically. A frequently used approach in this regard is to employ features related to speaker identity, such as speaker-embeddings. However, over-reliance on speaker identity features in mental health screening systems can compromise patient privacy. Moreover, some aspects of speaker identity may not be relevant for depression detection and could serve as a bias factor that hampers system performance. To overcome these limitations, we propose disentangling speaker-identity information from depression-related information. Specifically, we present four distinct disentanglement methods to achieve this — adversarial speaker identification (SID)-loss maximization (ADV), SID-loss equalization with variance (LEV), SID-loss equalization using Cross-Entropy (LECE) and SID-loss equalization using KL divergence (LEKLD). Our experiments, which incorporated diverse input features and model architectures, have yielded improved F1 scores for MDD detection and voice-privacy attributes, as quantified by Gain in Voice Distinctiveness (GVD) and De-Identification Scores (DeID). On the DAIC-WOZ dataset (English), LECE using ComparE16 features results in the best F1-Scores of 80% which represents the audio-only SOTA depression detection F1-Score along with a GVD of −1.1 dB and a DeID of 85%. On the EATD dataset (Mandarin), ADV using raw-audio signal achieves an F1-Score of 72.38% surpassing multi-modal SOTA along with a GVD of −0.89 dB dB and a DeID of 51.21%. By reducing the dependence on speaker-identity-related features, our method offers a promising direction for speech-based depression detection that preserves patient privacy.

ECG signals-based security and steganography approaches in WBANs: A comprehensive survey and taxonomy

Wireless Body Area Networks (WBANs) are integral components of e-healthcare systems, responsible for monitoring patients' physiological states through intelligent implantable or wearable sensor nodes. These nodes collect medical data, which is then transmitted to remote healthcare facilities for thorough evaluation. Securing medical data within WBANs is paramount due to its central role in preserving patient privacy and confidentiality. Notably, Electrocardiogram (ECG) signals have recently gained prominence as pivotal elements within diverse security frameworks. Incorporating ECG signals strategically enhances the security and reliability of WBANs and broader e-healthcare systems, instilling greater trustworthiness. This survey article provides an in-depth exploration of contemporary ECG-based security schemes, adding to the scholarly discourse. The imperative to categorize these security paradigms revolves around their use of ECG signals. This categorization identifies three key domains: the first involves schemes that utilize ECG signals for cryptographic operations, encompassing key generation, agreement, management, and authentication. The second category employs steganography-based techniques, using ECG signals to conceal patients' sensitive medical data. The third category focuses on enhancing ECG signal security during data transmission. Each category is meticulously elaborated, detailing architectural foundations, notable contributions, and intrinsic security services. Furthermore, each section presents a comprehensive overview of the attributes characterizing ECG-based security frameworks. This includes insights into employed datasets, simulation environments, evaluation metrics, and inherent advantages and limitations. Expanding on this, a thorough analysis of distinctive attributes underpinning these security frameworks concludes by shedding light on potential directions for future research.

Federated Inverse Reinforcement Learning for Smart ICUs With Differential Privacy

Clinical decision-making models have been developed to support therapeutic interventions based on medical data from either a single hospital or multiple hospitals. However, models based on multi-hospital data require collaboration among hospitals to integrate local data, which can result in information leakage and violate patient privacy. To address this challenge, we propose a novel approach that combines federated learning with inverse reinforcement learning to create an efficient medical decision-making support tool while preserving patient privacy. Our approach uses an inverse reinforcement learning algorithm with differential privacy to train a neural network-based agent on local data containing clinician trajectories, which learns a private treatment policy by observing patients’ conditions. Additionally, we integrate federated learning into the proposed algorithm to learn a global optimal action policy collaboratively among various smart ICUs, overcoming data limitations at each hospital. We evaluate our approach using real-world medical data and demonstrate that it achieves superior performance in a distributed manner.

Association of Health Care Work With Anxiety and Depression During the COVID-19 Pandemic: Structural Topic Modeling Study

Background Stressors for health care workers (HCWs) during the COVID-19 pandemic have been manifold, with high levels of depression and anxiety alongside gaps in care. Identifying the factors most tied to HCWs’ psychological challenges is crucial to addressing HCWs’ mental health needs effectively, now and for future large-scale events. Objective In this study, we used natural language processing methods to examine deidentified psychotherapy transcripts from telemedicine treatment during the initial wave of COVID-19 in the United States. Psychotherapy was delivered by licensed therapists while HCWs were managing increased clinical demands and elevated hospitalization rates, in addition to population-level social distancing measures and infection risks. Our goal was to identify specific concerns emerging in treatment for HCWs and to compare differences with matched non-HCW patients from the general population. Methods We conducted a case-control study with a sample of 820 HCWs and 820 non-HCW matched controls who received digitally delivered psychotherapy in 49 US states in the spring of 2020 during the first US wave of the COVID-19 pandemic. Depression was measured during the initial assessment using the Patient Health Questionnaire-9, and anxiety was measured using the General Anxiety Disorder-7 questionnaire. Structural topic models (STMs) were used to determine treatment topics from deidentified transcripts from the first 3 weeks of treatment. STM effect estimators were also used to examine topic prevalence in patients with moderate to severe anxiety and depression. Results The median treatment enrollment date was April 15, 2020 (IQR March 31 to April 27, 2020) for HCWs and April 19, 2020 (IQR April 5 to April 27, 2020) for matched controls. STM analysis of deidentified transcripts identified 4 treatment topics centered on health care and 5 on mental health for HCWs. For controls, 3 STM topics on pandemic-related disruptions and 5 on mental health were identified. Several STM treatment topics were significantly associated with moderate to severe anxiety and depression, including working on the hospital unit (topic prevalence 0.035, 95% CI 0.022-0.048; P&lt;.001), mood disturbances (prevalence 0.014, 95% CI 0.002-0.026; P=.03), and sleep disturbances (prevalence 0.016, 95% CI 0.002-0.030; P=.02). No significant associations emerged between pandemic-related topics and moderate to severe anxiety and depression for non-HCW controls. Conclusions The study provides large-scale quantitative evidence that during the initial wave of the COVID-19 pandemic, HCWs faced unique work-related challenges and stressors associated with anxiety and depression, which required dedicated treatment efforts. The study further demonstrates how natural language processing methods have the potential to surface clinically relevant markers of distress while preserving patient privacy.

An Open-Source Software Tool to Facilitate Data Protection Impact Assessments

In the realm of medical research, preserving patient privacy while facilitating effective research and collaborations poses a significant challenge. Data protection impact assessments (DPIAs) and associated methodologies have emerged as a response to this dual imperative. DPIAs necessitate expertise across diverse domains, resulting in a complex procedural landscape. To address this, we present “DPIA click&amp;go”, a user-friendly tool designed to streamline the DPIA process in a plug-and-play manner. This tool enables users to semi-automatically select risks from predefined categories, construct evaluation matrices, access risk-mitigating measures, and re-evaluate risks after the application of mitigation strategies. Tailoring risks and measures to each institute’s needs is essential, facilitated by the provided data model, considerably simplifying DPIA creation at an institutional level. The efficacy of the DPIA click&amp;go tool was validated with a real-world project, comparing its performance with a manually created DPIA in terms of risk coverage and mitigation strategies. The promising outcomes of this tool underscore its potential within the national data protection landscape, suggesting its possible foundational role in harmonizing data protection practices at a larger, potentially, European or global, scale.

A decentralized public-permissioned blockchain framework for enhanced security of health records in fog computing

Medical health records comprise sensitive patient data for precise diagnosis and successive treatment. However, it must be stored and shared securely to protect data privacy. Generally, health records are kept on centralized servers, which raise the risk of security breaches and involve trust in a single authority that cannot efficiently defend data from internal attacks. Blockchain (BC) is extensively used in medical health records management because of its decentralized and tamper-proof properties. This work introduces a public-permissioned BC technology with a decentralized ledger (DL) to manage medical health records in the fog computing layer. The considered BC is decentralized and allows the transmission of records within the decentralized network of records. The data blocks are hashed using the SHA-256 hash algorithm. Especially, an Adaptive RSA Digital Signature Algorithm (ARSA-DS) is developed to prevent data tampering with medical health records in the fog computing layer. Moreover, an Ebola Search Optimization based Key Selection (ESO-KS) technique is employed to find the ideal key from the randomly generated keys to reduce processing time and increase overall efficiency. The proposed decentralized BC framework will help to preserve patient privacy and prevent the tampering of health records by attacks; moreover, it is efficient in terms of confidentiality, integrity, and availability.