Smart Medical Devices Research Articles

Secure Remote Multi-Factor Authentication Scheme Based on Chaotic Map Zero-Knowledge Proof for Crowdsourcing Internet of Things

Recently, application scenario of crowdsourcing IoT has covered to e-healthcare service, smart home, smart city, internet of vehicles due to the proliferation of smart devices such as smart mobile devices, smart wearable device, smart medical devices and smart furniture, etc. Patient's data collected by the smart devices send to the various remote medical servers. A group of medical professionals remote access patient data stored at the medical server database. Smart home users want to remote real-time access information of smart devices at home. All these operations need via wireless remote communication, which is suffering from various kinds of threat and attacks. Hence, there are a large number of multi-factor remote authentication and key agreement schemes designed for the application of crowdsourcing IoT. However, in most existing related multi-factor schemes, all factors for identity authentication only act as a parameter for encrypting the local secret key. In this paper, we propose a new secure remote multi-factor authentication scheme that includes three factors: 1) user identity; 2) password; and 3) user biometrics, which are authenticated by the remote server, act as a part of the secret key and participate in the key agreement process. We choose the chaotic map since it has a smaller key size and lower computational overhead, and then achieve remote multi-factor authentication and key agreement by artfully employ it to zero-knowledge technology and the fuzzy extractor technology. Our scheme is more secure and robust since the user revealing nothing sensitive information, and the adversary cannot impersonate any user even if he gets the server's master key. We have done security proof for our proposed scheme using the Random-Or-Real(ROR) model, Burrows-Abadi-Needham (BAN) logic, and ProVerif 2.00 to show that the presented scheme is secure. Also, we give an additional security analysis for other various attacks. Finally, according to the test and simulation result, the proposed scheme is very suitable for the power-constrained smart devices, and in the next generation 5G communication environment, its applicability and usability will be greatly enhanced.

BAKMP-IoMT: Design of Blockchain Enabled Authenticated Key Management Protocol for Internet of Medical Things Deployment

The Internet of Medical Things (IoMT) is a kind of connected infrastructure of smart medical devices along with software applications, health systems and services. These medical devices and applications are connected to healthcare systems through the Internet. The Wi-Fi enabled devices facilitate machine-to-machine communication and link to the cloud platforms for data storage. IoMT has the ability to make accurate diagnoses, with fewer mistakes and lower costs of care. IoMT with smartphone applications permits the patients to exchange their health related confidential and private information to the healthcare experts (i.e., doctors) for the better control of diseases, and also for tracking and preventing chronic illnesses. Due to insecure communication among the entities involved in IoMT, an attacker can tamper with the confidential and private health related information for example an attacker can not only intercept the messages, but can also modify, delete or insert malicious messages during communication. To deal this sensitive issue, we design a novel blockchain enabled authentication key agreement protocol for IoMT environment, called BAKMP-IoMT. BAKMP-IoMT provides secure key management between implantable medical devices and personal servers and between personal servers and cloud servers. The legitimate users can also access the healthcare data from the cloud servers in a secure way. The entire healthcare data is stored in a blockchain maintained by the cloud servers. A detailed formal security including the security verification of BAKMP-IoMT using the widely-accepted Automated Validation of Internet Security Protocols and Applications (AVISPA) tool is performed to demonstrate its resilience against the different types of possible attack. The comparison of BAKMP-IoMT with relevant existing schemes is conducted which identifies that the proposed system furnishes better security and functionality, and also needs low communication and computational costs as compared to other schemes. Finally, the simulation of BAKMP-IoMT is conducted to demonstrate its impact on the performance parameters.

Customized Smart Medical Devices Based on 3D Printing-assisted Fabrication

Customized Smart Medical Devices Based on 3D Printing-assisted Fabrication

Advances in urinary biomarker discovery in urological research.

A disease-specific biomarker (or biomarkers) is a characteristic reflecting a pathological condition in human body, which can be used as a diagnostic or prognostic tool for the clinical management. A urine-based biomarker(s) may provide a clinical value as attractive tools for clinicians to utilize in the clinical setting in particular to bladder diseases including bladder cancer and other bladder benign dysfunctions. Urine can be easily obtained by patients with no preparation or painful procedures required from patients' side. Currently advanced omics technologies and computational power identified potential omics-based novel biomarkers. An unbiased profiling based on transcriptomics, proteomics, epigenetics, metabolomics approaches et al. found that expression at RNA, protein, and metabolite levels are linked with specific bladder diseases and outcomes. In this review, we will discuss about the urine-based biomarkers reported by many investigators including us and how these biomarkers can be applied as a diagnostic and prognostic tool in clinical trials and patient care to promote bladder health. Furthermore, we will discuss how these promising biomarkers can be developed into a smart medical device and what we should be cautious about toward being used in real clinical setting.

Integration of Internet of things technology into the experimental teaching reform of biomedical sensor

In recent years, the rapid development of the Internet of things technology has opened up broad prospects for the integration of the Internet of things technology into medical education to train interdisciplinary talents who master knowledge in both medicine and engineering. The researchers incorporated the Internet of things technology in the experimental teaching of the course Biomedical sensors, reformed the contents and methods of experimental teaching, and developed and designed a biomedical sensor experimental teaching system based on the Internet of things technology. As a result, the new experimental teaching can help students understand the system design methods of the Internet of things in smart medical devices and cultivate their practical ability and innovative ability, which has obtained preliminary teaching results. Key words: Internet of things; Experimental teaching; Biomedical sensor

Fully Biobased Shape Memory Thermoplastic Vulcanizates from Poly(Lactic Acid) and Modified Natural Eucommia Ulmoides Gum with Co-Continuous Structure and Super Toughness.

Novel, fully biobased shape memory thermoplastic vulcanizates (TPVs) were prepared using two sustainable biopolymers, poly(lactic acid) (PLA), and modified natural Eucommia ulmoides gum (EUG-g-GMA), via a dynamic vulcanization technique. Simultaneously, in situ compatibilization was achieved in the TPVs to improve interfacial adhesion and the crosslinked modified Eucommia ulmoides gum (EUG) was in “netlike” continuous state in the PLA matrix to form “sea-sea” phase structure. The promoted interface and co-continuous structure played critical roles in enhancing shape memory capacity and toughness of the TPVs. The TPV with 40 wt % modified EUG displayed the highest toughness with an impact strength of 54.8 kJ/m2 and the most excellent shape memory performances with a shape fixity ratio (Rf) of 99.83% and a shape recovery ratio (Rr) of 93.74%. The prepared shape memory TPVs would open up great potential applications in biobased shape memory materials for smart medical devices.

IOT Based Portable Medical Kit

Medication requirements and health issues have been on the rise in the last decade and to cater to this numerous technologies have been introduced to the health sector. Internet of Medical Things (IoMT) has been on the rise and providing medical care to the much needed through services, smart medical devices that not only provides an enhanced platform to the doctor but also to the patients to maintain better healthcare levels. This paper addresses the implementation of a multilayered architecture for a health monitoring kit incorporated with sensors and alert mechanism to activate a pill dispenser. The sensor data is relayed to a personalized android application and care has been taken to make sure that the patient receives the medicine on time and in the required dosage.

(Invited) Atomic Layer Deposition Coatings for Medical Devices

Implantable medical devices must withstand the corrosive environment inside the human body for prolonged periods of time. Hermetic sealing of the device to protect it from the corrosive environment of human body and vice versa is a key step to enable long life time for the smart medical devices. Atomic layer deposition (ALD) is an advanced deposition technique belonging to the family of chemical vapor deposition (CVD) techniques. In ALD the substrate to be coated is exposed sequentially to precursor chemicals that react with the reactive surface sites on the substrate and form a chemically bonded adsorption layer. This growth mode of the film enables extremely conformal and uniform films to be coated on three-dimensional objects having any shape. Even the smallest, nanometer sized features on the objects can be coated with ease, making the technique extremely useful when hermetic sealing of complex shaped objects are required. The advantages of ALD over other deposition techniques makes it powerful method for applications where sensitive substrate materials combine with extreme demands on coating quality and temperature/chemical resistance, such as those often seen in the medical applications. In order to make a robust protective sealing for the medical device, the film properties must fulfill certain key criteria. First and foremost, the film material needs to be non-toxic for human cells in order to be biocompatible. Secondly, the film needs to function as an highly efficient diffusion barrier against the ions and molecules present in body fluids. In addition, the adhesion of the film with the device surface needs to be strong enough to prevent the delamination of the film. In our recent work [1] we have shown that SiO2-HfO2 coated sub-millimeter-sized microelectronic chiplets for wireless body implants can last without degradation and electronic failure in accelerated aging tests in saline at T = 87 °C for more than 180 days. This corresponds an equivalent lifetime of more than 10 years at human body equivalent temperature of 37 °C. Latest results on ALD films (deposited with Picosun® R-200 Advanced ALD reactor) for medical applications will also be discussed. Biocompatibility tests for Al2O3, TiO2, HfO2, SiO2, Ta2O5 films using the ISO standard Cytotoxicity of Medical Device (ISO 10993-5) procedure will be presented. In addition, we will show results of corrosion tests in PBS solution at elevated temperature (87 °C) for a number of ALD oxides and their nanolaminates, highlighting a stress control method that can improve the long-term delamination resistance of the coatings. Furthermore, we will show some results on the diffusion barrier properties of Al2O3, TiO2, HfO2, SiO2, Ta2O5 and their nanolaminates on different electrode materials (Al, Au, Pt, TiN) when exposed to PBS solution. [1] Conformal Hermetic Sealing of Wireless Microelectronic Implantable Chiplets by Multilayered Atomic Layer Deposition (ALD) by J. Jeong, F. Laiwalla, J. Lee, R. Ritasalo, M. Pudas, L. Larson, V. Leung, and A. Nurmikko, https://doi.org/10.1002/adfm.201806440. Acknowledgements: This work is part of the ULIMPIA project funded by PENTA under grant number PENTA-2017-Call2-16101-ULIMPIA

A security risk mitigation framework for cyber physical systems

AbstractCyber physical systems (CPSs) are safety‐critical, be it weapon systems, smart medical devices, or grid stations. This makes ensuring security of all the components constituting a CPS unavoidable. The rise in the demand of interconnectedness has made such systems vulnerable to attacks, ie, cyberattacks. Over 170 cases of cyber‐security breaches in CPS were reported over the past two decades. An increase in the number of cyberattack incidents on CPS makes them more exposed and less trustworthy. However, identifying the security requirements of the CPS to pinpoint the relevant risks may help to counteract the potential attacks. Literature reveals that the most targeted security requirements of CPS are authentication, integrity, and availability. However, little attention has been paid on certain crucial security attributes such as data freshness and nonrepudiation. One major reason of security breaches in CPS is the lack of custom or generalized countermeasures. Therefore, we propose a security risk mitigation framework for a CPS focused on constraints, ie, authentication, data integrity, data freshness, nonrepudiation, and confidentiality. Furthermore, we evaluate the proposed work using a case study of a safety critical system. The results show a decrease in the severity of the identified security risks, ie, man‐in‐the‐middle attack, spoofing, and data tempering.

Conceptualizing the key features of cyber‐physical systems in a multi‐layered representation for safety and security analysis

AbstractMany safety‐related systems are evolving into cyber‐physical systems (CPSs), integrating information technologies in their control architectures and modifying the interactions among automation and human operators. Particularly, a promising potential exists for enhanced efficiency and safety in applications such as autonomous transportation systems, control systems in critical infrastructures, smart manufacturing and process plants, robotics, and smart medical devices, among others. However, the modern features of CPSs are ambiguous for system designers and risk analysts, especially considering the role of humans and the interactions between safety and security. The sources of safety risks are not restricted to accidental failures and errors anymore. Indeed, cybersecurity attacks can now cascade into safety risks leading to physical harm to the system and its environment. These new challenges demand system engineers and risk analysts to understand the security vulnerabilities existing in CPS features and their dependencies with physical processes. Therefore, this paper (a) examines the key features of CPSs and their relation with other system types; (b) defines the dependencies between levels of automation and human roles in CPSs from a systems engineering perspective; and (c) applies systems thinking to describe a multi‐layered diagrammatic representation of CPSs for combined safety and security risk analysis, demonstrating an application in the maritime sector to analyze an autonomous surface vehicle.

Super-tough poly(lactic acid) thermoplastic vulcanizates with heat triggered shape memory behaviors based on modified natural Eucommia ulmoides gum

To take full advantage of renewability and environmental friendliness of poly(lactic acid) (PLA) and natural Eucommia ulmoides gum (EUG), PLA was used with epoxidized natural Eucommia ulmoides gum (EEUG) to prepare novel bio-based TPVs via a dynamic vulcanization method. The PLA/EEUG TPVs exhibited not only super toughness but also excellent shape memory behaviors, which might provide a new approach for the industrialization of super-toughened and bio-based shape memory TPVs. It was found that the in situ compatibilization achieved by grafting reaction between PLA and EEUG and “sea-sea” phase structure were vital for the enhancement of toughness and shape memory properties. The TPV with 40 wt% EEUG displayed not only super toughness with the impact strength of 47.3 kJ/m2 (nearly 20 times than that of neat PLA 2.4 kJ/m2) but also the best shape memory properties, with a shape fixity ratio and shape recovery ratio of 99.28% and 94.19%, respectively. These bio-based shape memory TPVs would show great application potential in smart medical devices and 3D printing materials.

Muddling through cybersecurity: Insights from the U.S. healthcare industry

The U.S. healthcare sector is inadequately prepared to deal with the reality of cyber threats. The increasing use of smart medical equipment and mobile devices is making healthcare organizations more susceptible to ransomware and other types of malware. The size and complexity of operations, coupled with the presence of numerous legacy and incompatible systems, make it difficult to implement effective cybersecurity measures. The daunting nature of the problem often results in an if-it-ain’t-broke-don’t-fix-it stance among senior healthcare leaders. The preponderance of healthcare-related laws, compliance regulations, and security guidance frameworks serve to complicate the cybersecurity challenge further and too often results in senior leadership assuming a state of blissful ignorance. This study sheds light on the key factors contributing to the chaotic state of affairs and presents a roadmap to a more deliberate and proactive approach to cybersecurity risk management.

A Group Decision Making Framework Based on Neutrosophic TOPSIS Approach for Smart Medical Device Selection.

Advances in the medical industry has become a major trend because of the new developments in information technologies. This research offers a novel approach for estimating the smart medical devices (SMDs) selection process in a group decision making (GDM) in a vague decision environment. The complexity of the selected decision criteria for the smart medical devices is a significant feature of this analysis. To simulate these processes, a methodology that combines neutrosophics using bipolar numbers with Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) under GDM is suggested. Neutrosophics with TOPSIS approach is applied in the decision making process to deal with the vagueness, incomplete data and the uncertainty, considering the decisions criteria in the data collected by the decision makers (DMs). In this research, the stress is placed upon the choosing of sugar analyzing smart medical devices for diabetics' patients. The main objective is to present the complications of the problem, raising interest among specialists in the healthcare industry and assessing smart medical devices under different evaluation criteria. The problem is formulated as a multi criteria decision type with seven alternatives and seven criteria, and then edited as a multi criteria decision model with seven alternatives and seven criteria. The results of the neutrosophics with TOPSIS model are analyzed, showing that the competence of the acquired results and the rankings are sufficiently stable. The results of the suggested method are also compared with the neutrosophic extensions AHP and MOORA models in order to validate and prove the acquired results. In addition, we used the SPSS program to check the stability of the variations in the rankings by the Spearman coefficient of correlation. The selection methodology is applied on a numerical case, to prove the validity of the suggested approach.

Assessing complex evolving cyber-physical systems (case study: smart medical devices)

Our environment becomes permeated by intelligent devices and systems that directly interact with physical objects, including our bodies. Such cyber-physical systems produce immense amount of data that can be stored and analysed. Those data are of value as 'actionable knowledge' only if the process of collection, cleaning, and analysis is well managed and unbiased. The system has to be well understood and the statistical questions properly formulated, otherwise spurious correlations can be misinterpreted as causation. A major challenge is the changing nature of the technical systems, of the environment in which they operate and of the humans who use them. Those interacting subsystems manifest novel dynamic behaviour, different from purely digital systems. We will discuss the general problems of assessing the quality of cyber-physical systems and use smart medical devices as a case study.

Mobile Health Applications, Smart Medical Devices, and Big Data Analytics Technologies

Mobile Health Applications, Smart Medical Devices, and Big Data Analytics Technologies

Mobile Health Applications, Smart Medical Devices, and Big Data Analytics Technologies

Mobile Health Applications, Smart Medical Devices, and Big Data Analytics Technologies

Assessing complex evolving cyber-physical systems (case study: smart medical devices)

Assessing complex evolving cyber-physical systems (case study: smart medical devices)

OP60 Challenges In Evaluating Smart Medical Devices

IntroductionSmart medical devices can empower elderly to live independently in their familiar surroundings. To enhance their dissemination, they have to be shown to be cost-effective. Economic studies evaluating such technologies are missing or are criticized for their low quality. There are several challenges in the evaluation of smart medical devices, including their complex nature and innovative character. The question arises: how can evaluations elicit the benefits and cost-effectiveness of smart medical devices. This research has the aim of outlining challenges and demands on the evaluation of smart medical devices.MethodsThe embedding of the technology in existing structures can influence the effectiveness of the technology. By comparing such a technology with a regular intervention, learning effects have to be considered. Regular modifications and further developments of these technologies can complicate the traceability of the effects. Complex cause-effect relationships with possible interactions arise that are difficult to quantify and express in standardized endpoints, utilities or monetary values. Demands on the evaluation of smart medical devices have been explored with literature reviews and scenario techniques using the example of intelligent rollators.ResultsIt is important to apply mixed-method approaches not only in the clinical but also practical setting and conduct observational as well as qualitative studies. Potential users, their relatives and care personnel should be involved in the evaluation of intelligent rollators and attention should be payed to subjects with disabilities. Prospective studies should be conducted at different stages along the lifecycle of the technology. A conceptual model should be developed and evaluated as well as adapted on a regular basis.ConclusionsThe research shows the need to adapt common methods used in economic evaluation to the characteristics of smart medical devices. As a next step, a framework for the economic evaluation of such technologies within the scope of Health Technology Assessment is developed based on these demands.

Smart medical device selection based on intuitionistic fuzzy Choquet integral

This paper presents a novel approach for evaluating the smart medical device selection process in a group decision-making setting in an uncertain decision environment. Intuitionistic fuzzy Choquet integral (IFCI) approach is applied to treat the uncertainty and vagueness in the decision-making process. IFCI also considers the interactions among the decision criteria in the data provided by the decision makers. In this paper, the emphasis is placed upon the selection of wearable monitoring devices for cardiac patients. The goal is to present the complexity of the problem, raise interest among specialists in the healthcare industry and assess smart medical devices under different evaluation criteria. The problem is formulated as a multi-criteria decision model with ten criteria and eight alternatives. The results of the IFCI model are analyzed using 9 sensitivity analysis scenarios, which prove the adequacy of the obtained results. The result of the proposed method is also compared with the IF extensions of the VIKOR, TOPSIS, COPRAS, MOORA and MULTIMOORA models in order to validate and verify the obtained outcome. The Spearman coefficient of correlation is applied to check the stability of the variations in the rankings. The results indicate that the model and the rankings it generates are sufficiently stable.

4D printing applications in medical field: A brief review

Background/objectivesThere are promising applications of 4D printing in the medical field. The need is to identify the research status and explore where this new set of technologies effectively can be deployed. MethodsResearch articles till September 2018 are searched from Scopus by keywords as “4D printing” and “4D printing""medical" and undertaken a bibliometric analysis of the identified papers. Further relevant papers were studied for application in the medical field. ResultsSearch through Scopus identified 171 research articles on 4D printing and 13 research articles on 4D printing in the medical field. This study states that 4D printing is the latest technology that creates innovation and addresses complex medical problems. Paper briefly describes the 4D printing and details its difference from 3D printing technology. We have identified five steps to be used to create a medical model by using this technology and its prospective implementation for medical applications. Identified that research is carried out on 4D printing, but decidedly less publication is available in the medical field reporting the application of this technology. Finally, we have identified nine significant applications of 4D printing in the medical field. The main limitation is that it requires extensive investment & support for transformation. Conclusions4D printing is to provide benefits to medical practitioners especially in the areas not covered by 3D printing technologies. 4D printing helps to create a 3D physical object by adding smart material layer by layer through computer-operated computer-aided design (CAD) data. It adds a dimension of transformation over time where printed products are sensitive to parameters like temperature, humidity, time etc. This technology can provide extensive support in the medical field, especially with better and smart medical implants, tools and devices. Now doctors and researchers can explore with 4D printing technology to provide better service to the patient.