Search

The Internet of Things (IoT) has become very popular during the last decade by providing new solutions to modern industry and to entire societies. At the same time, the rise of the industrial Internet of Things (IIoT) has provided various benefits by linking infrastructure around the world via sensors, machine learning, and data analytics. However, the security of IoT devices has been proven to be a major concern. Almost a decade ago, the IPv6 Routing Protocol for Low-Power and Lossy Networks (RPL) was designed to handle routing in IoT and IIoT. Since then, numerous types of attacks on RPL have been published. In this paper, a novel intrusion detection system (IDS) is designed and implemented for RPL-based IoT. The objective is to perform an accurate and efficient detection of various types of routing and denial-of-service (DoS) attacks such as version number attack, blackhole attack, and grayhole attack, and different variations of flooding attacks such as Hello flood attack, DIS attack, and DAO insider attack. To achieve this, different detection strategies are combined, taking advantage of the strengths of each individual strategy. In addition, the proposed IDS is experimentally evaluated by performing a deep analysis of the aforementioned attacks in order to study the impact caused. This evaluation also estimates the accuracy and effectiveness of the IDS performance when confronted with the considered attacks. The obtained results show high detection accuracy. Furthermore, the overhead introduced in terms of CPU usage and power consumption is negligible. In particular, the CPU usage overhead is less than 2% in all cases, whereas the average power consumption increase is no more than 0.5%, which can be considered an insignificant impact on the overall resource utilisation.

Introduction Since the onset of the Covid-19 Pandemic, Telehealth utilization has grown rapidly; however, little is known about its efficacy in specific areas of healthcare, including trauma care in the emergency department. We aim to evaluate telehealth utilization in the care of adult trauma patients within United States emergency departments and associated outcomes over the past decade. Methods PubMed, Google Scholar, EMBASE, ProQuest, and Cochrane were searched for relevant articles published from database conception to Dec 12th, 2022. Our review includes studies that assessed the utilization of telehealth practices within a United States emergency department for the treatment of adult (age ≥ 18) trauma patients. Evaluated outcomes included emergency department length of stay, transfer rates, cost incurred to patients and telehealthimplementing hospitals, patient satisfaction, and rates of left without being seen. Results A total of 11 studies, evaluating 59,319 adult trauma patients, were included in this review. Telehealth practices resulted in comparable or reduced emergency department length of stay for trauma patients admitted to the emergency department. Costs incurred to the patient and rates of leaving without being seen were significantly reduced following telehealth implementation. There was no difference in transfer rates or patient satisfaction for telehealth practices compared to in-person treatment. Conclusion Emergency department telehealth utilization significantly reduced trauma patient care-related costs, emergency department length of stay, and rates of leaving without being seen. No significant differences were found in patient transfer rates, patient satisfaction rates, or mortality rates following emergency department telehealth utilization.

Background We aim to investigate the costs associated with growth in the administrators, health care staff, and physicians to provide direction to establish a sustainable and cost-effective U.S. health care system. Methods Data from the U.S. Bureau of Labor Statistics, particularly the Labor Force Statistics from the Current Population Survey, were utilized from 2009 to 2020. Wages and employment of medical and health service managers (administrators), health care practitioners and technical operations (health care staff), and physicians were used to calculate the total cost. Results Administrator wages have grown similarly to health care staff wages (−4.40 vs −3.01%, P = .454) and physician wages (−4.40 vs −3.29%, P = .672). Additionally, there has been a similar increase in health care staff employment (9.91 vs 14.23%, P = .269) and physician employment (9.91 vs 15.35%, P = .252) compared to administrator employment. Overall, the total growth in administrator cost is similar to the growth in total health care staff cost (6.23 vs 11.80, P = .104) and total physician cost (6.23 vs 13.02%, P = .079). In 2020, physicians had the highest employment growth but the smallest wage increase. Conclusion Although health care staff experienced a greater percent growth in employment and cost per employee than administrators since 2009, the cost per administrator remains greater than that of health care staff. Understanding differences in wages and costs is essential to reduce health care spending without compromising access, delivery, and quality of health care services.

Per- and polyfluoroalkyl substances (PFAS) are a class of anthropogenic chemicals used to provide water and stain resistance in many consumer products. Their widespread use, nearly ubiquitous presence across multiple environments, and growing list of adverse health effects has raised concerns among communities. PFAS have been frequently detected and quantified globally in wastewater, groundwater, surface and drinking water; however, the presence of PFAS in swimming pool water - a unique matrix in which constituents may concentrate through evaporation and which also may present a high risk of direct human exposure - has not been reported. Here, ultra-high performance liquid chromatography - tandem mass spectrometry (UHPLC-MS/MS) was used to monitor 92 PFAS in 54 water samples collected from city, apartment, hotel, and personal swimming pools in six Florida cities. In total, 14 PFAS were detected with six perfluoroalkyl acids - perfluorobutanoic acid (PFBA), perfluorohexanoic acid (PFHxA), perfluoroheptanoic acid (PFHpA) and perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorobutane sulfonate (PFBS) - detected in every sample. PFHxA accounted for 49% of all PFAS quantified in this study. PFAS profiles were compared between sites as a function of pool type, rate of use, and geographic location. Total ΣPFAS concentrations were similar across pool types, with both the highest (633 ng/L) and lowest (1.9 ng/L) measurements found in public city pools. Between sites, higher PFAS levels were observed in city pools in Miami, Melbourne and Tampa compared to Naples, Orlando and Gainesville. Our findings highlight the potential exposure of PFAS in an underexplored and yet important exposure pathway in communities.

Per- and polyfluoroalkyl substances (PFAS) are a class of synthetic chemicals commonly found in everyday consumer products and are an emerging concern due to their ubiquitous presence in ecosystems around the world. PFAS exposure, which often occurs through contaminated water, has been linked to several adverse health effects in humans and wildlife. PFAS can be transported in surface water and storm runoff in the nearshore environment. Episodic events, such as hurricanes, are projected to increase in frequency and intensity, and a critical unanswered question is: how do episodic events influence the concentrations and distributions of emerging contaminants, such as PFAS, in coastal systems? Here, we investigated the impact of the 2019 Hurricane Dorian on the Florida coast to assess how natural disasters, such as hurricanes, influence the fate and transport of PFAS in surface water. Water samples collected throughout the St. Augustine Intracoastal waterway before, during, and after the storm were analyzed and compared with baseline concentrations. Ultra-high-pressure liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) was used in the detection and quantification of 23 and 17 PFAS, respectively. Perfluorooctane sulfonic acid (PFOS) was the compound with the highest concentration across all sampling sites. Mean PFOS levels showed the highest increase of 177% during the hurricane and returned to baseline levels after two days. Our findings highlight the need for continued research focused on understanding how large storms near all coastlines can impact the transport of environmental pollutants, such as PFOS, that can have adverse effects on human and environmental health. Further monitoring of PFAS in coastal systems is necessary to identify potential PFAS hotspots, investigate the impacts of episodic events on PFAS transport, develop mitigation practices capable of reducing the risk of PFAS exposure.

Reverse vaccinology is an evolving approach for improving vaccine effectiveness and minimizing adverse responses by limiting immunizations to critical epitopes. Towards this goal, we sought to identify immunogenic amino acid motifs and linear epitopes of the SARS-CoV-2 spike protein that elicit IgG in COVID-19 mRNA vaccine recipients. Paired pre/post vaccination samples from N=20 healthy adults, and post-vaccine samples from an additional N=13 individuals were used to immunoprecipitate IgG targets expressed by a bacterial display random peptide library, and preferentially recognized peptides were mapped to the spike primary sequence. The data identify several distinct amino acid motifs recognized by vaccine-induced IgG, a subset of those targeted by IgG from natural infection, which may mimic 3-dimensional conformation (mimotopes). Dominant linear epitopes were identified in the C-terminal domains of the S1 and S2 subunits (aa 558-569, 627-638, and 1148-1159) which have been previously associated with SARS-CoV-2 neutralization in vitro and demonstrate identity to bat coronavirus and SARS-CoV, but limited homology to non-pathogenic human coronavirus. The identified COVID-19 mRNA vaccine epitopes should be considered in the context of variants, immune escape and vaccine and therapy design moving forward.

This research investigates interagency collaboration concepts and practices in the context of a national security setting. Interagency collaboration practices exist side by side with traditional hierarchical organizational structures and practices. The Government Accountability Office (GAO) defines interagency collaboration as “any joint activity that is intended to produce more public value than could be produced when the agencies act alone” (Steinhardt, 2005, p. 4). Interagency collaboration enables governmental responses to complex missions and tasks associated with intractable national-level problems. Interagency organizations require collaborative mechanisms to improve partnerships with other organizations. GAO defines collaborative mechanisms as arrangements or applications that facilitate the implementation of collaboration goals (Mihm, 2012). These mechanisms are thought to support practices that can enhance and sustain interagency collaboration efforts (Steinhardt, 2005). A review of the academic and practitioner literature precedes investigation into an exemplar for interagency collaboration. This analysis responds to questions about whether interagency collaboration is a viable structural counterpart to purely hierarchical organizations, particularly as a means to resolve intractable national-level problems. The principal research question asks: what organizational mechanisms support interagency collaboration practices? A related question asks how interagency collaboration is differentiated from other forms of collaboration. Assuming collaboration practices are a requirement for operating in the interagency environment, do mechanisms better facilitate collaborative capacity to resolve national-level problems? This chapter explores interagency collaboration in the context of the national security domain, an arena in which collaboration has become an important element of interorganizational activity. We will examine this activity by analyzing several exemplar cases to illustrate the foundational concepts of interagency collaboration. Four primary activities comprise the chapter. First, a review of concepts begins the process to differentiate and specify interagency collaboration. Inparticular, mandated collaboration differentiates interagency collaboration from other forms of collaboration. Next, a list of interagency collaboration mechanisms is explored. Third, an exemplar of interagency collaboration from the national security domain is found to support conceptual interagency mechanisms. Intractable and complex problems may be nowhere more evident than in the national security domain concerned with the defense, foreign relations, and protection of national interests. Last, recommendations for future research focus on improving understanding relationships between interagency collaboration mechanisms and interagency effectiveness.

This paper discusses the problem statement of a project: "Conduct analysis to determine the effectiveness of FFW equipment and ensure it increases the combat power of a small combat unit" in environments other than MOUT scenarios. Suggestions included looking at the jungle or mountain environment or a scenario involving a FFW equipped small combat unit searching a cave for weapons. Another interest was to determine how effectively different simulation programs (IWARS, JCATS, OOS, etc.) replicate FFW equipment as well as the programs' ability to produce applicable data. The project used the experience and knowledge of the members of the group who have worked or are familiar with these programs as the basis for the evaluation of the different solutions. It was suggested that to use small unit team exploratory simulation (SUTES) to depict an SCU using current equipment in battle drills and then compare that to battle drills incorporating FFW equipment