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Abstract The expansion of wireless communication introduces security vulnerabilities, emphasizing the essential need for secure systems that prioritize confidentiality, integrity, and other key aspects of data protection. Since computational security acknowledges the possibility of breaches when adequate computational resources are available, that is why information-theoretic security is being explored, which suggests the existence of unbreakable cryptographic systems even in the presence of limitless processing power. Secret key exchange has traditionally relied on RSA or DH protocols, but researchers are now exploring innovative approaches for sharing secret keys among wireless network devices, leveraging physical or link layer characteristics. This research seeks to revolutionize secure multi-party key acquisition in wireless networks, capitalizing on information-theoretic security and collaborative data extraction. The proposed secret key generation framework comprehensively organizes and explains the information-theoretic aspects of secret key generation within the lower layers of wireless networks, especially the link layer, proposes a novel information-theoretic SKG framework for the dynamic acquisition of symmetric secret keys, and responds to contemporary information security challenges by relying on information-theory principles rather than vulnerable mathematical relationships in the post-quantum period. A new cryptographic key can be generated using a straightforward method, and when it is combined (XORed) with the previous key, it creates a continuously changing secret for encryption and decryption. This approach enhances security because, as attackers attempt to break the encryption, the system generates fresh, dynamic keys, making it progressively more challenging for them to succeed. The research work in question integrates key renewal, or how often keys are updated (dynamic keys), with a security off-period. It introduces a framework for determining the best key refresh rate based on the anticipated rate at which keys might be compromised. Furthermore, the proposed framework is scalable, allowing new nodes to quickly join the existing network. The system was tested with multiple nodes equipped with IEEE 802.11 interfaces, which were set in monitor mode to capture frames at the link layer. Nodes map their on-time frames onto their Bloom filters. Nodes exchange these Bloom filters in a feedback mechanism. Nodes extract those frames from their .pcap files, which are present in all Bloom filters; these are common frames among all nodes. These frames are used to form a shared secret that is passed to HMAC Key Derivation Function by each node to acquire the final encryption key of the required length. The validation of this encryption key is performed using a simple challenge-response protocol; upon successful validation, encrypted communication begins. Otherwise, the key generation process is restarted.

Abstract Constitutional heterozygous pathogenic variants in genes coding for some components of the Fanconi anemia-BRCA signaling pathway, which repairs DNA interstrand crosslinks, represent risk factors for common cancers, including breast, ovarian, pancreatic and prostate cancer. A high cancer risk is also a main clinical feature in patients with Fanconi anemia (FA), a rare condition characterized by bone marrow failure, endocrine and physical abnormalities. The mainly recessive condition is caused by germline pathogenic variants in one of 21 FA-BRCA pathway genes. Among patients with FA, the highest cancer risks are observed in patients with biallelic pathogenic variants in BRCA2 or PALB2. These patients develop a range of embryonal tumors and leukemia during the first decade of life, however, little is known about specific clinical, genetic and pathologic features or toxicities. Here, we present genetic, clinical, pathological and treatment characteristics observed in an international cohort of eight patients with FA due to biallelic BRCA2 pathogenic variants and medulloblastoma (MB), an embryonal tumor of the cerebellum. Median age at MB diagnosis was 32.5 months (range 7–58 months). All patients with available data had sonic hedgehog-MB. Six patients received chemotherapy and one patient also received proton radiation treatment. No life-threatening toxicities were documented. Prognosis was poor and all patients died shortly after MB diagnosis (median survival time 4.5 months, range 0–21 months) due to MB or other neoplasms. In conclusion, MB in patients with biallelic BRCA2 pathogenic variants is a lethal disease. Future experimental treatments are necessary to help these patients.

Abstract The wormhole attack is one of the most treacherous attacks projected at the routing layer that can bypass cryptographic measures and derail the entire communication network. It is too difficult to prevent a priori; all the possible countermeasures are either too expensive or ineffective. Indeed, literature solutions either require expensive hardware (typically UWB or secure GPS transceivers) or pose specific constraints to the adversarial behavior (doing or not doing a suspicious action). The proposed solution belongs to the second category because the adversary is assumed to have done one or more known suspicious actions. In this solution, we adopt a heuristic approach to detect wormholes in ad hoc networks based on the detection of their illicit behaviors. Wormhole and post wormhole attacks are often confused in literature; that’s why we clearly state that our methodology does not provide a defence against wormholes, but rather against the actions that an adversary does after the wormhole, such as packet dropping, tampering with TTL, replaying and looping, etc. In terms of contributions, the proposed solution addresses the knock-out capability of attackers that is less targeted by the researcher’s community. In addition, it neither requires any additional hardware nor a change in it; instead, it is compatible with the existing network stack. The idea is simulated in ns2.30, and the average detection rate of the proposed solution is found to be 98-99%. The theoretical time to detect a wormhole node lies between 0.07-0.71 seconds. But, from the simulation, the average detection and isolation time is 0.67 seconds. In term of packet loss, the proposed solution has a relatively overhead of $$\approx$$ ≈ 22%. It works well in static and mobile scenarios, but the frame losses are higher in mobile scenarios as compared to static ones. The computational complexity of the solution is O(n). Simulation results advocate that the solution is effective in terms of memory, processing, bandwidth, and energy cost. The solution is validated using statistical parameters such as Accuracy, Precision, F1-Score and Matthews correlation coefficient ( $$M_{cc}$$ M cc ).

Since its inception more than a decade ago, Internet of Things (IoT) technology has been guiding people in the development of a world full of smart solutions in which all devices and physical objects, represented as “things,” are interlinked with sensors using the Internet. In some areas, the delivery of medications to patients or receivers at their destinations remains highly outdated and informal. In smart medicine delivery, the medicine needs to maintain its original state while facing multiple environmental factors, such as temperature fluctuations, humidity, etc. This paper presents an effective implementation of IoT (Internet of Things) for monitoring the transportation of medicines and vaccines, along with temperature control facilitated through mobile applications and sensor networks. The system employs mobile applications as the user interface, utilizes Arduino, MQTT (Message Queuing Telemetry Transport) for communication, incorporates a temperature sensor, and employs a mini portable cooling box. Designed for the generalized delivery of medicines/vaccines from sender to receiver, the system also suggests CRC-32 as an optimal algorithm for error detection instead of complex hash functions such as MD5 and SHA, ensuring better performance, smooth operation, and data integrity. In addition, elliptic curve-based shared keys are used for protected data transmission. The accuracy of the proposed system is 89.88%, and the value of the F1-score is 0.686, which is greater than the threshold of 0.5, hence conclusively validating the authenticity and reliability of the proposed system.

Wireless Sensor Networks (WSN) are deployed on a large scale and require protection from malicious energy drainage attacks, particularly those directed at the routing layer. The complexity increases during critical operations like cluster head selection where detection of such attacks is challenging. The dependency of WSN on batteries elevates the concern posed by these threats, making detection and isolation crucial, especially within the framework of energy-efficient clustering protocols such as Low Energy Adaptive Clustering Hierarchy (LEACH). Various approaches have been proposed in prior research to deal with such attacks. However, the use of memory-efficient data structures has yet to be effectively addressed. In this article, considering the limitations of WSN, we utilize memory-efficient data structures named Bloom filters, count-min (CM) sketch, and cellular automata (CA) to address abnormal energy drainage. A CA-based trust model is used to choose the legitimate node as the cluster head. CM sketch is used to control the frequency of a node selected as a cluster head, achieving fairness in the cluster head selection process, and Bloom filters maintain the record of malicious nodes blocked from participating in the communication or cluster head selection process. CA and trust functions collectively keep a record of neighbors’ energy and their trust in the network. Grayhole, blackhole, and scheduling attacks are three well-known threats that lead to abnormal energy drainage in legitimate nodes. The proposed solution effectively detects and addresses abnormal energy drainage in WSN. Its impact is simulated and observed using ns2 IEEE 802.15.4 medium access control (MAC) and LEACH clustering protocols, specifically in the context of the mentioned attacks. The effectiveness of the proposed model was rigorously analysed, and it was observed that it reduces the energy consumption of WSN by approximately 16.66%, 48.33%, and 43.33% in the cases of grayhole, blackhole, and scheduling attacks, respectively. In terms of space/time complexity, its growth is linear O(n). The proposed solution also consumes 0.08-0.10 J more energy compared to the original LEACH as a cost of the solution, which is not more than 2% of the total initial energy. The trade-off of implementing heightened security is worthwhile, as the proposed approach outperforms the original LEACH and related methods, effectively mitigating abnormal energy drainage in WSN and extending network lifetime, especially in challenging environments with persistent battery recharging challenges.

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with liver and cardiovascular morbidity and mortality. Recently published NAFLD Quality Standards include 11 key performance indicators (KPIs) of good clinical care. This national study, endorsed by British Association for the Study of the Liver (BASL) and British Society of Gastroenterology (BSG), aimed to benchmark NAFLD care in UK hospitals against these KPIs. Methods: This study included all new patients with NAFLD reviewed in the outpatient clinic in the months of March 2019 and March 2022. Participating UK hospitals self-registered for the study through BASL/BSG. KPI outcomes were compared using Fisher’s exact or Chi-square tests. Results: Data from 776 patients with NAFLD attending 34 hospitals (England [25], Scotland [four], Wales [three], Northern Ireland [two]) were collected. A total of 85.3% of hospitals reported established local liver disease assessment pathways, yet only 27.9% of patients with suspected NAFLD had non-invasive fibrosis assessment documented at the point of referral to secondary care. In secondary care, 79.1% of patients had fibrosis assessment. Assessment of cardiometabolic risk factors including obesity, type 2 diabetes, hypertension, and smoking were conducted in 73.2%, 33.0%, 19.3%, and 54.9% of all patients, respectively. There was limited documentation of diet (35.7%) and exercise advice (55.1%). Excluding those on statins, only 9.1% of patients with NAFLD at increased cardiovascular risk (T2DM and/or QRISK-3 >10%) had documented discussion of statin treatment. Significant KPI improvements from 2019 to 2022 were evident in use of non-invasive fibrosis assessment before secondary care referral, statin recommendations, and diet and exercise recommendations. Conclusions: This national study identified substantial variation in NAFLD management in the UK with clear areas for improvement, particularly fibrosis risk assessment before secondary care referral and management of associated cardiometabolic risk factors. Impact and implications: This study identified significant variation in the management of NAFLD in the UK. Only 27.9% of patients with suspected NAFLD had non-invasive fibrosis assessment performed to identify those at greater risk of advanced liver disease before specialist referral. Greater emphasis is needed on the management of associated cardiometabolic risk factors in individuals with NAFLD. Hospitals with multidisciplinary NAFLD service provision had higher rates of fibrosis evaluation and assessment and management of cardiometabolic risk than hospitals without multidisciplinary services. Further work is needed to align guideline recommendations and real-world practice in NAFLD care.

Abstract Pediatric neoplasms in the central nervous system (CNS) show extensive clinical and molecular heterogeneity and are fundamentally different from those occurring in adults. Molecular genetic testing contributes to accurate diagnosis and enables an optimal clinical management of affected children. Here, we investigated a rare, molecularly distinct type of pediatric high-grade neuroepithelial tumor (n = 18), that was identified through unsupervised visualization of genome-wide DNA methylation array data, together with copy number profiling, targeted next-generation DNA sequencing, and RNA transcriptome sequencing. DNA and/or RNA sequencing revealed recurrent fusions involving the capicua transcriptional repressor (CIC) gene in 10/10 tumor samples analyzed, with the most common fusion being CIC::LEUTX (n = 9). In addition, a CIC::NUTM1 fusion was detected in one of the tumors. Apart from the detected fusion events, no additional oncogenic alteration was identified in these tumors. The histopathological review demonstrated a morphologically heterogeneous group of high-grade neuroepithelial tumors with positive immunostaining for markers of glial differentiation in combination with weak and focal expression of synaptophysin, CD56 and CD99. All tumors were located in the supratentorial compartment, occurred during childhood (median age 8.5 years) and typically showed early relapses. In summary, we expand the spectrum of pediatric-type tumors of the CNS by reporting a previously uncharacterized group of rare high-grade neuroepithelial tumors that share a common DNA methylation signature and recurrent gene fusions involving the transcriptional repressor CIC. Downstream functional consequences of the fusion protein CIC::LEUTX and potential therapeutic implications need to be further investigated.

Secure exchange of sensitive information between different entities is a serious challenge in today’s environment. Therefore, various cryptosystems have been created specifically for this purpose. Various operations are used in these cryptosystems. The most common operations used are substitution and permutation. The substitution-box (S-box), a look-up table that takes x bits as input and replaces them with y bits, is responsible for the substitution operation. The construction of an S-box with strong cryptographic attributes is an essential part of building a robust and secure cryptosystem.Numerous researchers have dedicated their efforts to devising intricate techniques for constructing S-boxes. In this study, a novel approach is proposed to design a robust and dynamic S-box based on a compound-chaotic map. The suggested method for constructing the S-box is characterized by its simplicity and resilience. Notably, the Tent-Sine chaotic system significantly expands the chaotic range, setting it apart from other chaotic systems and rendering it more suitable for cryptographic applications. This research introduces a promising avenue for enhancing the security and effectiveness of S-boxes, contributing to the advancement of cryptographic systems. A number of widely accepted metrics, such as Non-Linearity (NL), Strict Avalanche Criterion (SAC), Bit Independence Criterion (BIC), Linear Probability (LP), and Differential Probability (DP), are extensively exercised for the analysis and evaluation of the proposed S-Box’s cryptographic strength. The results of the proposed of S-box are compared with the S-boxes of other researchers, and it is observed that it is cryptographically sound and worthy of inclusion in modern cryptosystems.

Cloud computing technology is rapidly becoming ubiquitous and indispensable. However, its widespread adoption also exposes organizations and individuals to a broad spectrum of potential threats. Despite the multiple advantages the cloud offers, organizations remain cautious about migrating their data and applications to the cloud due to fears of data breaches and security compromises. In light of these concerns, this study has conducted an in-depth examination of a variety of articles to enhance the comprehension of the challenges related to safeguarding and fortifying data within the cloud environment. Furthermore, the research has scrutinized several well-documented data breaches, analyzing the financial consequences they inflicted. Additionally, it scrutinizes the distinctions between conventional digital forensics and the forensic procedures specific to cloud computing. As a result of this investigation, the study has concluded by proposing potential opportunities for further research in this critical domain. By doing so, it contributes to our collective understanding of the complex panorama of cloud data protection and security, while acknowledging the evolving nature of technology and the need for ongoing exploration and innovation in this field. This study also helps in understanding the compound annual growth rate (CAGR) of cloud digital forensics, which is found to be quite high at ≈16.53% from 2023 to 2031. Moreover, its market is expected to reach ≈USD 36.9 billion by the year 2031; presently, it is ≈USD 11.21 billion, which shows that there are great opportunities for investment in this area. This study also strategically addresses emerging challenges in cloud digital forensics, providing a comprehensive approach to navigating and overcoming the complexities associated with the evolving landscape of cloud computing.

Hospitals and healthcare centers are experiencing a remarkable implementation of new systems based on wireless communications technologies. Many of these systems provide location services and identification of materials, instrumentation and even patients, which promotes the increase of the quality and the efficiency of healthcare. A tracking system based on short-range radio frequency, UHF-RFID is evaluated. This system helps with location of orthopedic prosthesis according to the criteria and requirements of a specific hospital environment. It is characterized the influence of UHF-RFID system in the electromagnetic environment by measuring the parameters and characteristics of the emission levels. The results of the assessment are represented through 2D contour maps and simulations have been performed by means of an in-house 3D-RL algorithm. The proposed graph aims to provide a methodology of studying the electromagnetic environments and the evaluation of the safety conditions of workers, patients, and people in general. E field exposure levels due to the RFID localization system were analyzed in order to verify regulations concerning the safety of patients and the general public in the labor and healthcare fields. Localized electromagnetic field exposure at levels which may cause electromagnetic hazards in the specific healthcare environment have been found and potentially excessive exposure to EMF emitted by UHF RFID devices may apply to patients or bystanders. In all cases, insufficient electromagnetic immunity of electronic devices (including AIMD and other medical devices) should be considered and the electromagnetic hazards may be limited also by relevant preventive measures, as also shown in this paper, together with the principles of an in-situ evaluation of electromagnetic hazards near the UHF-RFID devices.

This paper examines the Confucian concept of learning, or xue ([character omitted]), from the perspective of ecological humanism. Through a comparative interpretation, this paper attempts to disclose the significance of Confucian xue conceived as a practice of aesthetic appreciation and creativity, emphasizing in particular its function within an eco-centric worldview. The author reviews the relevant concepts of ecological humanism as expressed in the ideas of John Dewey and Thomas Alexander, then applies these as a theoretical framework for interpreting xue and its related concepts and practices as they appear in the Confucian text the Lunyu ([characters omitted] ). It is argued that xue is a process of developing and expressing virtuosity and artistry in the "arts of life," and that its practice was understood as a direct participation in the creative development of nature. The significance of such a concept of learning for contemporary educational philosophy is discussed in conclusion.

BackgroundNeurocognitive deficits in pediatric cancer survivors occur frequently; however, individual outcomes are unpredictable. We investigate clinical, genetic, and imaging predictors of neurocognition in pediatric cancer survivors, with a focus on survivors of central nervous system (CNS) tumors exposed to radiation.MethodsOne hundred eighteen patients with benign or malignant cancers (median diagnosis age: 7; 32% embryonal CNS tumors) were selected from an existing multi-institutional cohort (RadART Pro) if they had: 1) neurocognitive evaluation; 2) available DNA; 3) standard imaging. Utilizing RadART Pro, we collected clinical history, genomic sequencing, CNS imaging, and neurocognitive outcomes. We performed single nucleotide polymorphism (SNP) genotyping for candidate genes associated with neurocognition: COMT, BDNF, KIBRA, APOE, KLOTHO. Longitudinal neurocognitive testing were performed using validated computer-based CogState batteries. The imaging cohort was made of patients with available iron-sensitive (n = 28) and/or T2 FLAIR (n = 41) sequences. Cerebral microbleeds (CMB) were identified using a semi-automated algorithm. Volume of T2 FLAIR white matter lesions (WML) was measured using an automated method based on a convolutional neural network. Summary statistics were performed for patient characteristics, neurocognitive assessments, and imaging. Linear mixed effects and hierarchical models assessed patient characteristics and SNP relationship with neurocognition over time. Nested case-control analysis was performed to compare candidate gene carriers to non-carriers.ResultsCMB presence at baseline correlated with worse performance in 3 of 7 domains, including executive function. Higher baseline WML volumes correlated with worse performance in executive function and verbal learning. No candidate gene reliably predicted neurocognitive outcomes; however, APOE ϵ4 carriers trended toward worse neurocognitive function over time compared to other candidate genes and carried the highest odds of low neurocognitive performance across all domains (odds ratio 2.85, P=0.002). Hydrocephalus and seizures at diagnosis were the clinical characteristics most frequently associated with worse performance in neurocognitive domains (5 of 7 domains). Overall, executive function and verbal learning were the most frequently negatively impacted neurocognitive domains.ConclusionPresence of CMB, APOE ϵ4 carrier status, hydrocephalus, and seizures correlate with worse neurocognitive outcomes in pediatric cancer survivors, enriched with CNS tumors exposed to radiation. Ongoing research is underway to verify trends in larger cohorts.

Purpose: Develop a new model that combines the concepts of Maintenance, Lean Philosophy, and Industry 4.0 to improve maintenance management. Methodology/Approach: For the elaboration the following methodology was used: Bibliographic review of the existing models of joint application: Maintenance, Lean Philosophy, and Industry 4.0. Critical analysis of the existing models of joint application of the three concepts. Preparation of the model proposal and analysis of the results. Findings: The model developed is easy to apply, flexible and inexpensive, being a useful tool for both the maintenance and production areas, in any size and industrial area. Research Limitation/implication: One of the limitations is the distance between the devices that make up the system, as it can influence their performance. The implementation of Total Productive Maintenance can present some challenges within companies. Originality/Value of paper: The study presents a new model to improve maintenance management, being unique since the existing models are mostly focused on predictive maintenance. The system also allows the introduction of the monitoring of other important parameters such as vibrations, temperature among others.

Abstract The FGFR1 gene encoding fibroblast growth factor receptor 1 has emerged as a frequently altered oncogene in the pathogenesis of multiple low-grade neuroepithelial tumor (LGNET) subtypes including pilocytic astrocytoma, dysembryoplastic neuroepithelial tumor (DNT), rosette-forming glioneuronal tumor (RGNT), and extraventricular neurocytoma (EVN). These activating FGFR1 alterations in LGNET can include tandem duplication of the exons encoding the intracellular tyrosine kinase domain, in-frame gene fusions most often with TACC1 as the partner, or hotspot missense mutations within the tyrosine kinase domain (either at p.N546 or p.K656). However, the specificity of these different FGFR1 events for the various LGNET subtypes and accompanying genetic alterations are not well defined. Here we performed comprehensive genomic and epigenomic characterization on a diverse cohort of 30 LGNET with FGFR1 alterations. We identified that RGNT harbors a distinct epigenetic signature compared to other LGNET with FGFR1 alterations, and is uniquely characterized by FGFR1 kinase domain hotspot missense mutations in combination with either PIK3CA or PIK3R1 mutation, often with accompanying NF1 or PTPN11 mutation. In contrast, EVN harbors its own distinct epigenetic signature and is characterized by FGFR1-TACC1 fusion as the solitary pathogenic alteration. Additionally, DNT and pilocytic astrocytoma are characterized by either kinase domain tandem duplication or hotspot missense mutations, occasionally with accompanying NF1 or PTPN11 mutation, but lacking the accompanying PIK3CA or PIK3R1 mutation that characterizes RGNT. The glial component of LGNET with FGFR1 alterations typically has a predominantly oligodendroglial morphology, and many of the pilocytic astrocytomas with FGFR1 alterations lack the biphasic pattern, piloid processes, and Rosenthal fibers that characterize pilocytic astrocytomas with BRAF mutation or fusion. Together, this analysis improves the classification and histopathologic stratification of LGNET with FGFR1 alterations.

Mobile ad hoc networks consist of wireless nodes and can be established quickly with minimal configuration and cost, because, they do not require any infrastructure in advance. Civil and military applications are using them extensively in emergency and mission-oriented scenarios respectively as multi-party communication systems. Whereas, the multi-party secret key acquisition is one of the acute issues in these low resource wireless ad hoc networks, especially, which are based on IEEE 802.11ah and IEEE 802.11ba (low power WiFi), IEEE 802.15.4(Zigbee), BLE, IEEE 802.15.6 (body-worn or wearable) devices. In this study, a novel low cost and robust approach has been proposed and tested to establish an identical secret key in a multi-user mobile ad hoc environment. We believe, it is one of the groundbreaking contributions toward establishing a cost-effective secret key acquisition solution with respect to memory, computation, and bandwidth. We have used Bloom-Filters to cope with these resource limitations of such wireless setups. The proposed approach has been tested using IEEE 802.11 adapters in a real environment, and we found it to be highly suitable for wireless resource-limited applications.

Abstract Bergmann's rule predicts that organisms at higher latitudes are larger than ones at lower latitudes. Here, we examine the body size pattern of the Atlantic marsh fiddler crab, Minuca pugnax (formerly Uca pugnax), from salt marshes on the east coast of the United States across 12 degrees of latitude. We found that M. pugnax followed Bergmann's rule and that, on average, crab carapace width increased by 0.5 mm per degree of latitude. Minuca pugnax body size also followed the temperature–size rule with body size inversely related to mean water temperature. Because an organism's size influences its impact on an ecosystem, and M. pugnax is an ecosystem engineer that affects marsh functioning, the larger crabs at higher latitudes may have greater per‐capita impacts on salt marshes than the smaller crabs at lower latitudes.

Abstrak Penelitian ini bertujuan untuk (1) menggali ideologi yang terkandung dalam bahasa politik Soekarno selaku salah satu tokoh pendiri bangsa dan proklamator kemerdekaan NKRI, (2) menggali motivasi yang ada di balik lahirnya ideologi dalam bahasa tersebut, dan (3) melihat perubahan sosial budaya sebagai dampak dari ideologi bahasa politik Soekarno. Untuk mencapai ketiga tujuan penelitian di atas, peneliti menggunakan Teori Analisis Wacana Kritis (AWK) model Fairclough (1989, 1995, 2005, 2006) sebagai teori utama, dan teori Ideologi sebagai teori pendukung. Metode yang diterapkan dalam pengumpulan data adalah metode dokumentasi, sedangkan metode yang diterapkan dalam analisis data adalah metode deskripstif kualitatif yang diterapkan berdasarkan tiga level analisis AWK Fairclough. Hasil penelitian menunjukkan bahwa Ideologi yang terkandung dalam bahasa Soekarno adalah ideologi ‘persatuan dan kesatuan sebagai hal yang penting’, ideologi ‘revolusi adalah bagian yang tidak terpisahkan dari jiwa bangsa Indonesia’, dan ideologi ‘imperialisme sebagai musuh utama bangsa Indonesia’. Ideologi tersebut perlu dihidupi sebagai salah satu strategi demi menjaga ketahanan, keamanan, dan perdamaian Indonesia. Selanjutnya, ideologi tersebut dilatari oleh keadaan bangsa yang plural dan kesadaran bahwa sifat statis adalah penghalang kemajuan bangsa. Kandungan ideologi dimaksud membawa perubahan dalam cara berkomunikasi dan cara hidup bangsa Indonesia. Kata kunci: ideologi, bahasa politik, analisis wacana kritis Abstract The current study aims at: (1) to explore the ideology conceived in Soekarno’s political language as one of the nation founding fathers and the proclaimer of Indonesia independence, (2) to explore the motivations behind the birth of ideology in the language, and (3) to see the socio-cultural changes as the result of Soekarno’s political ideology. To achieve the research objectives, researcher used Critical Discourse Analysis Theory (CDA) of Fairclough (1989, 1995, 2005, 2006) as the main theory, and the theory of Ideology as a supporting theory. The method applied in data collection was documentation method, while the method applied in data analysis was descriptive qualitative method that applied based on three analysis levels of Fairclough CDA theory. The results show that the ideology contained in Soekarno’s political language is the ideology of ‘unity as an important thing’, the ideology of ‘revolution as an integral part of the Indonesian nation soul’, and the ideology of ‘imperialism as the main enemy of the Indonesia’. The ideology needs to be lived for the sake of Indonesia’s endurance, security and peace. Furthermore, the ideology is based on a plural nation state and the realization that static nature is a barrier to the progress of a nation. The ideology contents have brought changes in the way of communication and the way of Indonesian nation life. Keywords: ideology, political language, critical discourse analysis

Climate services are seen as key for informing decision-making and policy planning around climate change adaptation. However, recent research shows the current application of climate services in actual decision-making and policy planning on the ground still being limited. A common critique in the current development of climate services is their tailoring toward those users with sufficient capacity to adapt, as opposed to those most in need of adaptation. In an attempt to address this key limitation, citizens‘ assemblies are proposed in contributing to the inclusivity of climate services, enhancing their legitimacy and potential for societal uptake. After introducing the concept of climate services and limitations thereof, citizens‘ assemblies are presented along with a blueprint for designing inclusive climate services.

The deployment of wearable or body-worn devices is increasing rapidly, and thus researchers’ interests mainly include technical and economical issues, such as networking, interoperability, security, power optimization, business growth and regulation. To address these issues properly, previous survey papers usually focused on describing the wireless body area network architecture and network protocols. This implies that deployment issues and awareness issues of wearable and BAN devices are not emphasized in previous work. To defeat this problem, in this study, we have focused on feasibility, limitations, and security concerns in wireless body area networks. In the aspect of the economy, we have focused on the compound annual growth rate of these devices in the global market, different regulations of wearable/wireless body area network devices in different regions and countries of the world and feasible research projects for wireless body area networks. In addition, this study focuses on the domain of devices that are equally important to physicians, sportsmen, trainers and coaches, computer scientists, engineers, and investors. The outcomes of this study relating to physicians, fitness trainers and coaches indicate that the use of these devices means they would be able to treat their clients in a more effective way. The study also converges the focus of businessmen on the Annual Growth Rate (CAGR) and provides manufacturers and vendors with information about different regulatory bodies that are monitoring and regulating WBAN devices. Therefore, by providing deployment issues in the aspects of technology and economy at the same time, we believe that this survey can serve as a preliminary material that will lead to more advancements and improvements in deployment in the area of wearable wireless body area networks. Finally, we present open issues and further research direction in the area of wireless body area networks.

Background: Smokers are known to have a higher risk of erectile dysfunction. We examined how daily consumption of low-dose tadalafil affected erectile function and circulation in smokers and assessed the medication safety. Methods: Men aged over 20 years with current smoking status were selected to complete four weeks of treatment with 5 mg tadalafil daily. Erectile function was measured using the International Index of Erectile Function (IIEF), and additional tests included measuring various serum parameters, electrocardiogram, and nail capillary blood flow. Results: The IIEF scores, capillary blood flow, and serum liver function enzyme levels significantly improved. There were no reported adverse side effects. Conclusions: Smokers who were administered 5 mg tadalafil daily for four weeks had improved International Index of Erectile Function scores, dilated capillary vessels, and improved blood liver function enzyme levels; proving not only safety of usage and its effectiveness but also possible features that can indicate usages of the drug in other purposes.

Abstract Ecosystems across the United States are changing in complex and surprising ways. Ongoing demand for critical ecosystem services requires an understanding of the populations and communities in these ecosystems in the future. This paper represents a synthesis effort of the U.S. National Science Foundation‐funded Long‐Term Ecological Research (LTER) network addressing the core research area of “populations and communities.” The objective of this effort was to show the importance of long‐term data collection and experiments for addressing the hardest questions in scientific ecology that have significant implications for environmental policy and management. Each LTER site developed at least one compelling case study about what their site could look like in 50–100 yr as human and environmental drivers influencing specific ecosystems change. As the case studies were prepared, five themes emerged, and the studies were grouped into papers in this LTER Futures Special Feature addressing state change, connectivity, resilience, time lags, and cascading effects. This paper addresses the “connectivity” theme and has examples from the Phoenix (urban), Niwot Ridge (alpine tundra), McMurdo Dry Valleys (polar desert), Plum Island (coastal), Santa Barbara Coastal (coastal), and Jornada (arid grassland and shrubland) sites. Connectivity has multiple dimensions, ranging from multi‐scalar interactions in space to complex interactions over time that govern the transport of materials and the distribution and movement of organisms. The case studies presented here range widely, showing how land‐use legacies interact with climate to alter the structure and function of arid ecosystems and flows of resources and organisms in Antarctic polar desert, alpine, urban, and coastal marine ecosystems. Long‐term ecological research demonstrates that connectivity can, in some circumstances, sustain valuable ecosystem functions, such as the persistence of foundation species and their associated biodiversity or, it can be an agent of state change, as when it increases wind and water erosion. Increased connectivity due to warming can also lead to species range expansions or contractions and the introduction of undesirable species. Continued long‐term studies are essential for addressing the complexities of connectivity. The diversity of ecosystems within the LTER network is a strong platform for these studies.

INTRODUCTION: Dyslipidemia and hypertension are independent cardiovascular risk factors that are linked by insulin resistance and commonly coexist as components of the metabolic syndrome. The consequences of dyslipidaemic patterns includes high cardiovascular risk profile and sequalae. Data on lipid patterns amongst hypertensive patients in Abuja, a city with affluent pattern of life style and rising cardiovascular risk profile is very scanty or limited to just levels of total plasma cholesterol. This study was aimed at determining the pattern and frequencies of dyslipidaemic forms among hypertensive patients in Abuja. METHODS: this was a retrospective cohort study with the following data collected; socio-demographics, anthropometric measures and certain metabolic parameters from the new and old groups and analyzed using IBM SPSS Statistics, version 23. All decisions were made using the assymp. 2-sided Pearson χ2 probability. Quantitative variables were expressed as means and standard deviations. Qualitative variables were expressed as percentages. A p-value of =.05 was set as significant. RESULTS: eight fifty eight (858) cases were enrolled for this study, 704 (82.1%) Olds and 154 (17.9%) news. There were 251 (29.3%) males and 607 (70.7%) females. The means of the two groups were largely comparable. The commonest dyslipidaemic type was reduced High density lipoprotein, HDL (96.1%), followed by elevated low-density lipoprotein, LDL (78.6%), then, elevated total cholesterol, (62.3%) TCHOL and elevated triglycerides, TG 43.5%. CONCLUSION: dyslipidemic forms are very common among hypertensive patients in Abuja, Nigeria, particularly reduced HDL. Some observed associations include; middle age, female gender, middle/upper socio-economic classes, low levels of physical activity, overweigh/obesity, dysglycaemia and long-standing hypertension.

Non-technical summary The ‘last mile’ is a transportation planning term that describes the movement of people and goods from a transportation hub to a final destination; a local place such as a home or a shop. This is the final step of the logistics process that unites the product with its new owner. We present and explain challenges of science-guided adaptation at the local level, and how this is an equivalent ‘last mile’ challenge for climate adaptation. Technical summary The ‘last mile’ issue, a term used in transportation planning, describes the movement of people and goods from a transportation hub to a final destination, a local place such as a home or a shop. This is the critical final step of the logistics process that unites the product with its new owner, and the point of the value chain. This analogy aptly describes the last steps between presenting scientific evidence of climate change to decision-makers for use in local adaptation and planning. Climate change data (observational and model simulation data e.g. climate change projections and predictions) remain under-utilised, especially by local institutions and actors for which adaptation is a priority. The assumptions and assertions of the classical data–information–knowledge–wisdom are challenged, and a derivative form of the information hierarchy is proposed. Elements of the classical information hierarchy are offset by four balancing elements of access (to data); usability (of information); governance (of knowledge) and politics (of wisdom). These balancing elements and their relatedness coincide with newer models of innovation relating to the interaction between different stakeholders across the different levels of governance, the inclusion of stakeholder expectations, transparency and accountability. Social media summary Climate data to wise decision-making in the ‘last mile’: a novel perspective on science-guided local adaptation.

Translating and incorporating climate information into decision-making and policy planning processes is challenging. In tailoring climate data to sector-specific user needs, climate services are seen as key mechanisms for facilitating this translation and incorporation, supporting climate change adaptation and sustainable development. The European water sector is especially in need of tailored climate data for informing climate-smart action and reducing human and economic impacts of climate change. This was the objective of the EU Horizon 2020 Project IMPREX (IMproving PRedictions and management of hydrological EXtremes). The paper shows how pre-identified shortcomings were addressed in the design of climate services in IMPREX, and how this process elucidated new research priorities for improving the effectiveness of climate services. The paper finds the use of participatory methods helped identify stakeholder needs, and advocates for the greater consideration of user and institutional capacity for integrating climate services into decision-making and policy planning processes.

This case presents a patient with bacteremia of an unusual organism with a history of monoclonal gammopathy of undetermined significance (MGUS). MGUS is typically thought to be asymptomatic until potential progression of the disease. This case reports a patient with a history of MGUS who does not show disease progression, however, may be showing symptoms, such as immunodeficiency. This case displays bacteremia with Streptococcus mitis within a two-week period of an invasive procedure. Recent studies parallel this case by showing MGUS patients may have two times the risk of infections compared to the unaffected population. This report brings up the question of taking prophylactic measures for this patient population to prevent future complications.

Besides BRCA1 and BRCA2, several other inheritable mutations have been identified that increase ovarian cancer risk. Surgical excision of the fallopian tubes and ovaries reduces ovarian cancer risk, but for some non-BRCA hereditary ovarian cancer mutations the benefit of this intervention is unclear. The fallopian tubes of women with hereditary ovarian cancer mutations provide many insights into the early events of carcinogenesis and process of malignant transformation. Here we review cancer pathogenesis in hereditary cases of ovarian cancer, the occurrence of pre-invasive lesions and occult carcinoma in mutation carriers and their clinical management.

Abstract Ganglioglioma is the most common epilepsy-associated neoplasm that accounts for approximately 2% of all primary brain tumors. While a subset of gangliogliomas are known to harbor the activating p.V600E mutation in the BRAF oncogene, the genetic alterations responsible for the remainder are largely unknown, as is the spectrum of any additional cooperating gene mutations or copy number alterations. We performed targeted next-generation sequencing that provides comprehensive assessment of mutations, gene fusions, and copy number alterations on a cohort of 40 gangliogliomas. Thirty-six harbored mutations predicted to activate the MAP kinase signaling pathway, including 18 with BRAF p.V600E mutation, 5 with variant BRAF mutation (including 4 cases with novel in-frame insertions at p.R506 in the β3-αC loop of the kinase domain), 4 with BRAF fusion, 2 with KRAS mutation, 1 with RAF1 fusion, 1 with biallelic NF1 mutation, and 5 with FGFR1/2 alterations. Three gangliogliomas with BRAF p.V600E mutation had concurrent CDKN2A homozygous deletion and one additionally harbored a subclonal mutation in PTEN. Otherwise, no additional pathogenic mutations, fusions, amplifications, or deletions were identified in any of the other tumors. Amongst the 4 gangliogliomas without canonical MAP kinase pathway alterations identified, one epilepsy-associated tumor in the temporal lobe of a young child was found to harbor a novel ABL2-GAB2 gene fusion. The underlying genetic alterations did not show significant association with patient age or disease progression/recurrence in this cohort. Together, this study highlights that ganglioglioma is characterized by genetic alterations that activate the MAP kinase pathway, with only a small subset of cases that harbor additional pathogenic alterations such as CDKN2A deletion.

Hyperarid, arid, semiarid, and dry subhumid areas cover approximately 41% of the global land area. The human population in drylands, currently estimated at 2.7 billion, faces limited access to sufficient, affordable, and nutritious food. We discuss the interlinkages among water security, environmental security, energy security, economic security, health security, and food security governance, and how they affect food security in drylands. Reliable and adequate water supply, and the prevention of water contamination, increase the potential for ample food, fodder, and fiber production. Protecting woodlands and rangelands increases food security by buffering the slow onset effects of climate change, including biodiversity loss, desertification, salinization, and land degradation. The protection of natural lands is expected to decrease environmental contamination, and simultaneously, reduce the transfer of diseases from wildlife to humans. Biofuel production and hydroelectric power plants increase energy security but generate land-use conflicts, deforestation, and ecosystem degradation. Economic security generally positively correlates with food security. However, economic growth often degrades the environment, changes tenure rights over natural resources, and stimulates migration to urban areas, resulting in lower food and health security. Moreover, civil unrest, political instability, and armed conflicts disrupt local economies in drylands. Maintaining food security is crucial for health security; conversely, malnourished populations and unresponsive health systems decrease economic security, and adversely affect environmental, energy, and food security. Climate change is expected to deteriorate health security by spreading vector-borne diseases. Effective governance and timely interventions can substantially shorten periods of food insecurity, lower their intensities, and accelerate recovery from inevitable crises, and are therefore crucial in preventing humanitarian crises. Since global drylands population will nearly double by 2050, and since drylands are among the most susceptible areas to climate change, integrated multi-hazard approaches to food security are needed.

Background: Venous thromboembolism after open gynecologic surgery is not uncommon, especially in the presence of other risk factors such as obesity, prolonged surgical time or gynecologic malignancy. Case: We present the case of a 62 y.o. patient who underwent open hysterectomy and surgical staging for uterine serous carcinoma. She was readmitted with lower extremity edema. During her workup, she underwent cardiovascular arrest secondary to saddle pulmonary embolus requiring cardiopulmonary resuscitation and extracorporeal membrane oxygenation. After systemic and catheter directed thrombolysis, and a long hospitalization, she was discharged home in stable condition. Conclusion: Saddle pulmonary embolus is a potentially catastrophic and fatal postoperative complication. This case demonstrates a successful implementation of directed thrombolysis, veno-arterial extracorporeal membrane oxygenation and multidisciplinary management in a case of postoperative saddle pulmonary embolus. Précis: We report a case of an endometrial cancer patient who sustained a massive postoperative pulmonary embolus and was successfully resuscitated using extracorporeal membrane oxygenation. Keywords: Pulmonary embolus, Extracorporeal membrane oxygenation, Thrombolysis, Endometrial cancer

Abstract Foundation species contribute to the recovery of animal communities from disturbance by engineering, by improving habitat quality, and by regulating food availability. In a salt marsh impacted by the Deepwater Horizon oil spill, we tested the hypothesis that nutrient subsidies would enhance the positive effects of the foundation species Spartina alterniflora on the initial recolonization of benthic invertebrate communities (e.g., copepods, annelids, nematodes) by augmenting food (i.e., microalgae) availability. After two months, plantings of S. alterniflora significantly elevated the densities of the polychaete Capitella capitata, meiofauna‐sized annelids, and total macroinfauna over unplanted plots. After 7 months, the significant effect of plantings persisted for meiofauna‐sized annelids, but not for C. capitata and total macroinfauna. Plantings had no effect on copepods (including Nannopus palustris, the dominant species), nematodes, or microalgal biomass for either month. Nutrient additions did not influence any taxon, despite initial increases in benthic microalgal biomass after 2 months. We hypothesize that the structural effects of plants were important to early colonization, possibly by facilitating larval settlement or ameliorating temperature and desiccation stress. Our results emphasize the importance of re‐establishing foundation species in oil‐impacted sites to enhance recolonization of saltmarsh annelids, but suggest that recolonization is not promoted by the addition of nutrients.

OBJECTIVES/SPECIFIC AIMS: Patients are increasingly using online materials to learn about gynecologic cancer. Recent studies demonstrate that 85-96% of patients with a gynecologic malignancy utilize the Internet as a health resource. Providers can refer patients to educational materials produced by major medical associations available on their websites. However, patient educational materials (PEMs) published by professional organizations from other surgical specialties have been shown to be difficult to read for the average American. The NIH and AMA recommend that PEMs be written between a sixth and eighth grade reading level. In this study, we assess the readability of online PEMs on gynecologic cancer published by major medical associations. METHODS/STUDY POPULATION: Seven national medical association websites with PEMs on gynecologic malignancy were surveyed: American College of Obstetricians and Gynecologists, Center for Disease Control, Foundation for Women’s Cancer, National Cancer Institute, National Cervical Cancer Coalition, National Ovarian Cancer Coalition, and Society of Gynecologic Oncology. Online PEMs were identified and analyzed using five validated readability indices. One-way ANOVA and Tukey’s test were performed to detect differences in readability between publishers. RESULTS/ANTICIPATED RESULTS: Two hundred and thirty PEMs were included in this analysis. Mean readability grade levels with standard deviation were: 11.3 (2.8) for Coleman-Liau index; 11.8 (3.2) for Flesch-Kincaid; 11.1 (1.2) for FORCAST formula; 12.5 (2.7) for Gunning FOG formula; 12.1 (2.6) for New Dale-Chall formula; and 13.5 (2.5) for SMOG formula. Overall, PEMs were written at a mean 12th grade reading level. Only 4.3% of articles were written at an 8th grade reading level or below. ANOVA demonstrated a significant difference in readability between publishing associations (p

Blood transfusion is commonly undertaken in critically ill patients; and studies have suggested the use of oxygen extraction ratio (O2ER) as an additional transfusion trigger in critically ill patients. The aim of this study was to establish the relationship between blood transfusion and oxygen extraction ratio in adult patients admitted to the general intensive care unit, using central venous oxygen saturation instead of mixed venous oxygen saturation. Methods: Arterial and central venous blood samples were drawn and a blood gas analysis immediately before commencement of blood transfusion was undertaken. At least 15 min after completion of the transfusion, similar samples were drawn and the blood gas analysis was repeated. The O2ER before and after transfusion was then calculated. Using paired student’s t-test, we checked whether the mean difference between the two O2ERs was statistically significant. Results: We enrolled 58 patients in the study, the mean (±SD) haemoglobin concentration before transfusion was 7.38 g/dl (±1.71). The mean change in haemoglobin concentration following blood transfusion was 2.29 g/dl (±1.18), after transfusing an average of 1.95 (±0.83) units of packed cells. Mean O2ER was 0.27 (±0.11) before, and 0.25 (±0.12) after RBC transfusion. The mean change in O2ER was −0.018 SD ± 0.10 (95% CI, −0.043–0.007; P = 0.15). Linear regression analysis showed no statistically significant relationship between change in haemoglobin concentration and change in O2ER; p-value = 0.12. Discussion: The change in oxygen extraction ratio was not statistically significant following blood transfusion in adult patients admitted to the general ICU at a tertiary teaching hospital. Further studies are required especially in patients with increased pre transfusion O2ER to evaluate the usefulness of this measurement as a possible transfusion trigger.

The current research aims at investigating the most important speech of Soekarno and the ideologies behind the speech. Since Soekarno was the proclaimer of Indonesian independence as well as the first president of Indonesia, we would claim that his speeches were important to be investigated. Among the speeches, we tried to reveal the most important one through a lingual investigation. This investigation was based on grounded theory and hermeneutic theory. It was focused on the text as a part of the language. The results have shown that the most important speech of Soekarno is the speech entitled, ‘Tahun Berdikari’. It is viewed as a high novelty finding because there is no researcher who has ever claimed ‘Tahun Berdikari’ as the most important speech in the history of Indonesia. The speech contained three main ideologies, namely (1) unity as the most important thing for Indonesians, (2) revolution must be in the Indonesian soul, and (3) imperialism and capitalism as Indonesia’s main enemy.

OBJECTIVES/SPECIFIC AIMS: Opioids are the first-line treatment for moderate to severe cancer-related pain. Increased awareness of opioid prescription misuse and adverse outcomes has prompted statements on their use from multiple national medical groups. In this study we characterize national-level opioid prescription patterns among gynecologic oncologists treating Medicare beneficiaries. METHODS/STUDY POPULATION: The Centers for Medicare and Medicaid Services (CMS) database was used to access Medicare Part D beneficiary data (2016). All available opioid claims prescribed by gynecologic oncologists were identified. Medication type, prescription length and other prescribing factors were recorded. Physician demographics were obtained from departmental websites and accrediting bodies. Physicians with 100 opioid claims (11%). Of these, the overwhelming majority were male (82%) and late career (46%, >15 years since board certification). Physicians in the South had the greatest number of opioid prescription claims and significantly more than physicians in the Northeast, who had the fewest (p

OBJECTIVES/SPECIFIC AIMS: Industry payments to physicians can present a conflict of interest. The Physician Payments Sunshine Act mandates the disclosure of these financial relationships to increase transparency. Recent studies in other surgical specialties have shown that research productivity is associated with greater industry funding. In this study, we characterize the relationship between academic influence and industry funding among academic gynecologic oncologists. METHODS/STUDY POPULATION: Departmental websites were used to identify academic gynecologist oncologists and their demographic information. The Hirsch index (h-index) relates an author’s number of publications to number of times referenced by other publications, a validated measure of an author’s academic influence. This was obtained from the Scopus database. The Center for Medicaid and Medicare Services Open Payments online database was searched for all industry payments in 2017. The NIH Reporter online database was searched for active grants. Goodness of fit testing showed that all variables followed nonparametric distributions. Medians were compared using Mann-Whitney U tests and Kruskal-Wallis analysis of variance with post-hoc Dunn’s test. RESULTS/ANTICIPATED RESULTS: Four hundred and sixty-six academic gynecologic oncologists were included in the analysis. In 2017, 89.7% of this group received industry funding totaling $41.4 million. Median industry funding was $453 [IQR $67-19684] and median h-index was 14 [IQR 8-26]. Only 8.1% of gynecologic oncologists were NIH grant recipients and they received significantly higher industry payments ($357 vs. 11,168, P$100,000 (N = 63, P

Urbanization and climate change are compounding the vulnerability of flooding for the urban poor, particularly in the Global South. However, local governance can be a greater determinant of flood risk than the hazard itself. Identifying strengths and weaknesses in local governance for water management is therefore crucial. This paper presents a governance assessment for Quarry Road West informal settlement, Durban, South Africa, in relation to flood risk by applying the Capital Approach Framework. Through developing a deeper understanding of the current governance system, the embeddedness of several social values can also be gauged. This is important particularly for integrative and transdisciplinary management of flood risk, enacted in the case of Quarry Road West informal settlement through the Palmiet Rehabilitation Project, a multi sector partnership at the climate change and water governance interface. Findings from this study indicate that, currently, climate change adaptation remains a challenge for decision-makers and policy-planners. A more effective integration of the residents of Quarry Road West informal settlement into local governance for water management is urgently needed. This is particularly important in the context of informal settlements that are marginalized and often lacking governance mechanisms to affect change.

INTRODUCTION: Dietary supplement (DS) use increased rapidly in recent years. However, evidence of benefits of many DSs for healthy users is scarce and may not equate with known risks of overdose, drug interaction and recently discovered negative long-term effects. This exploratory study aimed to investigate the perceptions and motivations of DS users in Lausanne, Switzerland. METHOD: A convenience sample (n = 147) was recruited at the entrances of local sales points. Data were collected in on-site semistructured interviews that assessed dietary supplementation habits. RESULTS: The majority of DSs were all-in-one products, containing a mixture of minerals and vitamins, or products containing only minerals. Among the 147 users, 72 (49%) used one all-in-one product and 3 (2%) used two all-in-one products. Thirty-one (21%) consumers did not know for at least one product what the purpose of their DS use was. Seventy-five percent of participants thought that DS use presents no risk or nearly no risk. Only 49% of participants stated that their physicians were informed about their consumption. Although men searched more often for potential risks (p