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Fulltext Detection and Mitigation of RPL Rank and Version Number Attacks in the Internet of Things: SRPL-RP

A Almusaylim Z, Jhanjhi NZ, Alhumam A

Sensors (Basel), 2020 Oct 22;20(21).
PMID: 33105891 DOI: 10.3390/s20215997

The rapid growth of the Internet of Things (IoT) and the massive propagation of wireless technologies has revealed recent opportunities for development in various domains of real life, such as smart cities and E-Health applications. A slight defense against different forms of attack is offered for the current secure and lightweight Routing Protocol for Low Power and Lossy Networks (RPL) of IoT resource-constrained devices. Data packets are highly likely to be exposed in transmission during data packet routing. The RPL rank and version number attacks, which are two forms of RPL attacks, can have critical consequences for RPL networks. The studies conducted on these attacks have several security defects and performance shortcomings. In this research, we propose a Secure RPL Routing Protocol (SRPL-RP) for rank and version number attacks. This mainly detects, mitigates, and isolates attacks in RPL networks. The detection is based on a comparison of the rank strategy. The mitigation uses threshold and attack status tables, and the isolation adds them to a blacklist table and alerts nodes to skip them. SRPL-RP supports diverse types of network topologies and is comprehensively analyzed with multiple studies, such as Standard RPL with Attacks, Sink-Based Intrusion Detection Systems (SBIDS), and RPL+Shield. The analysis results showed that the SRPL-RP achieved significant improvements with a Packet Delivery Ratio (PDR) of 98.48%, a control message value of 991 packets/second, and an average energy consumption of 1231.75 joules. SRPL-RP provided a better accuracy rate of 98.30% under the attacks.

Matched MeSH terms: Telemedicine
Fulltext Paper-Based Flexible Antenna for Wearable Telemedicine Applications at 2.4 GHz ISM Band

Ullah MA, Islam MT, Alam T, Ashraf FB

Sensors (Basel), 2018 Dec 01;18(12).
PMID: 30513719 DOI: 10.3390/s18124214

This paper demonstrates the performance of a potential design of a paper substrate-based flexible antenna for intrabody telemedicine systems in the 2.4 GHz industrial, scientific, and medical radio (ISM) bands. The antenna was fabricated using 0.54 mm thick flexible photo paper and 0.03 mm copper strips as radiating elements. Design and performance analyses of the antenna were performed using Computer Simulation Technology (CST) Microwave Studio software. The antenna performances were investigated based on the reflection coefficient in normal and bent conditions. The total dimensions of the proposed antenna are 40 × 35 × 0.6 mm³. The antenna operates at 2.33⁻2.53 GHz in the normal condition. More than an 8% fractional bandwidth is expressed by the antenna. Computational analysis was performed at different flexible curvatures by bending the antenna. The minimum fractional bandwidth deviation is 5.04% and the maximum is 24.97%. Moreover, it was mounted on a homogeneous phantom muscle and a four-layer human tissue phantom. Up to a 70% radiation efficiency with a 2 dB gain was achieved by the antenna. Finally, the performance of the antenna with a homogeneous phantom muscle was measured and found reliable for wearable telemedicine applications.

Matched MeSH terms: Telemedicine
A comparative review of mobile health and electronic health utilization in sub-Saharan African countries

Bervell B, Al-Samarraie H

Soc Sci Med, 2019 07;232:1-16.
PMID: 31035241 DOI: 10.1016/j.socscimed.2019.04.024

This study distinguished between the application of e-health and m-health technologies in sub-Saharan African (SSA) countries based on the dimensions of use, targeted diseases or health conditions, locations of use, and beneficiaries (types of patients or health workers) in a country specific context. It further characterized the main opportunities and challenges associated with these dimensions across the sub-region. A systematic review of the literature was conducted on 66 published peer reviewed articles. The review followed the scientific process of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of identification, selection, assessment, synthesis and interpretation of findings. The results of the study showed that m-health was prevalent in usage for promoting information for treatment and prevention of diseases as well as serving as an effective technology for reminders towards adherence. For e-health, the uniqueness lay in data acquisition and patients' records management; diagnosis; training and recruitment. While m-health was never used for monitoring or training and recruitment, e-health on the other hand could not serve the purpose of reminders or for reporting cases from the field. Both technologies were however useful for adherence, diagnosis, disease control mechanisms, information provision, and decision-making/referrals. HIV/AIDS, malaria, and maternal (postnatal and antenatal) healthcare were important in both m-health and e-health interventions mostly concentrated in the rural settings of South Africa and Kenya. ICT infrastructure, trained personnel, illiteracy, lack of multilingual text and voice messages were major challenges hindering the effective usage of both m-health and e-health technologies.

Matched MeSH terms: Telemedicine/organization & administration*
Fulltext Personal health records: mobile biosensors and smartphones for developing countries

Simon SK, Seldon HL

Stud Health Technol Inform, 2012;182:125-32.
PMID: 23138087

A target of telehealth is to maintain or improve the health of people outside the normal healthcare infrastructure. A modern paradigm in healthcare, and one which fits perfectly with telehealth, is "person self-monitoring", and this fits with the concept of "personal health record" (PHR). One factor in maintaining health is to monitor physiological parameters; this is of course especially important in people with chronic maladies such as diabetes or heart disease. Parameters to be monitored include blood pressure, pulse rate, temperature, weight, blood glucose, oxygen saturation, electrocardiogram (ECG), etc. So one task within telehealth would be to help monitor an individual's physiological parameters outside of healthcare institutions and store the results in a PHR in a way which is available, comprehensible and beneficial to the individual concerned and to healthcare providers. To date many approaches to this problem have been fragmented - emphasizing only part of the problem - or proprietary and not freely verifiable. We describe a framework to approach this task; it emphasizes the implementation of standards for data acquisition, storage and transmission in order to maximize the compatibility among disparate components, e.g. various PHR systems. Data from mobile biosensors is collected on a smartphone using the IEEE 11073 standard where possible; the data can be stored in a PHR on the phone (using standard formats) or can be converted in real-time into more useful information in the PHR, which is based on the International Classification for Primary Care (ICPC2e). The phone PHR data or information can be uploaded to a central online PHR using either the Wi-Fi or GSM transmission protocol together with the Continuity of Care Record message format (CCR, ASTM E2369).

Matched MeSH terms: Telemedicine/instrumentation; Telemedicine/organization & administration*
A proposal to design a Location-based Mobile Cardiac Emergency System (LMCES)

Keikhosrokiani P, Mustaffa N, Zakaria N, Sarwar MI

Stud Health Technol Inform, 2012;182:83-92.
PMID: 23138083

Healthcare for elderly people has become a vital issue. The Wearable Health Monitoring System (WHMS) is used to manage and monitor chronic disease in elderly people, postoperative rehabilitation patients and persons with special needs. Location-aware healthcare is achievable as positioning systems and telecommunications have been developed and have fulfilled the technology needed for this kind of healthcare system. In this paper, the researchers propose a Location-Based Mobile Cardiac Emergency System (LMCES) to track the patient's current location when Emergency Medical Services (EMS) has been activated as well as to locate the nearest healthcare unit for the ambulance service. The location coordinates of the patients can be retrieved by GPS and sent to the healthcare centre using GPRS. The location of the patient, cell ID information will also be transmitted to the LMCES server in order to retrieve the nearest health care unit. For the LMCES, we use Dijkstra's algorithm for selecting the shortest path between the nearest healthcare unit and the patient location in order to facilitate the ambulance's path under critical conditions.

Matched MeSH terms: Telemedicine/instrumentation; Telemedicine/methods*
Personal health records: retrieving contextual information with Google Custom Search

Ahsan M, Seldon HL, Sayeed S

Stud Health Technol Inform, 2012;182:10-8.
PMID: 23138074

Ubiquitous personal health records, which can accompany a person everywhere, are a necessary requirement for ubiquitous healthcare. Contextual information related to health events is important for the diagnosis and treatment of disease and for the maintenance of good health, yet it is seldom recorded in a health record. We describe a dual cellphone-and-Web-based personal health record system which can include 'external' contextual information. Much contextual information is available on the Internet and we can use ontologies to help identify relevant sites and information. But a search engine is required to retrieve information from the Web and developing a customized search engine is beyond our scope, so we can use Google Custom Search API Web service to get contextual data. In this paper we describe a framework which combines a health-and-environment 'knowledge base' or ontology with the Google Custom Search API to retrieve relevant contextual information related to entries in a ubiquitous personal health record.

Matched MeSH terms: Telemedicine
Tailoring teleconsultation to meet the current needs of neurosurgical services: a multimodality oriented neurosurgical consultation

Narenthiranathan NR, Adnan JS, Haspani MS

Stud Health Technol Inform, 2010;161:112-21.
PMID: 21191164

Teleconsultation in Neurosurgery was introduced in Malaysia in 2006 with the aims of enhancing quality services in the field of Neurosurgery. The present teleconsultation system is equipped with user friendly features which allow physicians to send and neurosurgeons to gain access to patient data in a swift and effective manner. In the past, teleconsultation in neurosurgery was tied with teleradiology, however we have now developed a multimodality system to cater specifically for neurosurgery. In Malaysia, the teleconsultation service is gaining momentum as evidenced by the large volume of cases channeled through this system. 944 cases within a span of 4 months were recorded on the system. 54.5% of the cases were trauma, 33.2% stroke, 6.1% intracranial tumours, 2% of cases were of spinal pathology, 2% pediatric anomalies and 2.2% intracranial infections. 50.2% of the referrals were after regular working hours reflecting the need for dedicated teleneurosurgery consultative services and the ability to review referrals outside of hospitals. Only 36% of cases needed emergency transfers and 9.9% of the cases were managed remotely at distant hospitals. Another 9.4% of the cases were either transferred electively or brought to the clinic for consultation. The above findings emphasise the importance of teleconsultation as a means to provide wide medical coverage within the region.

Matched MeSH terms: Telemedicine/organization & administration*
An overview of the national telehealth initiative in Malaysia

Maon SN, Edirippulige S

Stud Health Technol Inform, 2010;161:95-103.
PMID: 21191162

Malaysia's national health statistics for the last half century show a remarkable improvement in the nation's health status. One important factor for this improvement is the Malaysian government's proactive intervention in the health sector. Among others, e-health has played a vital role in delivering and managing healthcare services in Malaysia. While the Government has integrated telehealth in its national digital infrastructure re-design, it has heavily invested in telehealth. The enactment of new laws to facilitate telehealth practices can also be noted as an important measure.

Matched MeSH terms: Telemedicine/organization & administration*
Integrated telehealth: putting it all together and addressing the challenges

Harum H

Stud Health Technol Inform, 2004;104:75-86.
PMID: 15747966

The Integrated Telehealth Project of Malaysia is considered a principal enabler for the nation's Vision 2020 as well as the National Health Vision. Being in such an unenviable position, of being not only the pioneer for such an integrated project, but also with no benchmark to compare with, the project implementers have faced manifold challenges along the way. This chapter deals with some of the challenges and lessons learnt that have accumulated as the project progressed.

Matched MeSH terms: Telemedicine/organization & administration*
E-leadership in the digital age: the equilibrium, the codes and the digital gap

Harum H

Stud Health Technol Inform, 2004;104:30-40.
PMID: 15747961

Malaysia's experience in implementing the Integrated Telehealth Project has placed her way ahead in the arena of world Telehealth. Thus, she has become the focus point, reference point and benchmark for similar endeavors around the world. In fact, it would not be presumptuous to state that the Integrated Telehealth project is a trail-blazing pioneer with e-leadership experience and skills developed over the last few years. It is hoped that the Integrated Telehealth concept will find acceptance and credence globally.

Matched MeSH terms: Telemedicine/organization & administration*
Governance and management of national telehealth programs in Asia

Marcelo A, Ganesh J, Mohan J, Kadam DB, Ratta BS, Kulatunga G, et al.

Stud Health Technol Inform, 2015;209:95-101.
PMID: 25980710

Telehealth and telemedicine are increasingly becoming accepted practices in Asia, but challenges remain in deploying these services to the farthest areas of many developing countries. With the increasing popularity of universal health coverage, there is a resurgence in promoting telehealth services. But while telehealth that reaches the remotest part of a nation is the ideal endpoint, such goals are burdened by various constraints ranging from governance to funding to infrastructure and operational efficiency.

Matched MeSH terms: Telemedicine/organization & administration*
Telemedicine in the Malaysian Multimedia Super Corridor: towards personalized lifetime health plans

Abidi SS, Yusoff Z

Stud Health Technol Inform, 1999;68:283-8.
PMID: 10724889

The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system--a distributed multimodule application for the periodic monitoring and generation of health-care advisories for all Malaysians. In line with the LHP project, we present an innovative healthcare delivery info-structure--LifePlan--that aims to provide life-long, pro-active, personalised, wellness-oriented healthcare services to assist individuals to manage and interpret their health needs. Functionally, LifePlan based healthcare services are delivered over the WWW, packaged as Personalised Lifetime Health Plans that allow individuals to both monitor their health status and to guide them in healthcare planning.

Matched MeSH terms: Telemedicine/trends*
Java-based framework for the secure distribution of electronic medical records

Goh A

Stud Health Technol Inform, 1999;68:582-7.
PMID: 10724956

In this paper, we present a Java-based framework for the processing, storage and delivery of Electronic Medical Records (EMR). The choice of Java as a developmental and operational environment ensures operability over a wide-range of client-side platforms, with our on-going work emphasising migration towards Extensible Markup Language (XML) capable Web browser clients. Telemedicine in support of womb-to-tomb healthcare as articulated by the Multimedia Supercorridor (MSC) Telemedicine initiative--which motivated this project--will require high-volume data exchange over an insecure public-access Wide Area Network (WAN), thereby requiring a hybrid cryptosystem with both symmetric and asymmetric components. Our prototype framework features a pre-transaction authentication and key negotiation sequence which can be readily modified for client-side environments ranging from Web browsers without local storage capability to workstations with serial connectivity to a tamper-proof device, and also for point-to-multipoint transaction processes.

Matched MeSH terms: Telemedicine
Telemedicine and medical informatics in the multimedia super corridor: the Malaysian vision

Abidi SS, Goh A, Yusoff Z

Stud Health Technol Inform, 1998;52 Pt 2:1282-6.
PMID: 10384666

The practice of medicine, with its wide range of environmental conditions and complex dependencies, has long been used as a test bed for various advanced technologies. Telemedicine, as conceptualised within the Multimedia Super Corridor (MSC) context, is seen as the application of several relatively mature technologiesartificial intelligence (AI), multimedia communication and information systems (IS) amongst othersso as to benefit a large cross-section of the Malaysian population. We will discuss in general terms the Malaysian vision on the comprehensive MSC telemedicine solution, its functionality and associated operational conditions. In particular, this paper focuses on the conceptualisation of one key telemedical component i.e. the Lifetime Health Plan (LHP) system, which is eventually intended to be a distributed multi-module application for the periodic monitoring and generation of health-care advisories for upwards of 20 million Malaysians.

Matched MeSH terms: Telemedicine*
Patient empowerment via 'pushed' delivery of Personalised Healthcare educational content over the internet

Abidi SS, Han CY, Abidi SR

Stud Health Technol Inform, 2001;84(Pt 2):1425-9.
PMID: 11604961

We present an Internet-based Personalised Healthcare Information (PHI) dissemination system. Information personalisation is guided by the individual's current health profile as recorded in his/her EMR. A PHI package is composed by intelligently selecting and synthesizing various topic-specific documents, each corresponding to some health parameter noted in the EMR. To ensure medical consistency, constraint satisfaction techniques are employed during the information selection phase. The resultant PHI package--covering both long-term and immediate health-maintenance requirements--can be pro-actively pushed to the individual via email, thereby ensuring the timely availability of situation-specific health maintenance information. The featured work is in line with the Malaysian Multimedia Super Corridor Telemedicine initiative and can serve as a test-bed to evaluate the effectiveness of PHI, system design and operational considerations for larger-scale deployment.

Matched MeSH terms: Telemedicine
Malaysia, Britain, U.S. to study sharing patient-information technology

Telemed Virtual Real, 1998 May;3(5):57.
PMID: 10178828
Matched MeSH terms: Telemedicine*
Teledentistry in practice: literature review

Khan SA, Omar H

Telemed J E Health, 2013 Jul;19(7):565-7.
PMID: 23672799 DOI: 10.1089/tmj.2012.0200

Teledentistry can be defined as the remote provision of dental care, advice, or treatment through the medium of information technology, rather than through direct personal contact with any patient(s) involved. Within dental practice, teledentistry is used extensively in disciplines like preventive dentistry, orthodontics, endodontics, oral surgery, periodontal conditions, detection of early dental caries, patient education, oral medicine, and diagnosis. Some of the key modes and methods used in teledentistry are electronic health records, electronic referral systems, digitizing images, teleconsultations, and telediagnosis. All the applications used in teledentistry aim to bring about efficiency, provide access to underserved population, improve quality of care, and reduce oral disease burden.

Matched MeSH terms: Telemedicine*
Categorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy

Varghese S, Scott RE

Telemed J E Health, 2004;10(1):61-9.
PMID: 15104917

Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend.

Matched MeSH terms: Telemedicine/economics; Telemedicine/legislation & jurisprudence; Telemedicine/organization & administration*; Telemedicine/standards
m-Health for Early Detection of Oral Cancer in Low- and Middle-Income Countries

Haron N, Zain RB, Ramanathan A, Abraham MT, Liew CS, Ng KG, et al.

Telemed J E Health, 2020 03;26(3):278-285.
PMID: 31081720 DOI: 10.1089/tmj.2018.0285

Background:
Up to 86% of oral cancer (OC) patients present at the late stage where survival is dismal. Limited access to specialist diagnosis is a significant factor for late presentation. The increasing use of smartphones presents an opportunity to use digital technology to facilitate early detection of OC.
Aim:
To evaluate the feasibility of using Mobile Mouth Screening Anywhere (MeMoSA®) to facilitate early detection of OC.
Methods:
A mobile phone app named MeMoSA was developed and the feasibility of integrating this for documentation of oral lesions, and communication between dentists and specialists for management decisions were evaluated. The experience of dentists and specialists in using MeMoSA was determined using qualitative questionnaires.
Results:
Communication between specialist and dentists using MeMoSA stratified cases and streamlined referral of patients. Twelve of 48 patients were found to have oral lesions or signs suspicious of cancer and 3 required referrals. The patient's compliance for referral was tracked with MeMoSA. All dentists agreed that MeMoSA could facilitate early detection of OC and believed that MeMoSA could assist in the identification of oral mucosal lesions through direct communication with specialists and continuous learning in the recognition of high-risk lesions.
Conclusions:
MeMoSA has the potential to be used to promote equitable health care and streamline patient management that could result in early detection of OC.

Matched MeSH terms: Telemedicine*
Mobile Phone Imaging in Low Resource Settings for Early Detection of Oral Cancer and Concordance with Clinical Oral Examination

Haron N, Zain RB, Nabillah WM, Saleh A, Kallarakkal TG, Ramanathan A, et al.

Telemed J E Health, 2017 03;23(3):192-199.
PMID: 27541205 DOI: 10.1089/tmj.2016.0128

INTRODUCTION: This study examined the concordance in clinical diagnosis of high-risk lesions in the oral cavity and referral decisions between clinical oral examination (COE) and teledentistry.
MATERIALS AND METHODS: Sixteen individuals with a range of oral potentially malignant disorders (OPMD) and normal oral mucosa were included. Five areas of the oral cavity were photographed by three dentists using mobile phone cameras with 5 MP-13 MP resolutions. On the same day, the patients were given COE by two oral medicine specialists (OMS) and 3 weeks later, they reviewed the images taken using the phone, and concordance was examined between the two by Kappa statistics. The sensitivity and specificity of clinical diagnosis using the phone images were also measured. Pre- and post-program questionnaires were answered by both the dentists and the OMS to determine the feasibility of integrating teledentistry in their clinical practice.
RESULTS: The Kappa values in determining the presence of lesion, category of lesion (OPMD or not), and making referral decision were moderate to strong (0.64-1.00). The overall sensitivity was more than 70% and specificity was 100%. The false negative rate decreased as the camera resolution increased. All dentists agreed that the process could facilitate early detection of oral mucosal lesion, and was easy to use in the clinic.
CONCLUSIONS: This study provides evidence that teledentistry can be used for communication between primary care and OMS and could be readily integrated into clinical setting for patient management.

Matched MeSH terms: Telemedicine/methods*

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