Through the broad usage of cloud computing and the extensive utilization of next-generation public clouds, people can share valuable information worldwide via a wireless medium. Public cloud ...computing is used in various domains where thousands of applications are connected and generate numerous amounts of data stored on the cloud servers via an open network channel. However, open transmission is vulnerable to several threats, and its security and privacy are still a big challenge. Some proposed security solutions for protecting next-generation public cloud environments are in the literature. However, these methods may not be suitable for a wide range of applications in a next-generation public cloud environment due to their high computing and communication overheads because if security protocol is strengthened, it inversely impacts performance and vice versa. Furthermore, these security frameworks are vulnerable to several attacks, such as replay, denial-of-service (DoS), insider, server spoofing, and masquerade, and also lack strong user anonymity and privacy protection for the end user. Therefore, this study aims to design an elliptic curve cryptographic (ECC) based data access control protocol for a public cloud environment. The security mechanism of the proposed protocol can be verified using BAN (Burrows-Abadi-Needham) logic and ProVerif 2.03, as well as informally using assumptions and pragmatic illustration. In contrast, in the performance analysis section, we have considered the parameters such as the complexity of storage overheads, communication, and computation time. As per the numerical results obtained in the performance analysis section, the proposed protocol is lightweight, robust, and easily implemented in a practical next-generation cloud computing environment.
A field study was conducted to test the potential of 5-year consecutive application of fresh industrial sludge (FIS) and composted industrial sludge (CIS) to restore soil functions at surface ...(0–15cm) and subsurface (15–30cm) of the degraded agricultural land. Sludge amendments increased soil fertility parameters including total organic carbon (TOC), soil available nitrogen (SAN), soil available phosphorus (SAP) and soil available potassium (SAK) at 0–15cm depth. Soil enzyme activities i.e. dehydrogenase (DHA), β-glucosidase (BGA) and alkaline phosphatase (ALp) were significantly enhanced by FIS and CIS amendments in surface soil. However, urease activity (UA) and acid phosphatase (ACp) were significantly reduced compared to control soil. The results showed that sludge amendments significantly increased microbial biomass nitrogen (MBN) and microbial biomass phosphorus (MBP) at both soil depth, and soil microbial biomass carbon (MBC) only at 0–15cm depth. Significant changes were also observed in the population of soil culturable microflora (bacteria, fungi and actinomycetes) with CIS amendment in surface soil suggesting persistence of microbial activity owing to the addition of organic matter source. Sludge amendments significantly reduced soil heavy metal concentrations at 0–15cm depth, and the effect was more pronounced with CIS compared to unamended control soil. Sludge amendments generally had no significant impact on soil heavy metal concentrations in subsoil. Agronomic viability test involving maize was performed to evaluate phytotoxicity of soil solution extract at surface and sub-surface soil. Maize seeds grown in solution extract (0–15cm) from sludge treated soil showed a significant increase of relative seed germination (RSG), relative root growth (RRG) and germination index (GI). These results suggested that both sludge amendments significantly improved soil properties, however, the CIS amendment was relatively more effective in restoring soil functions and effectively immobilizing wastewater derived heavy metals compared to FIS treatment.
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•FIS and CIS amended for 5 consecutive years on a degraded agricultural soil.•Soil quality markedly improved in the surface layer by FIS and CIS amendments.•FIS and CIS could immobilize heavy metals in surface soil.•Sludge amendments enhanced agronomic viability of surface soil more than subsurface.•CIS can be recommended for the restoration of high pH degraded soil.
An innovative biacetyl-modified
Triticum aestivum
(BMTA) was prepared and its biosorption efficiency was investigated for the removal of Pb(II) and Cr(III) ions from synthesized single and binary ...metal solutions. The characterization using infrared spectrum, surface area determination and potentiometric titrations indicated an increased acid content of the biomass, indicating BMTA as a potential choice for the binding of metal ions at a relatively low pH. The isoelectric point was found to be at pH 4.5. Various biosorption parameters were optimized. Langmuir model best fitted the experimental equilibrium data with q
max
27.39mg/g for Pb(II) ions and 24.69mg/g for Cr(III) ions in single metal system and 24.21mg/g for Pb(II) and 12.97mg/g for Cr(III) ions in binary system, respectively. The kinetics was described by pseudo-second-order model both in single and binary metal system. The studies indicated relatively selective biosorption of Pb(II) ions by BMTA compared to other metal ions.
To study an outbreak of Mycobacterium mucogenicum bloodstream infections in an outpatient setting.
Outbreak investigation and retrospective chart review.
University outpatient clinic. Patients. ...Patients whose blood cultures tested positive for M. mucogenicum in May or June 2008.
An outbreak investigation and a review of infection control practices were conducted. During the process, environmental culture samples were obtained. Isolates from patients and the environment were genotyped with the DiversiLab typing system to identify the source. Chart reviews were conducted to study the management and outcomes of the patients.
Four patients with sickle cell disease and implanted ports followed in the same hematology outpatient clinic developed blood cultures positive for M. mucogenicum. A nurse in the clinic had prepared intravenous port flushes on the sink counter, using a saline bag that was hanging over the sink throughout the shift. None of the environmental cultures grew M. mucogenicum except for the tap water from 2 rooms, 1 of which had a faucet aerator. The 4 patient isolates and the tap water isolate from the room with the aerator were found to have greater than 98.5% similarity. The subcutaneous ports were removed, and patients cleared their infections after a course of antibiotic therapy.
The source of the M. mucogenicum bacteremia outbreak was identified by genotyping analysis as the clinic tap water supply. The preparation of intravenous medications near the sink was likely an important factor in transmission, along with the presence of a faucet aerator.
Abstract Background This study evaluated the effectiveness of using trained volunteer staff in reducing 30-day readmissions of congestive heart failure (CHF) patients. Methods From June 2010 to ...December 2010, 137 patients (mean age 73 years) hospitalized for CHF were randomly assigned to either: an interventional arm (arm A) receiving dietary and pharmacologic education by a trained volunteer, follow-up telephone calls within 48 hours, and a month of weekly calls; or a control arm (arm B) receiving standard care. Primary outcomes were 30-day readmission rates for CHF and worsening New York Heart Association (NYHA) functional classification; composite and all-cause mortality were secondary outcomes. Results Arm A patients had decreased 30-day readmissions (7% vs 19%; P < .05) with a relative risk reduction (RRR) of 63% and an absolute risk reduction (ARR) of 12%. The composite outcome of 30-day readmission, worsening NYHA functional class, and death was decreased in the arm A (24% vs 49%; P < .05; RRR 51%, ARR 25%). Standard-care treatment and hypertension, age ≥65 years and hypertension, and cigarette smoking were predictors of increased risk for readmissions, worsening NYHA functional class, and all-cause mortality, respectively, in the multivariable analysis. Conclusions Utilizing trained volunteer staff to improve patient education and engagement might be an efficient and low-cost intervention to reduce CHF readmissions.
Biosorption of Cu(II) ions onto blackgram bran (BGB) waste biomass in a well stirred batch system was investigated and optimum conditions were determined. The maximum Cu(II) uptake capacity of BGB ...was 107.65
mg
L
−1 at pH 5, biosorbent dose 0.025
g/100
mL, biosorbent particle size <0.250
mm at an initial metal concentration of 50
mg
L
−1 achieved after equilibrium time of 480
min. The equilibrium data fitted very well to Langmuir isotherm model as compared to the isothermal model of Freundlich. The pseudo 1st and 2nd order kinetic models were used to describe the kinetic data. The experimental data fitted well to 2nd order kinetic model. Due to its outstanding Cu(II) ions uptake capacity, BGB biomass proved to be an excellent material of bioorigin for accumulating Cu(II) ions from aqueous solutions.
There has been a significant increase in the prevalence, severity, and mortality of Clostridium difficile infection (CDI), with an estimated three million new cases per year in the United States. Yet ...diagnosing CDI remains problematic. The most commonly used test is stool enzyme immunoassay (EIA) detecting toxin A and/or B, but there are no clear guidelines specifying the optimal number of tests to be ordered in the diagnostic workup, although multiple tests are frequently ordered. Thus, we designed a study with the primary objective of evaluating the diagnostic utility of repeat second and third tests of stool EIA detecting both toxins A and B (EIA (A&B)) in cases with negative initial samples, and sought to describe the physicians' patterns of ordering this test in the workup of suspected CDI.
A retrospective study was carried out using a database of all stool EIA (A&B) tests ordered for a presumptive diagnosis of CDI. All patients were adults admitted to a major teaching hospital over a three-and-a-half-year period (tests completed within 5 days of ordering the first test were grouped into a single episode, and only the first three samples per episode were analyzed). Age, gender, and results of stool EIA were tabulated. In addition, physicians' ordering patterns and proportion of positive stools relative to the number of tests ordered were also analyzed. A single positive EIA result was interpreted as evidence for the clinical presence of CDI.
A total of 3,712 patients contributed to 5,865 separate diarrhea episodes (total stool EIA (A&B)=9,178), and 1,165 (19.9%) of these episodes were positive for CDI. Of the positive patients, 73.2% were over the age of 65 years and 54.2% of them were females. The most frequent ordering pattern for presumptive CDI was a single stool test (60.1%), followed by two more tests (23.2%). Three tests were still ordered in 16.6% of the cases. Of the 1,165 positive cases, 1,046 (89.8%) were diagnosed in the very first test, 95 (8.2%) in the second, and only 24 (2.0%) in the third test. In 1,934 instances, a second test was ordered after an initial negative result, of which 95 (4.91%) became positive. In 793 episodes, a third test was ordered after two negative samples, of which only 24 (3.03%) became positive.
This study highlights the low diagnostic yield of repeat stool EIA (A&B) testing. Findings strongly support the utility of limiting the workup of suspected CDI to a single stool test with only one repeat test in cases of high clinical suspicion, and avoiding the routine ordering of multiple stool samples. As Clostridium difficile is becoming an endemic health-care problem resulting in major financial burdens for the US health-care system, clear guidelines specifying the optimal number of stool EIA (A&B) tests to be ordered in the diagnostic workup of suspected CDI must be established to assist physicians in the practice of evidence-based medicine.
