Search

The use of physical unclonable functions (PUFs) linked to the manufacturing process of the electronic devices supporting applications that exchange critical data over the Internet has made these elements essential to guarantee the authenticity of said devices, as well as the confidentiality and integrity of the information they process or transmit. This paper describes the development of a configurable PUF/TRNG module based on ring oscillators (ROs) that takes full advantage of the structure of modern programmable devices offered by Xilinx 7 Series families. The proposed architecture improves the hardware efficiency with two main objectives. On the one hand, we perform an exhaustive statistical characterization of the results derived from the exploitation of RO configurability. On the other hand, we undertake the development of a new version of the module that requires a smaller amount of resources while considerably increasing the number of output bits compared to other proposals previously reported in the literature. The design as a highly parameterized intellectual property (IP) module connectable through a standard interface to a soft- or hard-core general-purpose processor greatly facilitates its integration into embedded solutions while accelerating the validation and characterization of this element on the same electronic device that implements it. The studies carried out reveal adequate values of reliability, uniqueness, and unpredictability when the module acts as a PUF, as well as acceptable levels of randomness and entropy when it acts as a true random number generator (TRNG). They also illustrate the ability to obfuscate and recover identifiers or cryptographic keys of up to 4096 bits using an implementation of the PUF/TRNG module that requires only an array of 4×4 configurable logic blocks (CLBs) to accommodate the RO bank.

Objective: Traditional pain management pathways following craniotomy are predicated on opioids. However, narcotics can confound critical neurological examination, contribute to respiratory depression, lower the seizure threshold, and lead to medication habituation, dependence, and/or abuse. Alternative medications to better address postoperative pain while mitigating opioid-related adverse effects remain insufficiently studied. Preliminary studies suggest sumatriptan, a 5-HT (1B/1D) receptor agonist known to regulate dural vasoactivity and inflammation, may moderate pain following trigeminal microvascular decompression and chronic postcraniotomy headache. In this study, the authors evaluated the efficacy of sumatriptan to modulate pain and opioid requirements following craniotomy surgery., Methods: This was a single academic center, retrospective cohort study of 300 consecutive adult patients who underwent elective craniotomy surgery between 2015 and 2022. Patients were equally divided between a control and a sumatriptan cohort contingent upon administration of 6 mg of subcutaneous sumatriptan within 1 hour of surgery completion and prior to opioid administration. Postoperative opioid consumption at 6, 12, and 24 hours, as well as admission total, inpatient length of stay, and 30-day global reevaluation, were assessed., Results: Three hundred patients were included for analysis. Significant differences were seen in baseline hypertension (p < 0.01), hyperlipemia (p < 0.01), anxiety (p = 0.04), and operative time (p = 0.02). A significant reduction of mean postoperative pain scores at 12 (p = 0.03) and 24 (p < 0.01) hours and total opioid consumption (p = 0.04) was observed in the sumatriptan cohort. Subgroup analysis revealed significantly lower postoperative pain scores at 6 (p = 0.05), 12 (p < 0.01), and 24 (p < 0.01) hours in patients who underwent burr hole placement in the sumatriptan cohort as compared with controls; however, no significant difference in opioid consumption was noted. No adverse events related to sumatriptan administration were noted throughout the study., Conclusions: Postoperative single-dose subcutaneous sumatriptan following elective craniotomy may reduce pain scores and opioid requirements. Additional studies are needed to better understand nuanced differences in opioid modulation and optimal patient selection.

The proliferation of devices for the Internet of Things (IoT) and their implication in many activities of our lives have led to a considerable increase in concern about the security of these devices, posing a double challenge for designers and developers of products. On the one hand, the design of new security primitives, suitable for resource-limited devices, can facilitate the inclusion of mechanisms and protocols to ensure the integrity and privacy of the data exchanged over the Internet. On the other hand, the development of techniques and tools to evaluate the quality of the proposed solutions as a step prior to their deployment, as well as to monitor their behavior once in operation against possible changes in operating conditions arising naturally or as a consequence of a stress situation forced by an attacker. To address these challenges, this paper first describes the design of a security primitive that plays an important role as a component of a hardware-based root of trust, as it can act as a source of entropy for True Random Number Generation (TRNG) or as a Physical Unclonable Function (PUF) to facilitate the generation of identifiers linked to the device on which it is implemented. The work also illustrates different software components that allow carrying out a self-assessment strategy to characterize and validate the performance of this primitive in its dual functionality, as well as to monitor possible changes in security levels that may occur during operation as a result of device aging and variations in power supply or operating temperature. The designed PUF/TRNG is provided as a configurable IP module, which takes advantage of the internal architecture of the Xilinx Series-7 and Zynq-7000 programmable devices and incorporates an AXI4-based standard interface to facilitate its interaction with soft- and hard-core processing systems. Several test systems that contain different instances of the IP have been implemented and subjected to an exhaustive set of on-line tests to obtain the metrics that determine its quality in terms of uniqueness, reliability, and entropy characteristics. The results obtained prove that the proposed module is a suitable candidate for various security applications. As an example, an implementation that uses less than 5% of the resources of a low-cost programmable device is capable of obfuscating and recovering 512-bit cryptographic keys with virtually zero error rate.

Objective: The research aims to evaluate short- and medium-term outcomes of patients treated using autologous matrix-induced chondrogenesis (AMIC) with a hyaluronic acid scaffold (Hyalofast, Anika Therapeutics, MA, USA) in grade IV chondral lesions according to the Outerbridge classification in the knee., Methods: This is a multicentre, non-randomized, retrospective study conducted between 2017 and 2022. To determine the clinical outcome of the patients, the follow-up was done with the subjective International Knee Documentation Committee (IKDC) score, pre-surgery, and with a follow-up at 12, 24, and 32 months., Results: Fifty patients (28 female) with a mean age of 45.9 ± 12.7 years were recruited. The mean size of the lesion was 3.5 cm 2 , and the injuries located in the patella (30%) and trochlear groove (24%) were the most frequent. The total IKDC clinical score significantly increased from baseline to the 32 months of follow-up with a mean difference of 36.4 (95% CI, 29.1-43.7, p < 0.001). Besides, there was a statistically significant improvement in all categories of the IKDC (symptoms, sports activities, function, and activity of daily living) compared between pre-surgery and 24 and 32 months of follow-up. The patients younger than 45 years presented better clinical outcomes than older ones with a difference between medians of 10.40 (95% CI, 1.10-11.50, p = 0.0247), and a negative correlation was found between the 32-month IKDC score and the age. In addition, no statistically significant difference was found when comparing the last results of the IKDC between patients with and without associated surgical procedures or between patients with single and several lesions, neither nor between men and women. The level of satisfaction with the procedure of all the patients, on a score of 1-10, was on average 8 ± 1.5., Conclusion: Results of this study indicate that patients who underwent the AMIC procedure with hyaluronic acid scaffold for the treatment of grade IV chondral lesions in the knee presented satisfactory results throughout the follow-up., Level of Evidence: Level IV., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Orthodontic appliances promote the accumulation of biofilm in the oral cavity and increase counts of Streptococcus mutans (S. mutans). However, there are few comparative studies of the effects generated by the interaction of saliva and microorganisms in absence and presence of orthodontic appliances., Aim: The aim of this study was to determine the S. mutans colony-forming unit count (CFU/mL) in participants with and without fixed orthodontic appliances., Materials and Method: It was an observational cross-sectional study on 21 participants, all over 18 years of age, non-smokers, without removable oral appliances, who had not been under antibiotic treatment within the previous three months. Sociodemographic variables, oral hygiene habits, S. mutans CFU/mL count, and salivary pH were assessed. Saliva samples were collected, and the data was analyzed using Fisher's exact and Kruskal Wallis tests. A p-value <0.05 was considered statistically significant., Results: Fourteen (66.7%) of the participants were female; average age was 20.4 ± 2.2 years. The group without fixed orthodontic appliances had the highest salivary S. mutans CFU/mL count (Me: 56.0×103, IQR: 9.2×103 - 75.5×103), but there was no statistically significant difference between groups (p=0.7459). There was a statistically significant difference in salivary pH, with the metal orthodontic appliance group having the lowest pH (p=0.0478). No statistically significant difference in salivary S. mutans CFU/mL count was found between groups. Salivary pH was lower in the group with metal appliances than in the groups with non-metal appliances and without appliances., Competing Interests: The authors declare no potential conflicts of interest regarding the research, authorship, and/or publication of this article., (Sociedad Argentina de Investigación Odontológica.)

Training for sustainable development is an educational challenge of prime importance. Physical activity and sports in natural environments provide training committed to sustainability and environmental education. The objective of this study was to assess the effects of an undergraduate training program in Physical Activities and Sports in Natural Environments concerned with sustainable development. A total of 113 students from the Autonomous University of Madrid (Spain) who are studying a Bachelor's Degree in Physical Activity and Sports Sciences and a Master's Degree in Teacher Training for Secondary Education and High School (specializing in Physical Education) were involved. Specifically, we aimed to assess the impact of this training program on three dimensions related to Environmental Education (knowledge, behaviors, and attitudes). Its effect was also examined bearing in mind students' sex, age and educational profile (sportive and educational). Mixed-methods were used: for the quantitative approach, data were collected with the Environmental Attitude in Physical Activities in Natural Environments validated scale; for the qualitative approach individual reflective diaries completed by students that attended the program were analyzed. The results show positive effects on the students regarding the three dimensions of Environmental Education, for both the sportive and educational training profiles. The quantitative results do not present significant differences concerning the gender variable, although the qualitative information shows that female students perceived a greater environmental sensitivity during their practices. Regarding the age variable, significant differences are found in the youngest students with an educational profile. To conclude, the study ratifies that the program carried out generated improvements in terms of knowledge, behaviors and attitudes toward the environment and sustainable development. Future research should use larger samples and consider other variables related to education for sustainability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Santos-Pastor, Ruiz-Montero, Chiva-Bartoll, Baena-Extremera and Martínez-Muñoz.)

Gestational diabetes mellitus (GDM) increases the risk of adverse events in pregnancy and jeopardizes long-term health of the mother and offspring. There is currently no consensus as to what screening strategies improve the efficiency of GDM diagnosis. Which criteria should be used? Is the one-step or two-step procedure better? There is no agreement as to what the best dietary approach in the treatment of GDM is. In addition, different nutritional interventions have been studied in the prevention of GDM. The Mediterranean diet seems to be effective in preventing GDM and other maternofoetal outcomes. We review herein our experience using the one-step criteria for GDM screening; the treatment and prevention strategies used; and the overall impact of nutrition on maternofoetal health., (Copyright © 2019 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Assess if video-based contraceptive education could be an efficient adjunct to contraceptive counseling and attain the same contraceptive knowledge acquisition as conversation-based counseling., Study Design: This was a multicenter randomized, controlled trial examining contraceptive counseling during labor and maternity hospitalization regarding the options of immediate postpartum contraception. At two urban public hospitals, we randomized participants to a structured conversation with a trained counselor or a 14-min video providing the same information. Both groups received written materials and were invited to ask the counselor questions. Our primary outcome was to compare mean time for video-based education and conversational counseling; secondary outcomes included intended postpartum contraceptive method, pre- and postintervention contraceptive knowledge, and perceived competence in choosing a method of contraception., Results: We enrolled 240 participants (conversation group=119, video group=121). The average time to complete either type of counseling was similar [conversational: 16.3 min, standard deviation (SD) ±3.8 min; video: 16.8 min, SD ±4.6 min, p=.32]. Of women intending to use nonpermanent contraception, more participants intended to use a long-acting reversible contraceptive (LARC) method after conversational counseling (72/103, 70% versus 59/105, 56%, p=.041). Following counseling, mean knowledge assessment scores increased by 2 points in both groups (3/7 points to 5/7 correct). All but two participants in the video group agreed they felt equipped to choose a contraceptive method after counseling., Conclusions: Compared to in-person contraceptive counseling alone, video-based intrapartum contraceptive education took a similar amount of time and resulted in similar contraceptive knowledge acquisition, though with fewer patients choosing LARC., Implications: Video-based contraceptive education may be useful in settings with limited personnel to deliver unbiased hospital-based, contraceptive counseling for women during the antepartum period., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Object: Early postoperative head CT scanning is routinely performed following intracranial procedures for detection of complications, but its real value remains uncertain: so-called abnormal results are frequently found, but active, emergency intervention based on these findings may be rare. The authors' objective was to analyze whether early postoperative CT scans led to emergency surgical interventions and if the results of neurological examination predicted this occurrence., Methods: The authors retrospectively analyzed 892 intracranial procedures followed by an early postoperative CT scan performed over a 1-year period at Rush University Medical Center and classified these cases according to postoperative neurological status: baseline, predicted neurological change, unexpected neurological change, and sedated or comatose. The interpretation of CT results was reviewed and unexpected CT findings were classified based on immediate action taken: Type I, additional observation and CT; Type II, active nonsurgical intervention; and Type III, surgical intervention. Results were compared between neurological examination groups with the Fisher exact test., Results: Patients with unexpected neurological changes or in the sedated or comatose group had significantly more unexpected findings on the postoperative CT (p < 0.001; OR 19.2 and 2.3, respectively) and Type II/III interventions (p < 0.001) than patients at baseline. Patients at baseline or with expected neurological changes still had a rate of Type II/III changes in the 2.2%-2.4% range; however, no patient required an immediate return to the operating room., Conclusions: Over a 1-year period in an academic neurosurgery service, no patient who was neurologically intact or who had a predicted neurological change required an immediate return to the operating room based on early postoperative CT findings. Obtaining early CT scans should not be a priority in these patients and may even be cancelled in favor of MRI studies, if the latter have already been planned and can be performed safely and in a timely manner. Early postoperative CT scanning does not assure an uneventful course, nor should it replace accurate and frequent neurological checks, because operative interventions were always decided in conjunction with the neurological examination.

Background: This report focuses on the overall survival and complications associated with treatment of cerebral metastases with surgical resection followed by stereotactic radiosurgery (SRS). Management and complications of corticosteroid therapy are underreported in the literature but represent an important source of morbidity for patients., Methods: Fifty-nine consecutive patients underwent surgical resection of a cerebral metastasis followed by SRS to the cavity. Patient charts were reviewed retrospectively to ascertain overall survival, local control, surgical complications, SRS complications, and corticosteroid complications., Results: Our mean follow-up was 14.4 months (median 12.0 months, range 0.9-62.9 months). Median overall survival in this series was 15.25 months and local control was 98.3%. There was a statistically significant survival benefit conferred by Radiation Therapy Oncology Group recursive partitioning analysis Classes 1 and 2. The surgical complication rate was 6.8% while the SRS complication rate was 2.4%. Corticosteroid complications are reported and dependence at 1 month was 20.3%, at 3 months 6.8%, at 6 months 1.7%, and at 12 months no patients remained on corticosteroid therapy., Conclusions: Overall survival and local control with this treatment paradigm compare well to the other published literature. Complications associated with this patient population are low. A corticosteroid tapering protocol is proposed and demonstrated lower rates of steroid-related complications and dependence than previously reported.

Introduction: Suicide is a major public health problem. It is believed that the media plays an important role in the onset of suicidal behavior. Certain sub-groups of the population (for instance, young people or those suffering from depression) can be especially vulnerable to engage in imitative suicidal behaviors., Objectives: To characterize news reports on suicide published in the printed press in Bogotá. To identify strategies, models or structures used in the print media (newspapers) to report suicide cases. To establish whether the way of reporting suicide cases is appropriate according to the recommendations of the World Health Organization (WHO)., Materials and Methods: A detailed search was performed to find news on suicide or suicide attempts published in three Colombian newspapers -2 of them with national circulation (El Espectador and El Tiempo), and one with local circulation (El Espacio)-, during the period between August 2009 and August 2011. Compliance with WHO recommendations by the 3 newspapers was compared using Fisher tests; the frequency of news release was assessed using statistical control charts, and headlines were evaluated by lexicometric analysis., Results: During the study period, a total of 135 items of news relating to cases occurring in Colombia were found. Although there were differences between the newspapers, none of them fully met the WHO recommendations. There was no clear trend in the way of presenting the news. Three styles were found in the presentation of news (suggestive, sensationalist, and revealing impact on survivors), which could be associated with each of the 3 newspapers evaluated., (Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Leptospirosis is a widely distributed zoonosis, and rats are its most common source of infection. Our goal was to determine the frequency for Leptospira infection in rodents in a farmers market in the city of Medellin. We performed a descriptive transversal study sampling 254 rodents. Rodents were bled and killed, and kidneys samples were taken. Supernatants of macerated kidneys were cultured on Fletcher medium. Microagglutination tests (MATs) with 11 serovars were also carried out in rat serum, and a polymerase chain reaction (PCR) specific for pathogenic species was used to test each bacterial culture. All animals were identified as Rattus norvegicus; 25% and 20% were positive by MAT and culture, respectively. PCR tests of 12 isolates were positive for pathogenic serovars, and 4 of them were confirmed as L. interrogans by sequencing. These data show the role of this natural carrier and shedder of pathogenic leptospires in the epidemiology of urban leptospirosis in Colombia.