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1. PUFchain 3.0: Hardware-Assisted Distributed Ledger for Robust Authentication in Healthcare Cyber–Physical Systems

   https://doi.org/10.3390/s24030938  

   Bathalapalli, Venkata K.; Mohanty, Saraju P.; Kougianos, Elias; Iyer, Vasanth; Rout, Bibhudutta (February 2024, Sensors)

   This article presents a novel hardware-assisted distributed ledger-based solution for simultaneous device and data security in smart healthcare. This article presents a novel architecture that integrates PUF, blockchain, and Tangle for Security-by-Design (SbD) of healthcare cyber–physical systems (H-CPSs). Healthcare systems around the world have undergone massive technological transformation and have seen growing adoption with the advancement of Internet-of-Medical Things (IoMT). The technological transformation of healthcare systems to telemedicine, e-health, connected health, and remote health is being made possible with the sophisticated integration of IoMT with machine learning, big data, artificial intelligence (AI), and other technologies. As healthcare systems are becoming more accessible and advanced, security and privacy have become pivotal for the smooth integration and functioning of various systems in H-CPSs. In this work, we present a novel approach that integrates PUF with IOTA Tangle and blockchain and works by storing the PUF keys of a patient’s Body Area Network (BAN) inside blockchain to access, store, and share globally. Each patient has a network of smart wearables and a gateway to obtain the physiological sensor data securely. To facilitate communication among various stakeholders in healthcare systems, IOTA Tangle’s Masked Authentication Messaging (MAM) communication protocol has been used, which securely enables patients to communicate, share, and store data on Tangle. The MAM channel works in the restricted mode in the proposed architecture, which can be accessed using the patient’s gateway PUF key. Furthermore, the successful verification of PUF enables patients to securely send and share physiological sensor data from various wearable and implantable medical devices embedded with PUF. Finally, healthcare system entities like physicians, hospital admin networks, and remote monitoring systems can securely establish communication with patients using MAM and retrieve the patient’s BAN PUF keys from the blockchain securely. Our experimental analysis shows that the proposed approach successfully integrates three security primitives, PUF, blockchain, and Tangle, providing decentralized access control and security in H-CPS with minimal energy requirements, data storage, and response time. 

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2. Self-Sovereign Identity in Semi-Permissioned Blockchain Networks Leveraging Ethereum and Hyperledger Fabric

   https://doi.org/10.1109/ICDH60066.2023.00053  

   Sahi, Niranjan; Liang, Anda; Van Devanter, Wyn; Oikonomou, Konstantinos; Zhang, Peng (July 2023, Digital Health (ICDH), IEEE International Conference on)

   Patients often have their healthcare data stored in centralized systems, leading to challenges when reconciling or consolidating their data across providers due to centralized databases that store patient identities. The challenges disrupt the flow of patient care where time is sensitive for both patients and providers. Decentralized technologies have enabled a new identity model–Self-Sovereign Identity (SSI)–that grants individuals the right to freely control, access, and share their own data. This work proposes a system that achieves SSI in a semi-permissioned blockchain network using an open protocol as the certificate of authority and several guidelines for securely handling transactions in the network. Open protocols like Keccak can grant access to a permission-based network such as Hyperledger Fabric. The network architecture ensures data security and privacy through mechanisms of multi-signature transactions and guidelines for storing transactions locally, making this architecture ideal for privacy-centered use cases, such as healthcare data-sharing applications. The ultimate goal is to give patients full control over their identity and other data derived from their identity within a semi-permissioned network. 

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3. Permissioned Blockchains: Properties, Techniques and Applications

   https://doi.org/10.1145/3448016.3457539  

   Amiri, Mohammad Javad; Agrawal, Divyakant; El Abbadi, Amr (June 2021, SIGMOD'2021)

   The unique features of blockchains such as immutability, transparency, provenance, and authenticity have been used by many large-scale data management systems to deploy a wide range of distributed applications including supply chain management, healthcare, and crowdworking in permissioned settings. Unlike permissionless settings, e.g., Bitcoin, where the network is public, and anyone can participate without a specific identity, a permissioned blockchain system consists of a set of known, identified nodes that might not fully trust each other. While the characteristics of permissioned blockchains are appealing to a wide range of largescale data management systems, these systems, have to satisfy four main requirements: confidentiality, verifiability, performance, and scalability. Various approaches have been developed in industry and academia to satisfy these requirements with varying assumptions and costs. The focus of this tutorial is on presenting many of these techniques while highlighting the trade-offs among them. We demonstrate the practicality of such techniques in real-life by presenting three different applications, i.e., supply chain management, large-scale databases, and multi-platform crowdworking environments, and show how those techniques can be utilized to meet the requirements of such applications 

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4. Blockchains and Databases: Opportunities and Challenges for the Permissioned and the Permissionless

   https://doi.org/10.1007/978-3-030-54832-2_1  

   Agrawal, D.; El Abbadi, A.; Amiri, M.J.; Maiyya, S.; Zakhary, V. (August 2020, Advances in Databases and Information Systems)

   Darmont, J; Novikov, B.; Wrembel, R. (Ed.)

   Bitcoin [12] is a successful and interesting example of a global scale peer-to-peer cryptocurrency that integrates many techniques and protocols from cryptography, distributed systems, and databases. The main underlying data structure is blockchain, a scalable fully replicated structure that is shared among all participants and guarantees a consistent view of all user transactions by all participants in the system. In a blockchain, nodes agree on their shared states across a large network of untrusted participants. Although originally devised for cryptocurrencies, recent systems exploit its many unique features such as transparency, provenance, fault tolerance, and authenticity to support a wide range of distributed applications. Bitcoin and other cryptocurrencies use permissionless blockchains. In a permissionless blockchain, the network is public, and anyone can participate without a specific identity. Many other distributed applications, such as supply chain management and healthcare, are deployed on permissioned blockchains consisting of a set of known, identified nodes that still might not fully trust each other. This paper illustrates some of the main challenges and opportunities from a database perspective in the many novel and interesting application domains of blockchains. These opportunities are illustrated using various examples from recent research in both permissionless and permissioned blockchains. Two main themes unite the various examples: (1) the important role of distribution and consensus in managing large scale systems and (2) the need to tolerate malicious failures. The advent of cloud computing and large data centers shifted large scale data management infrastructures from centralized databases to distributed systems. One of the main challenges in designing distributed systems is the need for fault-tolerance. Cloud-based systems typically assume trusted infrastructures, since data centers are owned by the enterprises managing the data, and hence the design typically only assumes and tolerates crash failures. The advent of blockchain and the underlying premise that copies of the blockchain are distributed among untrusted entities has shifted the focus of fault-tolerance from tolerating crash failures to tolerating malicious failures. These interesting and challenging settings pose great opportunities for database researchers. 

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5. An Approach Towards the Security Management for Sensitive Medical Data in the IoMT Ecosystem

   https://doi.org/10.1145/3565287.3623388  

   Chatterjee, Pushpita; Das, Debashis; Banerjee, Sourav; Ghosh, Uttam; Mpembele, Armando B; Rogers, Tamara (October 2023, ACM)

   The Internet of Medical Things (IoMT) is a network of interconnected medical devices, wearables, and sensors integrated into healthcare systems. It enables real-time data collection and transmission using smart medical devices with trackers and sensors. IoMT offers various benefits to healthcare, including remote patient monitoring, improved precision, and personalized medicine, enhanced healthcare efficiency, cost savings, and advancements in telemedicine. However, with the increasing adoption of IoMT, securing sensitive medical data becomes crucial due to potential risks such as data privacy breaches, compromised health information integrity, and cybersecurity threats to patient information. It is necessary to consider existing security mechanisms and protocols and identify vulnerabilities. The main objectives of this paper aim to identify specific threats, analyze the effectiveness of security measures, and provide a solution to protect sensitive medical data. In this paper, we propose an innovative approach to enhance security management for sensitive medical data using blockchain technology and smart contracts within the IoMT ecosystem. The proposed system aims to provide a decentralized and tamper-resistant plat- form that ensures data integrity, confidentiality, and controlled access. By integrating blockchain into the IoMT infrastructure, healthcare organizations can significantly enhance the security and privacy of sensitive medical data. 

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