Towards access control for visual Web model management

2004-2005 > Academic research: refereed > Refereed conference paperVersion of RecordPublishe

Incentive and Trust Issues in Assured Information Sharing

Abstract. Assured information sharing among different organizations in a coalitional environment is an important first step in accomplishing many critical tasks. For example, different security agencies may need to share intelligence information for detecting terrorist plots. At the same, each organization participating in the assured information sharing process may have different incentives. In this paper, we explore the effects of different incentives and potential trust issues among organizations on the assured information sharing process by developing an evolutionary game theoretic framework. In addition, we provide extensive simulation analysis that illustrates the impact of various different information sharing strategies

Case Report Ignition of Free Gas in the Peritoneal Cavity: An Explosive Complication

We report an extremely rare event where the use of diathermy to enter the peritoneal cavity caused the free gas within it to ignite and consequently burn the surgeon during a standard right hemicolectomy procedure for a caecal perforation. is should be noted as a possible safety concern intraoperatively. We conclude that sharp dissection should always be used initially when entering the peritoneal cavity where free gas is present, cautery can subsequently be used once the free air has escaped

Optimized immunosuppression to prevent graft failure in renal transplant recipients with HLA antibodies (OuTSMART): a randomised controlled trial

Background: 3% of kidney transplant recipients return to dialysis annually upon allograft failure. Development of antibodies (Ab) against human leukocyte antigens (HLA) is a validated prognostic biomarker of allograft failure. We tested whether screening for HLA Ab, combined with an intervention to improve adherence and optimization of immunosuppression could prevent allograft failure. Methods: Prospective, open-labelled randomised biomarker-based strategy (hybrid) trial in 13 UK transplant centres [EudraCT (2012-004308-36) and ISRCTN (46157828)]. Patients were randomly allocated (1:1) to unblinded or double-blinded arms and screened every 8 months. Unblinded HLA Ab+ patients were interviewed to encourage medication adherence and had tailored optimisation of Tacrolimus, Mycophenolate mofetil and Prednisolone. The primary outcome was time to graft failure in an intention to treat analysis. The trial had 80% power to detect a hazard ratio of 0.49 in donor specific antibody (DSA)+ patients. Findings: From 11/9/13 to 27/10/16, 5519 were screened for eligibility and 2037 randomised (1028 to unblinded care and 1009 to double blinded care). We identified 198 with DSA and 818 with non-DSA. Development of DSA, but not non-DSA was predictive of graft failure. HRs for graft failure in unblinded DSA+ and non-DSA+ groups were 1.54 (95% CI: 0.72 to 3.30) and 0.97 (0.54–1.74) respectively, providing no evidence of an intervention effect. Non-inferiority for the overall unblinded versus blinded comparison was not demonstrated as the upper confidence limit of the HR for graft failure exceeded 1.4 (1.02, 95% CI: 0.72 to 1.44). The only secondary endpoint reduced in the unblinded arm was biopsy-proven rejection. Interpretation: Intervention to improve adherence and optimize immunosuppression does not delay failure of renal transplants after development of DSA. Whilst DSA predicts increased risk of allograft failure, novel interventions are needed before screening can be used to direct therapy