Undetectable Selfish Mining

Seminal work of Eyal and Sirer (2014) establishes that a strategic Bitcoin miner may strictly profit by deviating from the intended Bitcoin protocol, using a strategy now termed *selfish mining*. More specifically, any miner with $>1/3$ of the total hashrate can earn bitcoin at a faster rate by selfish mining than by following the intended protocol (depending on network conditions, a lower fraction of hashrate may also suffice). One convincing critique of selfish mining in practice is that the presence of a selfish miner is *statistically detectable*: the pattern of orphaned blocks created by the presence of a selfish miner cannot be explained by natural network delays. Therefore, if an attacker chooses to selfish mine, users can detect this, and this may (significantly) negatively impact the value of BTC. So while the attacker may get slightly more bitcoin by selfish mining, these bitcoin may be worth significantly less USD. We develop a selfish mining variant that is provably *statistically undetectable*: the pattern of orphaned blocks is statistically identical to a world with only honest miners but higher network delay. Specifically, we consider a stylized model where honest miners with network delay produce orphaned blocks at each height independently with probability $\beta'$. We propose a selfish mining strategy that instead produces orphaned blocks at each height independently with probability $\beta > \beta'$. We further show that our strategy is strictly profitable for attackers with $38.2\% \ll 50\%$ of the total hashrate (and this holds for all natural orphan rates $\beta'$).Comment: 44 page

When Bidders Are DAOs

In a typical decentralized autonomous organization (DAO), people organize themselves into a group that is programmatically managed. DAOs can act as bidders in auctions, with a DAO's bid treated by the auctioneer as if it had been submitted by an individual, without regard to the internal structure of the DAO. We study auctions in which the bidders are DAOs. More precisely, we consider the design of two-level auctions in which the "participants" are groups of bidders rather than individuals. Bidders form DAOs to pool resources, but must then also negotiate the terms by which the DAO's winnings are shared. We model the outcome of a DAO's negotiations by an aggregation function (which aggregates DAO members' bids into a single group bid), and a budget-balanced cost-sharing mechanism (that determines DAO members' access to the DAO's allocation and distributes the total payment demanded from the DAO to its members). We pursue two-level mechanisms that are incentive-compatible (with truthful bidding a dominant strategy for members of each DAO) and approximately welfare-optimal. We prove that, even in the case of a single-item auction, incentive-compatible welfare maximization is not possible: No matter what the outer mechanism and the cost-sharing mechanisms used by DAOs, the welfare of the resulting two-level mechanism can be a $\approx \ln n$ factor less than optimal. We complement this lower bound with a natural two-level mechanism that achieves a matching approximate welfare guarantee. Our upper bound also extends to multi-item auctions where individuals have additive valuations. Finally, we show that our positive results cannot be extended much further: Even in multi-item settings with unit-demand bidders, truthful two-level mechanisms form a highly restricted class and as a consequence cannot guarantee any non-trivial approximation of the maximum social welfare

Transaction Fee Mechanism Design with Active Block Producers

The incentive-compatibility properties of blockchain transaction fee mechanisms have been investigated with *passive* block producers that are motivated purely by the net rewards earned at the consensus layer. This paper introduces a model of *active* block producers that have their own private valuations for blocks (representing, for example, additional value derived from the application layer). The block producer surplus in our model can be interpreted as one of the more common colloquial meanings of the term ``MEV.'' The main results of this paper show that transaction fee mechanism design is fundamentally more difficult with active block producers than with passive ones: with active block producers, no non-trivial or approximately welfare-maximizing transaction fee mechanism can be incentive-compatible for both users and block producers. These results can be interpreted as a mathematical justification for the current interest in augmenting transaction fee mechanisms with additional components such as order flow auctions, block producer competition, trusted hardware, or cryptographic techniques

Asynchronous Majority Dynamics in Preferential Attachment Trees

We study information aggregation in networks where agents make binary decisions (labeled incorrect or correct). Agents initially form independent private beliefs about the better decision, which is correct with probability $1/2+\delta$. The dynamics we consider are asynchronous (each round, a single agent updates their announced decision) and non-Bayesian (agents simply copy the majority announcements among their neighbors, tie-breaking in favor of their private signal). Our main result proves that when the network is a tree formed according to the preferential attachment model \cite{BarabasiA99}, with high probability, the process stabilizes in a correct majority within $O(n \log n/ \log\log n)$ rounds. We extend our results to other tree structures, including balanced $M$-ary trees for any $M$.Comment: ICALP 202

Transaction Fee Mechanism Design in a Post-MEV World

The incentive-compatibility properties of blockchain transaction fee mechanisms have been investigated with passive block producers that are motivated purely by the net rewards earned at the consensus layer. This paper introduces a model of active block producers that have their own private valuations for blocks (representing, for example, additional value derived from the application layer). The block producer surplus in our model can be interpreted as one of the more common colloquial meanings of the phrase ``maximal extractable value (MEV).\u27\u27 We first prove that transaction fee mechanism design is fundamentally more difficult with active block producers than with passive ones: With active block producers, no non-trivial or approximately welfare maximizing transaction fee mechanism can be incentive-compatible for both users and block producers. These impossibility results can be interpreted as a mathematical justification for augmenting transaction fee mechanisms with additional components such as orderflow auctions, block producer competition, trusted hardware, or cryptographic techniques. We then proceed to a more fine-grained model of block production that is inspired by current practice, in which we distinguish the roles of ``searchers\u27\u27 (who actively identify opportunities for value extraction from the application layer and compete for the right to take advantage of them) and ``proposers\u27\u27 (who participate directly in the blockchain protocol and make the final choice of the published block). Searchers can effectively act as an ``MEV oracle\u27\u27 for a transaction fee mechanism, thereby enlarging the design space. Here, we first consider a transaction fee mechanism that resembles how searchers have traditionally been incorporated into the block production process, with each transaction effectively sold off to a searcher through a first-price auction. We then explore the design space with searchers more generally, and design a mechanism that circumvents our impossibility results for mechanisms without searchers. Our mechanism (the ``SAKA\u27\u27 mechanism) is deterministic, incentive-compatible (for users, searchers, and the block producer), and sybil-proof, and it guarantees roughly 50% of the maximum-possible welfare when transaction sizes are small relative to block sizes. We conclude with a matching negative result: even when transactions are small relative to blocks, no incentive-compatible, sybil proof, and deterministic transaction fee mechanism can guarantee more than 50% of the maximum-possible welfare

Brief Announcement: Phase Transitions of the k-Majority Dynamics in a Biased Communication Model

We analyze the binary-state (either ? or ?) k-majority dynamics in a biased communication model where nodes have some fixed probability p, independent of the dynamics, of being seen in state ? by their neighbors. In this setting we study how p, as well as the initial unbalance between the two states, impact on the speed of convergence of the process, identifying sharp phase transitions

Determination of the incidence of cardiovascular composite events in Patients with Obstructive Sleep Apnea: A 3-year follow-up

Background: The occurrence of obstructive sleep apnea (OSA) and its health-related issues, especially cardiovascular diseases (CVD), are increasing in developing countries. With a 3-year follow-up study, the present study aimed to determine the incidence of cardiovascular events in patients with OSA in an Iranian population.Methods: In this prospective cohort study, 415 adults (300 patients with OSA and 115 patients without OSA) with a history of snoring and/or witnessed apneas or other suspected sleep breathing disorders were consecutively enrolled and followed up for three successive years to evaluate the development of cardiovascular events including acute coronary syndrome, cerebrovascular accidents (including ischemic or hemorrhagic strokes or transient ischemic attacks), death due to cardiac causes and all-cause mortality. Results: 415 patients were studied with a mean age of 56.2 ±15.7 years, 211 (50.8) of whom were male. Cardiovascular events developed in 15 participants (5%) of the OSA group, and 3 participants (2.6 %) of the OSA negative group. No significant differences were observed between the two groups in terms of the incidence of any of these events (P-value> 0.05). Using multiple logistic regression model (with P-value <0.2 as the significance level), age, OSA, and history of CVD remained as significant predictors for the development of cardiac composite events (incidence of CVD, CVA, death due to cardiac causes, and all-cause mortality) with the odds ratios of (95% confidence interval) 1.03 (1.01, 1.06), 2.41 (1.02, 5.76), and 7.40 (2.91, 18.67), respectively.Conclusions: The present study showed that OSA is associated with a more than twofold increased risk of cardiovascular events. Thus, obstructive sleep apnea should be considered an independent cardiovascular risk factor

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication