3,602 research outputs found
Deep Random based Key Exchange protocol resisting unlimited MITM
We present a protocol enabling two legitimate partners sharing an initial
secret to mutually authenticate and to exchange an encryption session key. The
opponent is an active Man In The Middle (MITM) with unlimited computation and
storage capacities. The resistance to unlimited MITM is obtained through the
combined use of Deep Random secrecy, formerly introduced and proved as
unconditionally secure against passive opponent for key exchange, and universal
hashing techniques. We prove the resistance to MITM interception attacks, and
show that (i) upon successful completion, the protocol leaks no residual
information about the current value of the shared secret to the opponent, and
(ii) that any unsuccessful completion is detectable by the legitimate partners.
We also discuss implementation techniques.Comment: 14 pages. V2: Updated reminder in the formalism of Deep Random
assumption. arXiv admin note: text overlap with arXiv:1611.01683,
arXiv:1507.0825
Seventy years of sex education in Health Education Journal: a critical review
This paper examines key debates and perspectives on sex education in Health Education Journal (HEJ), from the date of the journal’s first publication in March 1943 to the present day. Matters relating to sexuality and sexual health are revealed to be integral to HEJ’s history. First published as Health and Empire (1921 – 1942), a key purpose of the journal since its inception has been to share information on venereal disease and its prevention within the UK and across the former British Empire. From 1943 to the present day, discussions on sex education in the newly-christened HEJ both reflect and respond to evolving socio-cultural attitudes towards sexuality in the UK. Changing definitions of sex education across the decades are examined, from the prevention of venereal disease and moral decline in war-time Britain in the 1940s, to a range of responses to sexual liberation in the 1960s and 1970s; from a focus on preventing sexually-transmitted infections, teenage pregnancy and HIV in the 1980s, to the provision of sexual health services alongside sex education in the 2000s. Over the past 70 years, a shift from prevention of pre-marital sexual activity to the management of its outcomes is apparent; however, while these changes over time are notable, perhaps the most striking findings of this review are the continuities in arguments for and against the discussion of sexual issues. After more than 70 years of debate, it would seem that there is little consensus concerning motivations for and the content of sex education
Omega-3 polyunsaturated fatty acids status and cognitive function in young women
© 2019 The Author(s). Background: Research indicates that low omega-3 polyunsaturated fatty acid (n-3 PUFA) may be associated with decreased cognitive function. This study examined the association between n-3 PUFA status and cognitive function in young Australian women. Methods: This was a secondary outcome analysis of a cross-sectional study that recruited 300 healthy women (18-35 y) of normal weight (NW: BMI 18.5-24.9 kg/m2) or obese weight (OB: BMI ≥30.0 kg/m2). Participants completed a computer-based cognition testing battery (IntegNeuro™) evaluating the domains of impulsivity, attention, information processing, memory and executive function. The Omega-3 Index (O3I) was used to determine n-3 PUFA status (percentage of EPA (20:5n-3) plus DHA (22:6n3) in the red cell membrane) and the participants were divided into O3I tertile groups: T1 6.75%. Potential confounding factors of BMI, inflammatory status (C-reactive Protein), physical activity (total MET-min/wk), alpha1-acid glycoprotein, serum ferritin and hemoglobin, were assessed. Data reported as z-scores (mean ± SD), analyses via ANOVA and ANCOVA. Results: Two hundred ninety-nine women (26.9 ± 5.4 y) completed the study (O3I data, n = 288). The ANOVA showed no overall group differences but a significant group × cognition domain interaction (p < 0.01). Post hoc tests showed that participants in the low O3I tertile group scored significantly lower on attention than the middle group (p = 0.01; ES = 0.45 [0.15-0.74]), while the difference with the high group was borderline significant (p = 0.052; ES = 0.38 [0.09-0.68]). After confounder adjustments, the low group had lower attention scores than both the middle (p = 0.01) and high (p = 0.048) groups. These findings were supported by univariate analyses which found significant group differences for the attention domain only (p = 0.004). Conclusions: Cognitive function in the attention domain was lower in women with lower O3I, but still within normal range. This reduced but normal level of cognition potentially provides a lower baseline from which cognition would decline with age. Further investigation of individuals with low n-3 PUFA status is warranted
Stress in childhood, adolescence and early adulthood, and cortisol levels in older age
The glucocorticoid hypothesis suggests that overexposure to stress may cause permanent upregulation of cortisol. Stress in youth may therefore influence cortisol levels even in older age. Using data from the 6-Day Sample, we investigated the effects of high stress in childhood, adolescence and early adulthood ¬� as well as individual variables contributing to these measures; parental loss, social deprivation, school and home moves, illness, divorce and job instability � upon cortisol levels at age 77 years. Waking, waking+45min (peak) and evening salivary cortisol samples were collected from 159 participants, and the 150 who were not using steroid medications were included in this study. After correcting for multiple comparisons, the only significant association was between early-adulthood job instability and later-life peak cortisol levels. After excluding participants with dementia or possible mild cognitive impairment, early-adulthood high stress showed significant associations with lower evening and mean cortisol levels, suggesting downregulation by stress, but these results did not survive correction for multiple comparisons. Overall, our results do not provide strong evidence of a relationship between stress in youth and later-life cortisol levels, but do suggest that some more long-term stressors, such as job instability, may indeed produce lasting upregulation of cortisol, persisting into the mid-to-late seventies
Can Axillary Lymph Node Dissection Be Safely Omitted for Early-Stage Breast Cancer Patients with Sentinel Lymph Node Micrometastasis?
Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: a systematic review of the literature
Background: The majority of lower limb amputations are undertaken in people with peripheral arterial occlusive disease,\ud
and approximately 50% have diabetes. Quality of life is an important outcome in lower limb amputations; little is known\ud
about what influences it, and therefore how to improve it.\ud
Objectives: The aim of this systematic review was to identify the factors that influence quality of life after lower limb\ud
amputation for peripheral arterial occlusive disease.\ud
Methods: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science and Cochrane databases were searched to identify\ud
articles that quantitatively measured quality of life in those with a lower limb amputation for peripheral arterial occlusive\ud
disease. Articles were quality assessed by two assessors, evidence tables summarised each article and a narrative\ud
synthesis was performed.\ud
Study design: Systematic review.\ud
Results: Twelve articles were included. Study designs and outcome measures used varied. Quality assessment scores\ud
ranged from 36% to 92%. The ability to walk successfully with a prosthesis had the greatest positive impact on quality\ud
of life. A trans-femoral amputation was negatively associated with quality of life due to increased difficulty in walking\ud
with a prosthesis. Other factors such as older age, being male, longer time since amputation, level of social support and\ud
presence of diabetes also negatively affected quality of life.\ud
Conclusion: Being able to walk with a prosthesis is of primary importance to improve quality of life for people with lower\ud
limb amputation due to peripheral arterial occlusive disease. To further understand and improve the quality of life of this\ud
population, there is a need for more prospective longitudinal studies, with a standardised outcome measure
Fluctuations, Saturation, and Diffractive Excitation in High Energy Collisions
Diffractive excitation is usually described by the Good--Walker formalism for
low masses, and by the triple-Regge formalism for high masses. In the
Good--Walker formalism the cross section is determined by the fluctuations in
the interaction. In this paper we show that by taking the fluctuations in the
BFKL ladder into account, it is possible to describe both low and high mass
excitation by the Good--Walker mechanism. In high energy collisions the
fluctuations are strongly suppressed by saturation, which implies that pomeron
exchange does not factorise between DIS and collisions. The Dipole Cascade
Model reproduces the expected triple-Regge form for the bare pomeron, and the
triple-pomeron coupling is estimated.Comment: 20 pages, 12 figure
Issues potentially affecting quality of life arising from long-term medicines use: a qualitative study
Background Polypharmacy is increasing and managing large number of medicines may create a burden for patients. Many patients have negative views of medicines and their use can adversely affect quality of life. No studies have specifically explored the impact of general long-term medicines use on quality of life. Objective To determine the issues which patients taking long-term medicines consider affect their day-to-day lives, including quality of life. Setting Four primary care general practices in North West England Methods Face-to-face interviews with adults living at home, prescribed four or more regular medicines for at least 1 year. Interviewees were identified from primary care medical records and purposively selected to ensure different types of medicines use. Interviews were recorded, transcribed and analysed thematically. Results Twenty-one interviews were conducted and analysed. Patients used an average of 7.8 medicines, 51 % were preventive, 40 % for symptom relief and 9 % treatment. Eight themes emerged: relationships with health professionals, practicalities, information, efficacy, side effects, attitudes, impact and control. Ability to discuss medicines with health professionals varied and many views were coloured by negative experiences, mainly with doctors. All interviewees had developed routines for using multiple medicines, some requiring considerable effort. Few felt able to exert control over medicines routines specified by health professionals. Over half sought additional information about medicines whereas others avoided this, trusting in doctors to guide their medicines use. Patients recognised their inability to assess efficacy for many medicines, notably those used for prophylaxis. All were concerned about possible side effects and some had poor experiences of discussing concerns with doctors. Medicines led to restrictions on social activities and personal life to the extent that, for some, life can revolve around medicines. Conclusion There is a multiplicity and complexity of issues surrounding medicines use, which impact on day-to-day lives for patients with long-term conditions. While most patients adapt to long-term medicines use, others did so at some cost to their quality of life
Outcomes of prolonged mechanic ventilation: a discrimination model based on longitudinal health insurance and death certificate data
Development and preliminary evaluation of EMPOWER for surrogate decision-makers of critically ill patients
OBJECTIVE: The objectives of this study were to develop and refine EMPOWER (Enhancing and Mobilizing the POtential for Wellness and Resilience), a brief manualized cognitive-behavioral, acceptance-based intervention for surrogate decision-makers of critically ill patients and to evaluate its preliminary feasibility, acceptability, and promise in improving surrogates' mental health and patient outcomes. METHOD: Part 1 involved obtaining qualitative stakeholder feedback from 5 bereaved surrogates and 10 critical care and mental health clinicians. Stakeholders were provided with the manual and prompted for feedback on its content, format, and language. Feedback was organized and incorporated into the manual, which was then re-circulated until consensus. In Part 2, surrogates of critically ill patients admitted to an intensive care unit (ICU) reporting moderate anxiety or close attachment were enrolled in an open trial of EMPOWER. Surrogates completed six, 15-20 min modules, totaling 1.5-2 h. Surrogates were administered measures of peritraumatic distress, experiential avoidance, prolonged grief, distress tolerance, anxiety, and depression at pre-intervention, post-intervention, and at 1-month and 3-month follow-up assessments. RESULTS: Part 1 resulted in changes to the EMPOWER manual, including reducing jargon, improving navigability, making EMPOWER applicable for a range of illness scenarios, rearranging the modules, and adding further instructions and psychoeducation. Part 2 findings suggested that EMPOWER is feasible, with 100% of participants completing all modules. The acceptability of EMPOWER appeared strong, with high ratings of effectiveness and helpfulness (M = 8/10). Results showed immediate post-intervention improvements in anxiety (d = -0.41), peritraumatic distress (d = -0.24), and experiential avoidance (d = -0.23). At the 3-month follow-up assessments, surrogates exhibited improvements in prolonged grief symptoms (d = -0.94), depression (d = -0.23), anxiety (d = -0.29), and experiential avoidance (d = -0.30). SIGNIFICANCE OF RESULTS: Preliminary data suggest that EMPOWER is feasible, acceptable, and associated with notable improvements in psychological symptoms among surrogates. Future research should examine EMPOWER with a larger sample in a randomized controlled trial
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