Parametric, Secure and Compact Implementation of RSA on FPGA

We present a fast, efficient, and parameterized modular multiplier and a secure exponentiation circuit especially intended for FPGAs on the low end of the price range. The design utilizes dedicated block multipliers as the main functional unit and Block-RAM as storage unit for the operands. The adopted design methodology allows adjusting the number of multipliers, the radix used in the multipliers, and number of words to meet the system requirements such as available resources, precision and timing constraints. The architecture, based on the Montgomery modular multiplication algorithm, utilizes a pipelining technique that allows concurrent operation of hardwired multipliers. Our design completes 1020-bit and 2040-bit modular multiplications in 7.62 μs and 27.0 μs, respectively. The multiplier uses a moderate amount of system resources while achieving the best area-time product in literature. 2040-bit modular exponentiation engine can easily fit into Xilinx Spartan-3E 500; moreover the exponentiation circuit withstands known side channel attacks

VoteBox Nano: A smaller, stronger FPGA-based voting machine

This thesis describes a minimal implementation of a cryptographically secure direct recording electronic (DRE) voting system, built with a low-cost Xilinx FPGA board. Our system, called VoteBox Nano, follows the same design principles as the VoteBox, a full-featured electronic voting system. The votes are encrypted using El-gamal homomorphic encryption and the correctness of the system can be challenged by real voters during an ongoing election. In order to fit within the limits of a minimal FPGA, VoteBox Nano eliminates VoteBox's sophisticated network replication mechanism and full-color bitmap graphics system. In return, VoteBox Nano runs without any operating or language runtime system and interacts with the voter using simple character graphics, radically shrinking the implementation complexity. VoteBox Nano also integrates a true random number generator (TRNG), providing improved security. In order to deter hardware tampering, we used FPGA's native JTAG interface coupled with TRNG. At boot-time, the proper FPGA configuration displays a random number on the built-in display. Any interaction with the JTAG interface will change this random number, allowing the poll workers to detect election-day tampering, simply by observing whether the number has changed

Porównanie urazu tkanek podczas brzusznej, pochwowej i laparoskopowej histerektomii

Objective: The aim of the study was to compare the extent of tissue trauma after abdominal hysterectomy(AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) using biochemical markers. Material and methods: Seventy-one patients requiring hysterectomy for benign uterine diseases were enrolled in the study and divided into three treatment groups: AH (n=24), VH (n=23), and TLH (n=24). Blood samples for assay of interleukin-6 (IL-6) and creatine phosphokinase (CPK) were collected pre-, intra-operatively, and 2, 6 and 24 h after surgery. Results: Serum levels of IL-6, and CPK were significantly elevated over basal values after surgery in all groups. IL-6 and CPK levels were significantly higher after AH as compared to VH and TLH. IL-6 concentrations were significantly higher in the VH group than the TLH group (p=0.001). There were no significant differences in CPK levels between the VH and TLH groups (p=0.824). TLH group had the smallest decrease in blood hemoglobin concentration and the shortest hospital stay. Conclusions: AH causes more tissue trauma as compared to VH and TLH. Owing to the fact that TLH is associated with less tissue trauma and offers significant clinical benefits, including less blood loss and shorter hospital stay, it should be considered in women with benign gynecologic conditions, especially in experienced centers.Cel pracy: Celem badania było porównanie rozległości urazu tkanek podczas brzusznej histerektomii (AH), pochwowej (VH) i laparoskopowej (TLH) przy pomocy biochemicznych markerów. Materiał i metoda: Do badania włączono siedemdziesiąt jeden pacjentek wymagających usunięcia macicy z powodu niezłośliwej patologii, które podzielono na trzy grupy badane: AH (n=24), VH (n=23), i TLH (n=24). Próbki krwi do badania w kierunku interleukiny 6 i kinazy fosfokreatynowej (CPK) pobierano przed-, podczas operacji, I 2,6 oraz 24 godziny po zabiegu. Wyniki: Poziom Il-6 i CPK w surowicy po operacji był istotnie podwyższony w porównaniu do poziomu wyjściowego we wszystkich grupach badanych. Poziom IL-6 i CPK były istotnie wyższe po AH niż po VH i TLH. Stężenie IL-6 było istotnie wyższe w grupie VH niż w grupie TLH (p=0.001). Nie stwierdzono istotnych różnic w poziomie CPK pomiędzy grupą VH i TLH (p=0.824). W grupie TLH odnotowano najmniejszy spadek hemoglobin I najkrótszy pobyt w szpitalu. Wnioski: AH powoduje większy uraz tkanek niż VH i TLH. Dzięki temu, że TLH jest związane z mniejszym urazem tkanek i daje istotne klinicznie korzyści, między innymi mniejszą utratę krwi i krótszy pobyt w szpitalu, powinno być rozważane u kobiet z niezłośliwą patologią, zwłaszcza w doświadczonych ośrodkach

The determinants of electronic payment systems usage from consumers’ perspective

Electronic Payment Systems (EPS) have been improving individuals’ quality of life through providing ease of payment for online transactions. The effects of trust and security on the use of EPS have long been recognised in e-commerce literature. However, very few studies have examined these two concepts from the viewpoint of users. This study has developed a conceptual model to examine the determinants of perceived security and trust as well as the impact of perceived security and trust on the use of EPS. A sample of 299 respondents was analysed through structural equation modelling (SEM); the findings indicate that both perceived security and trust have a significant influence on EPS use. Technical protection and past experience have been found to be the common determinants of perceived security and trust. Managerial implications of the findings are discussed in light of the study’s limitations and suggestions for further research indicated

Biosimilar filgrastim vs filgrastim: a multicenter nationwide observational bioequivalence study in patients with chemotherapy-induced neutropenia

Background: We studied the comparative effectiveness of biosimilar filgrastim vs original filgrastim in patients with chemotherapy-induced neutropenia.Patients and methods: This multicenter, observational study was conducted at 14 centers. The study included 337 patients experiencing neutropenia under chemotherapy. Patients were given either filgrastim 30 MIU or 48 MIU (Neupogen (R)) or biosimilar filgrastim 30 MIU (Leucostim (R)). Data regarding age, chemotherapeutic agents used, number of chemotherapy courses, previous diagnosis of neutropenia, neutrophil count of patients after treatment, medications used for the treatment of neutropenia, and duration of neutropenia were collected. Time to absolute neutrophil count (ANC) recovery was the primary efficacy measure.Results: Ambulatory and hospitalized patients comprised 11.3% and 45.1% of the enrolled patients, respectively, and a previous diagnosis of neutropenia was reported in 49.3% of the patients, as well. Neutropenia occurred in 13.7% (n=41), 45.5% (n=136), 27.4% (n=82), 11.4% (n=34), and 2.0% (n=6) of the patients during the first, second, third, fourth, and fifth cycles of chemotherapy, respectively. While the mean neutrophil count was 0.53 +/- 0.48 before treatment, a significant increase to 2.44 +/- 0.66 was observed after treatment (p=0.0001). While 90.3% of patients had a neutrophil count,1.49 before treatment, all patients had a neutrophil count >= 1.50 after treatment. Neutropenia resolved within <= 4 days of filgrastim therapy in 60.1%, 56.7%, and 52.6% of the patients receiving biosimilar filgrastim 30 MIU, original filgrastim 30 MIU, and original filgrastim 48 MIU, respectively. However, there was no significant difference between the three arms (p=0.468). Similarly, time to ANC recovery was comparable between the treatment arms (p=0.332).Conclusion: The results indicate that original filgrastim and biosimilar filgrastim have comparable efficacy in treating neutropenia. Biosimilar filgrastim provides a valuable alternative; however, there is need for further studies comparing the two products in different patient subpopulations

GENERAL CHARACTERISTICS AND TREATMENT OPTIONS OF THE PATIENTS WITH GASTROINTESTINAL STROMAL TUMOR

Background: Gastrointestinal stromal tumors (GIST) are rare mesenchimal tumors may develop in any site in the gastrointestinal system. KIT gene mutations are detected in 95% of cases. In this study, we aimed to assess treatment options and general characteristics of patients with GIST. Methods: GIST patients admitted to Abdurrahman Yurtaslan Oncology Education and Training hospital’s oncology clinic between February 2009 and May 2012 are observed retrospectively. Demographic characteristics of the patients and the treatment they received were recorded from hospital’s database. Results: Eighteen patients included to study havinng Mean age of 57.8 years (32-78).  Five (28%) of the patients were female and thirteen (72%) were male. Diagnosis were made in 16 patients by pathological assessment of surgical material. Trucut biopsy and gastroscopic biopsy used for diagnosis in remaining two patients. Localizations of the tumor were as follows: small intestine in 9 patients, colon in 5 patients, stomach in 4 patients. All of the patients were KIT positive. Tumor was defined at high risk in 62%, at moderate risk in 17% and at low risk in 21% of the cases. Imatinib was administered in 5 patients with metastatic disease. Mean follow up period for the patients was 48 months. Relapse or progression developed in 4 of all patients in follow up period. Only one of the five patients with metastaic disease developed progression. Other 3 cases were relapsed. Conclusion: Surgical resection of tumor without fragmentatin is the main treatment of localized GIST cases. Imatinib, a tyrosine kinase inhibitor, is used in metastatic/ inoperable tumors and in cases at high risk for metastasis, recently. In conclusion, after surgical resection of the tumor, we suggest Imatinib treatment in patients considered at high risk

Fanconi anemia manifesting as a squamous cell carcinoma of the hard palate: a case report

Fanconi Anemia is a rare autosomal recessive disorder characterized by various congenital malformations, progressive bone marrow failure at a very young age and of solid tumors development. The authors present a rare case of a squamous cell carcinoma of the hard palate in a Fanconi Anaemia patient. The atypical clinical manifestation rendered the diagnosis more difficult. This case, for age of appearance, sex and localization, is unique in international literature. We recommend a quarterly follow up of the oral-rhino-pharynx complex in FA patients and to consider as carcinomas, all oral lesions that last more than two weeks

Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate objective is to improve palliative care for Turkish and Moroccan immigrants in the Netherlands, by taking account of socio-cultural factors in the guidelines for palliative care.</p> <p>Methods</p> <p>A systematic literature review was undertaken. The data sources were seventeen national and international literature databases, four Dutch journals dedicated to palliative care and 37 websites of relevant national and international organizations. All the references found were checked to see whether they met the structured inclusion criteria. Inclusion was limited to publications dealing with primary empirical research on the relationship between socio-cultural factors and the health or care situation of Turkish or Moroccan patients with an oncological or incurable disease. The selection was made by first reading the titles and abstracts and subsequently the full texts. The process of deciding which studies to include was carried out by two reviewers independently. A generic appraisal instrument was applied to assess the methodological quality.</p> <p>Results</p> <p>Fifty-seven studies were found that reported findings for the countries of origin (mainly Turkey) and the immigrant host countries (mainly the Netherlands). The central themes were experiences and perceptions of family care, professional care, end-of-life care and communication. Family care is considered a duty, even when such care becomes a severe burden for the main female family caregiver in particular. Professional hospital care is preferred by many of the patients and relatives because they are looking for a cure and security. End-of-life care is strongly influenced by the continuing hope for recovery. Relatives are often quite influential in end-of-life decisions, such as the decision to withdraw or withhold treatments. The diagnosis, prognosis and end-of-life decisions are seldom discussed with the patient, and communication about pain and mental problems is often limited. Language barriers and the dominance of the family may exacerbate communication problems.</p> <p>Conclusions</p> <p>This review confirms the view that family members of patients with a Turkish or Moroccan background have a central role in care, communication and decision making at the end of life. This, in combination with their continuing hope for the patient’s recovery may inhibit open communication between patients, relatives and professionals as partners in palliative care. This implies that organizations and professionals involved in palliative care should take patients’ socio-cultural characteristics into account and incorporate cultural sensitivity into care standards and care practices<it>.</it></p

Prospective Observational Study of Pazopanib in Patients with Advanced Renal Cell Carcinoma (PRINCIPAL Study)

Background: Real-world data are essential to accurately assessing efficacy and toxicity of approved agents in everyday practice. PRINCIPAL, a prospective, observational study, was designed to confirm the real-world safety and efficacy of pazopanib in patients with advanced renal cell carcinoma (RCC). Subjects, Materials, and Methods: Patients with clear cell advanced/metastatic RCC and a clinical decision to initiate pazopanib treatment within 30 days of enrollment were eligible. Primary objectives included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), relative dose intensity (RDI) and its effect on treatment outcomes, change in health-related quality of life (HRQoL), and safety. We also compared characteristics and outcomes of clinical-trial-eligible (CTE) patients, defined using COMPARZ trial eligibility criteria, with those of non-clinical-trial-eligible (NCTE) patients. Secondary study objectives were to evaluate clinical efficacy, safety, and RDI in patient subgroups. Results: Six hundred fifty-seven patients were enrolled and received ≥1 dose of pazopanib. Median PFS and OS were 10.3 months (95% confidence interval [CI], 9.2–12.0) and 29.9 months (95% CI, 24.7 to not reached), respectively, and the ORR was 30.3%. HRQoL showed no or little deterioration over time. Treatment-related serious adverse events (AEs) and AEs of special interest occurred in 64 (9.7%), and 399 (60.7%) patients, respectively. More patients were classified NCTE than CTE (85.2% vs. 14.8%). Efficacy of pazopanib was similar between the two groups. Conclusion: PRINCIPAL confirms the efficacy and safety of pazopanib in patients with advanced/metastatic RCC in a real-world clinical setting. Implications for Practice: PRINCIPAL is the largest (n = 657) prospective, observational study of pazopanib in patients with advanced/metastatic renal cell carcinoma, to the authors’ knowledge. Consistent with clinical trial results that often contain specific patient types, the PRINCIPAL study demonstrated that the effectiveness and safety of pazopanib is similarly safe and effective in patients with advanced kidney cancer in a real-world clinical setting. The PRINCIPAL study showed that patients with advanced kidney cancer who are treated with first-line pazopanib generally do not show disease progression for approximately 10 months and generally survive for nearly 30 months