End-to-end verifiable voting for developing countries -- what's hard in Lausanne is harder still in Lahore

In recent years end-to-end verifiable voting (E2EVV) has emerged as a promising new paradigm to conduct evidence-based elections. However, E2EVV systems thus far have primarily been designed for the developed world and the fundamental assumptions underlying the design of these systems do not readily translate to the developing world, and may even act as potential barriers to adoption of these systems. This is unfortunate because developing countries account for 80\% of the global population, and given their economic and socio-political dilemmas and their track record of contentious elections, these countries arguably stand to benefit most from this exciting new paradigm. In this paper, we highlight various limitations and challenges in adapting E2EVV systems to these environments, broadly classed across social, political, technical, operational, and human dimensions. We articulate corresponding research questions and identify significant literature gaps in these categories. We also suggest relevant strategies to aid researchers, practitioners, and policymakers in visualizing and exploring solutions that align with the context and unique ground realities in these environments. Our goal is to outline a broader research agenda for the community to successfully adapt E2EVV voting systems to developing countries

End-to-end verifiable voting for developing countries - what’s hard in Lausanne is harder still in Lahore

In recent years end-to-end verifiable voting (E2EVV) has emerged as a promising new paradigm to conduct evidence-based elections. However, E2EVV systems thus far have primarily been designed for the developed world and the fundamental assumptions underlying the design of these systems do not readily translate to the developing world, and may even act as potential barriers to adoption of these systems. This is unfortunate because developing countries account for 80\% of the global population, and given their economic and socio-political dilemmas and their track record of contentious elections, these countries arguably stand to benefit most from this exciting new paradigm. In this paper, we highlight various limitations and challenges in adapting E2EVV systems to these environments, broadly classed across social, political, technical, operational, and human dimensions. We articulate corresponding research questions and identify significant literature gaps in these categories. We also suggest relevant strategies to aid researchers, practitioners, and policymakers in visualizing and exploring solutions that align with the context and unique ground realities in these environments. Our goal is to outline a broader research agenda for the community to successfully adapt E2EVV voting systems to developing countries

Pilot Investigation into the Use of an Anthropomorphic Breast Sonography Phantom as a Training and Assessment Tool

A device for the training and quantitative assessment of the competency of trainee radiologists in the technically challenging area of breast sonography was developed and evaluated. Currently, suitable commercially available devices are lacking, and there is a growing realization that the reliance on direct exposure to patients for learning may not represent best practice from either the trainees\u27 or patients\u27 perspective. Three devices (PI, PII and PIII) were designed to produce very realistic sonographic images of breast morphology with a range of embedded pathologies. The pilot evaluation used a case study research design to evaluate the role of the anthropomorphic breast sonography training device in training and assessment in a clinical environment. Through the case study, it was possible to evaluate the process and relationships when using this type of training intervention for a small group of radiology resident trainees. The investigation involved a baseline assessment of trainees\u27 (n = 4) ability to detect and characterize all lesions in PI, followed by a 4-wk training period on PII and a post-training assessment using PIII. The evaluation revealed an improvement of 30% ± 8% in the trainee\u27s performance from pre- to post-training. It was expected that the performance of the trainees would improve as the training phantom described in this study aligns with the learning theory of constructivism and fits the ideal specifications of a medical training device in terms of its realism and facilitation of self-directed learning and deliberate practice of the trainees. The device provides a useful platform upon which training and assessment can be facilitated

The role of forensic investigation in systemic risk enquiry: Reflections from case studies of disasters in Istanbul, Kathmandu, Nairobi, and Quito

The systemic nature of risk is increasingly acknowledged within scholarship, policy and practice relating to disaster management. However, a number of conceptual and methodological challenges arise in advancing empirical inquiry in this regard. These challenges relate to how the boundaries of the system are determined both spatially and temporally, how expertise from across disciplines is integrated to allow for consideration of institutional and broad socio-economic drivers of risk in addition to physical drivers, and, crucially, how causality operates within system complexity. The potential of forensic investigations of disasters that typically deploy in-depth case studies to overcome these obstacles is evaluated on the basis of causal mapping with experts from a range of disciplinary backgrounds in Istanbul, Kathmandu, Nairobi and Quito. It is found that such investigations can serve to interrogate the fundamental value of any given system and its spatial and temporal bounds, generate collective mental models of the system from which risk emerges, and drive reflection on its root causes. However, it is critical that forensic investigation approaches carefully consider participant selection and facilitation in order to effectively operationalise the systemic risk concept in complementarity with other approaches

Preoperative Exercise to Improve Fitness in Patients Undergoing Complex Surgery for Cancer of the Lung or Oesophagus (PRE-HIIT): Protocol for a Randomized Controlled Trial

Patients with cancer of the lung or oesophagus, undergoing curative treatment, usually require a thoracotomy and a complex oncological resection. These surgeries carry a risk of major morbidity and mortality, and risk assessment, preoperative optimisation, and enhanced recovery after surgery (ERAS) pathways are modern approaches to optimise outcomes. Pre-operative fitness is an established predictor of postoperative outcome, accordingly, targeting pre-operative fitness through exercise prehabilitation has logical appeal. Exercise prehabilitation is challenging to implement however due to the short opportunity for intervention between diagnosis and surgery. Therefore, individually prescribed, intensive exercise training protocols which convey clinically meaningful improvements in cardiopulmonary fitness over a short period need to be investigated. This project will examine the influence of exercise prehabilitation on physiological outcomes and postoperative recovery and, through evaluation of health economics, the impact of the programme on hospital costs

Investigating the Potential and Pitfalls of EV-Encapsulated MicroRNAs as Circulating Biomarkers of Breast Cancer

Extracellular vesicles (EVs) shuttle microRNA (miRNA) throughout the circulation and are believed to represent a fingerprint of the releasing cell. We isolated and characterized serum EVs of breast tumour-bearing animals, breast cancer (BC) patients, and healthy controls. EVs were characterized using transmission electron microscopy (TEM), protein quantification, western blotting, and nanoparticle tracking analysis (NTA). Absolute quantitative (AQ)-PCR was employed to analyse EV-miR-451a expression. Isolated EVs had the appropriate morphology and size. Patient sera contained significantly more EVs than did healthy controls. In tumour-bearing animals, a correlation between serum EV number and tumour burden was observed. There was no significant relationship between EV protein yield and EV quantity determined by NTA, highlighting the requirement for direct quantification. Using AQ-PCR to relate miRNA copy number to EV yield, a significant increase in miRNA-451a copies/EV was detected in BC patient sera, suggesting potential as a novel biomarker of breast cancer

Multidisciplinary team meetings and their impact on workflow in radiology and pathology departments

<p>Abstract</p> <p>Background</p> <p>The development of multidisciplinary team meetings (MDTMs) for radiology and pathology is a burgeoning area that increasingly impacts on work processes in both of these departments. The aim of this study was to examine work processes and quantify the time demands on radiologists and pathologists associated with MDTM practices at a large teaching hospital. The observations reported in this paper reflect a general trend affecting hospitals and our conclusions will have relevance for others implementing clinical practice guidelines.</p> <p>Methods</p> <p>For one month, all work related to clinical meetings between pathology and radiology with clinical staff was documented and later analysed.</p> <p>Results</p> <p>The number of meetings to which pathology and radiology contribute at a large university teaching hospital, ranges from two to eight per day, excluding grand rounds, and amounts to approximately 50 meetings per month for each department. For one month, over 300 h were spent by pathologists and radiologists on 81 meetings, where almost 1000 patients were discussed. For each meeting hour, there were, on average, 2.4 pathology hours and 2 radiology hours spent in preparation. Two to three meetings per week are conducted over a teleconferencing link. Average meeting time is 1 h. Preparation time per meeting ranges from 0.3 to 6 h for pathology, and 0.5 to 4 for radiology. The review process in preparation for meetings improves internal quality standards. Materials produced externally (for example imaging) can amount to almost 50% of the material to be reviewed on a single patient. The number of meetings per month has increased by 50% over the past two years. Further increase is expected in both the numbers and duration of meetings when scheduling issues are resolved. A changing trend in the management of referred patients with the development of MDTMs and the introduction of teleconferencing was noted.</p> <p>Conclusion</p> <p>Difficulties are being experienced by pathology and radiology departments participating fully in several multidisciplinary teams. Time spent at meetings, and in preparation for MDTMs is significant. Issues of timing and the coordination of materials to be reviewed are sometimes irreconcilable. The exchange of patient materials with outside institutions is a cause for concern when full data are not made available in a timely fashion. The process of preparation for meetings is having a positive influence on quality, but more resources are needed in pathology and radiology to realise the full benefits of multidisciplinary team working.</p

Cardiovasc Diabetol

Lower-extremity arterial disease (LEAD) is a major endemic disease with an alarming increased prevalence worldwide. It is a common and severe condition with excess risk of major cardiovascular events and death. It also leads to a high rate of lower-limb adverse events and non-traumatic amputation. The American Diabetes Association recommends a widespread medical history and clinical examination to screen for LEAD. The ankle brachial index (ABI) is the first non-invasive tool recommended to diagnose LEAD although its variable performance in patients with diabetes. The performance of ABI is particularly affected by the presence of peripheral neuropathy, medial arterial calcification, and incompressible arteries. There is no strong evidence today to support an alternative test for LEAD diagnosis in these conditions. The management of LEAD requires a strict control of cardiovascular risk factors including diabetes, hypertension, and dyslipidaemia. The benefit of intensive versus standard glucose control on the risk of LEAD has not been clearly established. Antihypertensive, lipid-lowering, and antiplatelet agents are obviously worthfull to reduce major cardiovascular adverse events, but few randomised controlled trials (RCTs) have evaluated the benefits of these treatments in terms of LEAD and its related adverse events. Smoking cessation, physical activity, supervised walking rehabilitation and healthy diet are also crucial in LEAD management. Several advances have been achieved in endovascular and surgical revascularization procedures, with obvious improvement in LEAD management. The revascularization strategy should take into account several factors including anatomical localizations of lesions, medical history of each patients and operator experience. Further studies, especially RCTs, are needed to evaluate the interest of different therapeutic strategies on the occurrence and progression of LEAD and its related adverse events in patients with diabetes