DEFCON: high-performance event processing with information security

In finance and healthcare, event processing systems handle sensitive data on behalf of many clients. Guaranteeing information security in such systems is challenging because of their strict performance requirements in terms of high event throughput and low processing latency. We describe DEFCON, an event processing system that enforces constraints on event flows between event processing units. DEFCON uses a combination of static and runtime techniques for achieving light-weight isolation of event flows, while supporting efficient sharing of events. Our experimental evaluation in a financial data processing scenario shows that DEFCON can provide information security with significantly lower processing latency compared to a traditional approach

Risk factors for human brucellosis in northern Tanzania

Little is known about the epidemiology of human brucellosis in sub-Saharan Africa. This hampers prevention and control efforts at the individual and population levels. To evaluate risk factors for brucellosis in northern Tanzania, we conducted a study of patients presenting with fever to two hospitals in Moshi, Tanzania. Serum taken at enrollment and at 4–6 week follow-up was tested by Brucella microagglutination test. Among participants with a clinically compatible illness, confirmed brucellosis cases were defined as having a ≥ 4-fold rise in agglutination titer between paired sera or a blood culture positive for Brucella spp., and probable brucellosis cases were defined as having a single reciprocal titer ≥ 160. Controls had reciprocal titers < 20 in paired sera. We collected demographic and clinical information and administered a risk factor questionnaire. Of 562 participants in the analysis, 50 (8.9%) had confirmed or probable brucellosis. Multivariable analysis showed that risk factors for brucellosis included assisting goat or sheep births (Odds ratio [OR] 5.9, 95% confidence interval [CI] 1.4, 24.6) and having contact with cattle (OR 1.2, 95% CI 1.0, 1.4). Consuming boiled or pasteurized dairy products was protective against brucellosis (OR 0.12, 95% CI 0.02, 0.93). No participants received a clinical diagnosis of brucellosis from their healthcare providers. The under-recognition of brucellosis by healthcare workers could be addressed with clinician education and better access to brucellosis diagnostic tests. Interventions focused on protecting livestock keepers, especially those who assist goat or sheep births, are needed

Risk factors for human acute leptospirosis in northern Tanzania

Introduction: Leptospirosis is a major cause of febrile illness in Africa but little is known about risk factors for human infection. We conducted a cross-sectional study to investigate risk factors for acute leptospirosis and Leptospira seropositivity among patients with fever attending referral hospitals in northern Tanzania. Methods: We enrolled patients with fever from two referral hospitals in Moshi, Tanzania, 2012–2014, and performed Leptospira microscopic agglutination testing on acute and convalescent serum. Cases of acute leptospirosis were participants with a four-fold rise in antibody titers, or a single reciprocal titer ≥800. Seropositive participants required a single titer ≥100, and controls had titers <100 in both acute and convalescent samples. We administered a questionnaire to assess risk behaviors over the preceding 30 days. We created cumulative scales of exposure to livestock urine, rodents, and surface water, and calculated odds ratios (OR) for individual behaviors and for cumulative exposure variables. Results: We identified 24 acute cases, 252 seropositive participants, and 592 controls. Rice farming (OR 14.6), cleaning cattle waste (OR 4.3), feeding cattle (OR 3.9), farm work (OR 3.3), and an increasing cattle urine exposure score (OR 1.2 per point) were associated with acute leptospirosis. Conclusions: In our population, exposure to cattle and rice farming were risk factors for acute leptospirosis. Although further data is needed, these results suggest that cattle may be an important source of human leptospirosis. Further investigation is needed to explore the potential for control of livestock Leptospira infection to reduce human disease

Acceptability and Impact of an Educational App (iCare) for Informal Carers Looking After People at Risk of Pressure Ulceration: Mixed Methods Pilot Study

BACKGROUND: Pressure ulcers are areas of skin damage resulting from sustained pressure. Informal carers play a central role in preventing pressure ulcers among older and disabled people living at home. Studies highlight the paucity of pressure ulcer training for informal carers and suggest that pressure ulcer risk is linked to high levels of carer burden. OBJECTIVE: This pilot study evaluated a smartphone app with a specific focus on pressure ulcer prevention education for informal carers. The app was developed based on the principles of microlearning. The study aimed to explore carer perspectives on the acceptability of the app and determine whether the app increased knowledge and confidence in their caring role. METHODS: In this concurrent mixed methods study, participants completed quantitative questionnaires at baseline and at the end of weeks 2 and 6, which examined caregiving self-efficacy, preparedness for caregiving, caregiver strain, pressure ulcer knowledge, and app acceptability and usability. A subsample of participants participated in a "think aloud" interview in week 1 and semistructured interviews at the end of weeks 2 and 6. RESULTS: Of the 32 participants, 23 (72%) participants completed the week 2 and 16 (50%) completed the week 6 questionnaires; 66% (21/32) of carers participated in qualitative "think aloud" interviews, and 18 (56%) also participated in semistructured interviews at week 2, and 13 (41%) at week 6. Pressure ulcer knowledge scores significantly changed (F1,6.112=21.624; P=.001) from baseline (mean 37.5; SE 2.926) to the second follow-up (mean 59.72, SE 3.985). Regarding the qualitative data, the theme "I'm more careful now and would react to signs of redness" captured participants' reflections on the new knowledge they had acquired, the changes they had made to their caring routines, their increased vigilance for signs of skin damage, and their intentions toward the app going forward. There were no significant results pertaining to improved preparedness for caregiving or caregiving self-efficacy or related to the Caregiver Strain Index. Participants reported above average usability scores on a scale of 0 to 100 (mean 69.94, SD 18.108). The app functionality and information quality were also rated relatively high on a scale of 0 to 5 (mean 3.84, SD 0.704 and mean 4.13, SD 0.452, respectively). Overall, 2 themes pertaining to acceptability and usability were identified: "When you're not used to these things, they take time to get the hang of" and "It's not a fun app but it is informative." All participants (n=32, 100%) liked the microlearning approach. CONCLUSIONS: The iCare app offers a promising way to improve informal carers' pressure ulcer knowledge. However, to better support carers, the findings may reflect the need for future iterations of the app to use more interactive elements and the introduction of gamification and customization based on user preferences

Protocol of a natural experiment to evaluate a supermarket intervention to improve food purchasing and dietary behaviours of women (WRAPPED study) in England: a prospective matched controlled cluster design

Introduction: Poor diet is a leading risk factor for non-communicable diseases and costs the National Health Service £5.8 billion annually. Product placement strategies used extensively in food outlets, like supermarkets, can influence customers’ preferences. Policy-makers, including the UK Government, are considering legislation to ensure placement strategies promote healthier food purchasing and dietary habits. High-quality scientific evidence is needed to inform future policy action. This study will assess whether healthier placement strategies in supermarkets improve household purchasing patterns and the diets of more than one household member. Methods and analyses: This natural experiment, with a prospective matched controlled cluster design, is set in discount supermarkets across England. The primary objective is to investigate whether enhanced placement of fresh fruit and vegetables improves household-level purchasing of these products after 6 months. Secondary objectives will examine: (1) differences in intervention effects on purchasing by level of educational attainment, (2) intervention effects on the dietary quality of women and their young children, (3) intervention effects on store-level sales of fruit and vegetables and (4) cost-effectiveness of the intervention from individual, retailer and societal perspectives. Up to 810 intervention and 810 control participants will be recruited from 18 intervention and 18 matched control stores. Eligible participants will be women aged 18–45 years, who hold a loyalty card and shop in a study store. Each control store will be matched to an intervention store on: (1) sales profile, (2) neighbourhood deprivation and (3) customer profile. A detailed process evaluation will assess intervention implementation, mechanisms of impact and, social and environmental contexts. Ethics and dissemination: Ethical approval was obtained from the University of Southampton, Faculty of Medicine Ethics Committee (ID 20986.A5). Primary, secondary and process evaluation results will be submitted for publication in peer-reviewed scientific journals and shared with policy-makers. Trial registration number: NCT03573973; Pre-results

Acceptability and impact of an educational app (iCare) for informal carers looking after people at risk of pressure ulceration: A mixed methods pilot study (Preprint)

Background: Pressure ulcers are areas of skin damage resulting from sustained pressure. Informal carers play a central role preventing pressure ulcers amongst older and disabled people living at home. Research highlights the paucity of pressure ulcer training for informal carers and suggests pressure ulcer risk is linked to high levels of carer burden. Objective: This pilot study evaluated a smartphone app with a specific focus on pressure ulcer prevention education for informal carers. The app was shaped by the principles of micro-learning. The study aimed to explore carer perspectives on the acceptability of the app and determine whether the app increased carers’ knowledge and confidence in their caring role. Methods: In this concurrent mixed methods study, participants completed quantitative questionnaires at baseline, and at the end of weeks 2 and 6, which examined caregiving self-efficacy, preparedness for caregiving, caregiver strain, and pressure ulcer knowledge, as well as app acceptability and usability. A sub-sample of participants took part in a ‘think aloud’ interview in week 1 as well as semi-structured interviews at the end of weeks 2 and 6. Results: In total, 23 (71.9%) participants completed the questionnaire at the end of week 2 and 16 (50%) at the end of week 6. For the qualitative component, 21 carers participated in ‘think aloud’ interviews, 18 went on to participate in semi-structured interviews at the end of week 2, and 13 at the end of week 6. Pressure ulcer knowledge scores significantly changed (F(1, 6.112)=21.624, p<0.001) from baseline(mean=37.5, se=2.926) to the second follow-up (mean=59.72, se=3.985). In relation to the qualitative data, the theme ‘I’m more careful now and would react to signs of redness’ captured participants’ reflections on the new knowledge they had acquired, the changes they had made to their caring routines, their increased vigilance for signs of skin damage, and their intentions towards the app going forwards. There were no significant results pertaining to improved preparedness for caregiving or caregiving self-efficacy or related to the caregiver strain index. Participants reported relatively high usability scores on a 0-100 scale (mean=69.94, SD=18.108). The app functionality and information quality were also rated relatively highly on a 0-5 scale (mean=3.84, SD=0.704; mean=4.13, SD=0.452). Two themes pertaining to acceptability and usability were identified, ‘When you’re not used to these things, they take time to get the hang of’, and ‘It’s not a fun app but it is informative’. All participants liked the micro-learning approach. Conclusions: The iCare app offers a promising way to convey information and improve informal carers’ pressure ulcer knowledge. However, to better support cares, the findings may reflect the need for future iterations of the app to employ more interactive elements, and the introduction of gamification and customisation to user preferences. Clinical Trial: Not applicabl

Octupole transitions in the 208Pb region

The 208Pb region is characterised by the existence of collective octupole states. Here we populated such states in 208Pb + 208Pb deep-inelastic reactions. γ-ray angular distribution measurements were used to infer the octupole character of several E3 transitions. The octupole character of the 2318 keV 17− → 14+ in 208Pb, 2485 keV 19/2 − → 13/2 + in 207Pb, 2419 keV 15/2 − → 9/2 + in 209Pb and 2465 keV 17/2 + → 11/2 − in 207Tl transitions was demonstrated for the first time. In addition, shell model calculations were performed using two different sets of two-body matrix elements. Their predictions were compared with emphasis on collective octupole states.This work is supported by the Science and Technology Facilities Council (STFC), UK, US Department of Energy, Office of Nuclear Physics, under Contract No. DEAC02-06CH11357 and DE-FG02-94ER40834, NSF grant PHY-1404442

Programmable active memories in real-time tasks: implementing data-driven triggers for LHC experiments

The future Large Hadron Collider (LHC), to be built at CERN, presents among other technological challenges a formidable problem of real-time data analysis. At a primary event rate of 40 MHz, a multi-stage trigger system has to analyze data to decide which is the fraction of events that should be preserved on permanent storage for further analysis. We report on implementations of local algorithms for feature extraction as part of triggering, using the detectors of the proposed ATLAS experiment as a model. The algorithms were implemented for a decision frequency of 100 kHz, on different data-driven programmable devices based on structures of field- programmable gate arrays and memories. The implementations were demonstrated at full speed with emulated input, and were also integrated into a prototype detector running in a test beam at CERN, in June 1994