90 research outputs found
Invasive adenocarcinoma with bronchoalveolar features: A population-based evaluation of the extent of resection in bronchoalveolar cell carcinoma
Non-Malleable Secret Sharing
A number of works have focused on the setting where an adversary tampers with the shares of a secret sharing scheme. This includes literature on verifiable secret sharing, algebraic manipulation detection(AMD) codes, and, error correcting or detecting codes in general. In this work, we initiate a systematic study of what we call non-malleable secret sharing. Very roughly, the guarantee we seek is the following: the adversary may potentially tamper with all of the shares, and still, either the reconstruction procedure outputs the original secret, or, the original secret is \u27\u27destroyed\u27\u27 and the reconstruction outputs a string which is completely \u27\u27unrelated\u27\u27 to the original secret. Recent exciting work on non-malleable codes in the split-state model led to constructions which can be seen as 2-out-of-2 non-malleable secret sharing schemes. These constructions have already found a number of applications in cryptography. We investigate the natural question of constructing t-out-of-n non-malleable secret sharing schemes. Such a secret sharing scheme ensures that only a set consisting of t or more shares can reconstruct the secret, and, additionally guarantees non-malleability under an attack where potentially every share maybe tampered with. Techniques used for obtaining split-state non-malleable codes (or 2-out-of-2 non-malleable secret sharing) are (in some form) based on two-source extractors and seem not to generalize to our setting.
Our first result is the construction of a t-out-of-n non-malleable secret sharing scheme against an adversary who arbitrarily tampers each of the shares independently. Our construction is unconditional and features statistical non-malleability.
As our main technical result, we present t-out-of-n non-malleable secret sharing scheme in a stronger adversarial model where an adversary may jointly tamper multiple shares. Our construction is unconditional and the adversary is allowed to jointly-tamper subsets of up to (t-1) shares. We believe that the techniques introduced in our construction may be of independent interest.
Inspired by the well studied problem of perfectly secure message transmission introduced in the seminal work of Dolev et. al (J. of ACM\u2793), we also initiate the study of non-malleable message transmission. Non-malleable message transmission can be seen as a natural generalization in which the goal is to ensure that the receiver either receives the original message, or, the original message is essentially destroyed and the receiver receives an \u27\u27unrelated\u27\u27 message, when the network is under the influence of an adversary who can byzantinely corrupt all the nodes in the network. As natural applications of our non-malleable secret sharing schemes, we propose constructions for non-malleable message transmission
How Far Must You See To Hear Reliably
We consider the problem of probabilistic reliable communication (PRC) over synchronous networks modeled as directed graphs in the presence of a Byzantine adversary when players\u27 knowledge of the network topology is not complete. We show that possibility of PRC is extremely sensitive to the changes in players\u27
knowledge of the topology. This is in complete contrast with earlier known results on the possibility of perfectly reliable communication over undirected graphs where the case of each player knowing only its neighbours gives the same result as the case where players have complete knowledge of the network. Specifically, in either case, -vertex connectivity is necessary and sufficient, where is the number of nodes that can be corrupted by the adversary \cite{DDWY93:PSMT,SKR05}. We introduce a novel model for quantifying players\u27 knowledge of network topology, denoted by {}. Given a directed graph , influenced by a Byzantine adversary that can corrupt up to any players, we give a necessary and sufficient condition for possibility of PRC over for any arbitrary topology knowledge {}. It follows from our main characterization theorem that knowledge of up to levels is sufficient for the solvability of honest player to honest player communication over any network over which PRC is possible when each player has complete knowledge of the topology. We also show the existence of networks where PRC is possible when players have complete topology knowledge but it is not possible when the players do not have knowledge of up to levels
Credibility of claims of subgroup effects in randomised controlled trials : systematic review
General Perfectly Secure Message Transmission Using Linear Codes
We study perfectly secure message transmission (PSMT) from a sender S to a receiver R in the general adversary model. In this model, instead of being bounded by a threshold, the Byzantine adversary in a network is characterized by an adversary structure. By regarding monotone general access structures as linear codes, we introduce some new properties that allow us to design efficient PSMT protocols. We give a number of efficient PSMT protocols in both undirected and directed network graphs. These protocols comprehensively improve the transmission complexity of some previous results in this area. More significantly, as all of our protocols are executed in either 3 or 2 rounds, our result is the first, in the context of PSMT in the general adversary model, to have constant round complexity when using interaction
Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3) : a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery
Altres ajuts: Canadian Institutes of Health Research (CIHR, FDN-143302); General Research Fund (14104419), Research Grant Council, Hong Kong SAR, China; National Health and Medical Research Council, Funding Schemes (NHMRC Project Grant 1162362), Australia; McMaster University Department of Medicine Career Research Award and a Physicians' Services Incorporated (PSI) Foundation Mid-Career Clinical Research Award.Background: For patients undergoing noncardiac surgery, bleeding and hypotension are frequent and associated with increased mortality and cardiovascular complications. Tranexamic acid (TXA) is an antifibrinolytic agent with the potential to reduce surgical bleeding; however, there is uncertainty about its efficacy and safety in noncardiac surgery. Although usual perioperative care is commonly consistent with a hypertension-avoidance strategy (i.e., most patients continue their antihypertensive medications throughout the perioperative period and intraoperative mean arterial pressures of 60 mmHg are commonly accepted), a hypotension-avoidance strategy may improve perioperative outcomes. Methods: The PeriOperative Ischemic Evaluation (POISE)-3 Trial is a large international randomized controlled trial designed to determine if TXA is superior to placebo for the composite outcome of life-threatening, major, and critical organ bleeding, and non-inferior to placebo for the occurrence of major arterial and venous thrombotic events, at 30 days after randomization. Using a partial factorial design, POISE-3 will additionally determine the effect of a hypotension-avoidance strategy versus a hypertension-avoidance strategy on the risk of major cardiovascular events, at 30 days after randomization. The target sample size is 10,000 participants. Patients ≥45 years of age undergoing noncardiac surgery, with or at risk of cardiovascular and bleeding complications, are randomized to receive a TXA 1 g intravenous bolus or matching placebo at the start and at the end of surgery. Patients, health care providers, data collectors, outcome adjudicators, and investigators are blinded to the treatment allocation. Patients on ≥ 1 chronic antihypertensive medication are also randomized to either of the two blood pressure management strategies, which differ in the management of patient antihypertensive medications on the morning of surgery and on the first 2 days after surgery, and in the target mean arterial pressure during surgery. Outcome adjudicators are blinded to the blood pressure treatment allocation. Patients are followed up at 30 days and 1 year after randomization. Discussion: Bleeding and hypotension in noncardiac surgery are common and have a substantial impact on patient prognosis. The POISE-3 trial will evaluate two interventions to determine their impact on bleeding, cardiovascular complications, and mortality. Trial registration: ClinicalTrials.gov NCT03505723. Registered on 23 April 2018
Asynchronous Byzantine Agreement with Subquadratic Communication
Understanding the communication complexity of Byzantine agreement (BA) is a fundamental problem in distributed computing. In particular, as protocols are run with a large number of parties (as, e.g., in the context of blockchain protocols), it is important to understand the dependence of the communication on the number of parties . Although adaptively secure BA protocols with communication are known in the synchronous and partially synchronous settings, no such protocols are known in the fully asynchronous case.
We show here an asynchronous BA protocol with subquadratic communication tolerating an adaptive adversary who can corrupt ).
One variant of our protocol assumes initial setup done by a trusted dealer, after which an unbounded number of BA executions can be run; alternately, we can achieve subquadratic amortized communication with no prior setup. We also show that some form of setup is needed for (non-amortized) subquadratic BA tolerating corrupted parties.
As a contribution of independent interest, we show a secure-computation protocol in the same threat model that has communication when computing no-input functionalities with short output (e.g., coin tossing)
Subgroup Analysis of Trials Is Rarely Easy (SATIRE): a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials
<p>Abstract</p> <p>Background</p> <p>Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1) to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2) to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3) to examine the analysis, and interpretation of subgroup effects for each study's primary outcome.</p> <p>Methods</p> <p>We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the <it>New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine</it>, and <it>BMJ </it>as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes.</p> <p>Discussion</p> <p>A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize the conduct and reporting of subgroup analyses, and claim and interpretation of subgroup effects in randomized trials.</p
Postoperative outcomes in oesophagectomy with trainee involvement
BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery
Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
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