UTM-Chain: Blockchain-Based Secure Unmanned Traffic Management for Internet of Drones

Unmanned aerial systems (UAVs) are dramatically evolving and promoting several civil applications. However, they are still prone to many security issues that threaten public safety. Security becomes even more challenging when they are connected to the Internet as their data stream is exposed to attacks. Unmanned traffic management (UTM) represents one of the most important topics for small unmanned aerial systems for beyond-line-of-sight operations in controlled low-altitude airspace. However, without securing the flight path exchanges between drones and ground stations or control centers, serious security threats may lead to disastrous situations. For example, a predefined flight path could be easily altered to make the drone perform illegal operations. Motivated by these facts, this paper discusses the security issues for UTM's components and addresses the security requirements for such systems. Moreover, we propose UTM-Chain, a lightweight blockchain-based security solution using hyperledger fabric for UTM of low-altitude UAVs which fits the computational and storage resources limitations of UAVs. Moreover, UTM-Chain provides secure and unalterable traffic data between the UAVs and their ground control stations. The performance of the proposed system related to transaction latency and resource utilization is analyzed by using cAdvisor. Finally, the analysis of security aspects demonstrates that the proposed UTM-Chain scheme is feasible and extensible for the secure sharing of UAV data

Recommendations for economic evaluations of cell and gene therapies: a systematic literature review with critical appraisal

Objective: No consensus exists on the ideal methodology to evaluate the economic impact and value of new, potentially curative gene therapies. We aimed to identify and describe published methodologic recommendations for the economic evaluation of gene therapies and assess whether these recommendations have been applied in published evaluations. Methods: This study was conducted in three stages: a systematic literature review of methodologic recommendations for economic evaluation of gene therapies; an assessment of the appropriateness of recommendations; and a review to assess the degree to which the recommendations were applied in published evaluations. Results: A total of 2,888 references were screened, 83 articles were reviewed to assess eligibility, and 20 papers were included. Fifty recommendations were identified, and 21 reached consensus thresholds. Most evaluations were based on naive treatment comparisons and did not apply consensus recommendations. Innovative payment mechanisms for gene therapies were rarely considered. The only widely applied recommendations related to modeling choices and methods. Conclusions: Methodological recommendations for economic evaluations of gene therapies are generally not being followed. Assessing the applicability and impact of the recommendations from this study may facilitate the implementation of consensus recommendations in future evaluations

Health economic evaluation of gene replacement therapies:Methodological issues and recommendations

Objective: To provide recommendations for addressing previously identified key challenges in health economic evaluations of Gene Replacement Therapies (GRTs), including: 1) the assessment of clinical effectiveness; 2) the valuation of health outcomes; 3) the time horizon and extrapolation of effects beyond trial duration; 4) the estimation of costs; 5) the selection of appropriate discount rates; 6) the incorporation of broader elements of value; and 7) affordability. Methods: A literature review on economic evaluations of GRT was performed. Interviews were conducted with 8 European and US health economic experts with experience in evaluations of GRT. Targeted literature reviews were conducted to investigate further potential solutions to specific challenges. Recommendations: Experts agreed on factors to be considered to ensure the acceptability of historical cohorts by HTA bodies. Existing prospective registries or, if not available, retrospective registries, may be used to analyse different disease trajectories and inform extrapolations. The importance of expert opinion due to limited data was acknowledged. Expert opinion should be obtained using structured elicitation techniques. Broader elements of value, beyond health gains directly related to treatment, can be considered through the application of a factor to inflate the quality-adjusted life years (QALYs) or a higher cost-effectiveness threshold. Additionally, the use of cost-benefit analysis and saved young life equivalents (SAVE) were proposed as alternatives to QALYs for the valuations of outcomes of GRT as they can incorporate broader elements of value and avoid problems of eliciting utilities for paediatric diseases. Conclusions: While some of the limitations of economic evaluations of GRT are inherent to limited clinical data and lack of experience with these treatments, others may be addressed by methodological research to be conducted by health economists

Résection laparoscopique d’une duplication gastrique chez l’adulte: traitement avec succès pour une pathologie rare

Les duplications de l'appareil digestif sont les malformations congénitales rares qui peuvent toucher tout  l'appareil digestive depuis la bouche jusqu' à l'anus. Certaines duplications sont asymptomatiques et sont diagnostiqués dans la plupart des cas pendant l'enfance. La prise en charge de la duplication gastrique est essentiellement chirurgicale. Le traitement de choix est l'exérèse complète de la duplication gastrique. Les auteurs rapportent un cas inhabituel de duplication gastrique complètement reséquée par laparoscopie. A notre connaissance, ceci est le premier cas d'une duplication gastrique traitée avec succès par laparoscopie dans la littérature Tunisienne. La Résection laparoscopique peut être ajoutée à l'arsenal thérapeutique dans le traitement chirurgical de duplications du tube digestif.Key words: Duplication, estomac, diagnostic, endoscopi

Variation in market access decisions for cell and gene therapies across the United States, Canada, and Europe

Transformative cell and gene therapies have now launched worldwide, and many potentially curative cell and gene therapies are in development, offering the prospect of significant health gains for patients. Access to these therapies depend on decisions made by health technology assessment (HTA) and payer organizations. We sought to describe the emerging cell and gene therapies market access landscape by analyzing 17 US commercial payer medical policies, and HTA reports from five European countries and Canada. We found that some US health plans applied coverage restrictions more often than others (four plans applied restrictions in all decisions, while four plans applied restrictions in < 30% of decisions). The European and Canadian HTA bodies recommend access to fewer therapies than US health plans, reflecting a more stringent approach in the context of limited evidence and high scientific uncertainty that is commonly associated with these treatments. Our findings suggest that patient access to approved cell and gene therapies is restricted in all regions studied, though the nature of these restrictions differs between US health plans and the European/Canada HTA recommendations. Payers, HTA groups, pharmaceutical companies, and other stakeholders should collaborate to more clearly define the “uncertainties” and develop market access policies that balance benefits of early access with ongoing data collection to close evidence gaps over time

ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.Peer reviewe

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Decentralized Identity Systems: Architecture, Challenges, Solutions and Future Directions

International audienceDue to the exponential rise of the Internet in the last two decades, the digital presence has seen an enormous increase. Today, billions of people, devices and objects are digitally connected making the interactions much easier than before. To securely establish this connectivity in the digital era, proving digital identities has become crucial. Due to this, a growing number of organizations are building solutions that establish, verify and manage digital identities. Yet, a solution whereby digital identities and their associated data are efficiently managed is still far from being achieved. To fully understand the reason behind this lack, this paper provides a detailed state of the art related to identity management systems. It overviews traditional systems, analyses their strengths and limitations. This work highly focuses on the novel decentralized identity systems based on blockchain; a complete study describing their architecture, components, lifecycle and workflow is detailed. Additionally, solutions enabling decentralized identity are discussed, analysed and compared according to the ten principles of self-sovereign identity. Lastly, the challenges hindering the shift toward the fully decentralized identity paradigm are discussed

Decentralized identity systems: Architecture, challenges, solutions and future directions

Received: 18th September 2020; Accepted: 10th December 2020; Published: 20th December 2020 Abstract: Due to the exponential rise of the Internet in the last two decades, the digital presence has seen an enormous increase. Today, billions of people, devices and objects are digitally connected making the interactions much easier than before. To securely establish this connectivity in the digital era, proving digital identities has become crucial. Due to this, a growing number of organizations are building solutions that establish, verify and manage digital identities. Yet, a solution whereby digital identities and their associated data are efficiently managed is still far from being achieved. To fully understand the reason behind this lack, this paper provides a detailed state of the art related to identity management systems. It overviews traditional systems, analyses their strengths and limitations. This work highly focuses on the novel decentralized identity systems based on blockchain; a complete study describing their architecture, components, lifecycle and workflow is detailed. Additionally, solutions enabling decentralized identity are discussed, analysed and compared according to the ten principles of self-sovereign identity. Lastly, the challenges hindering the shift toward the fully decentralized identity paradigm are discussed