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PurposeTo evaluate two chest tomosynthesis (CTS) scoring systems for cystic fibrosis (CF), one system developed by Vult von Steyern et al. (VvS) and one system based on the Brody scoring system for high-resolution computed tomography (HRCT) (modified Brody (mB)). Brody scoring of HRCT was used as reference.MethodsIn conjunction with routine control HRCT at clinical follow-up, 10 consecutive adult CF patients underwent CTS for research purposes. Four radiologists scored the CTS examinations using the mB and VvS scoring systems. All scores were compared to the Brody HRCT scores. The agreement between the evaluated CTS scoring systems and the reference HRCT scoring system was determined using Spearman’s rank correlation coefficient and the intraclass correlation coefficient (ICC).Major findingsSpearman’s rank correlation coefficient showed strong correlations between HRCT score and both the mB and the VvS CTS total scores (median rs = 0.81 and 0.85, respectively). The ICC showed strong correlation between the CTS scoring systems and the reference: 0.88 for mB and 0.85 for VvS scoring. The median time for scoring was 20 and 10 minutes for the mB and VvS scoring systems, respectively.ConclusionsBoth evaluated CTS scoring systems correlate well with the reference standard Brody HRCT scoring. The VvS CTS scoring system has a shorter reading time, suggesting its advantage in clinical practice.

Background The study aimed to determine the prevalence and risk factors of allergic rhinitis and related comorbidities in school-age children in Budapest, capital of Hungary. Data and epidemiological studies on this disease are still limited. Methods A cross sectional study was conducted in 21 representative and randomly selected primary schools in 2019. International Study of Asthma and Allergies in Childhood-based questionnaires (n = 6869) inquiring about prevalence and related risk factors of allergic rhinitis were distributed to all parents. The data were characterised with standard descriptive statistics: frequencies (percentages) and means for categorical and quantitative data, respectively. Results 3836 of the questionnaires (1857 M/1979F) were completed. The prevalence of current allergic rhinitis was 29.3% (1043), physician-diagnosed allergic rhinitis was 9.7% (373), cumulative allergic rhinitis was 36.2% (1289) and current allergic rhinoconjunctivitis was 16.2% (577). The presence of physician diagnosed atopic disease–asthma (p Conclusions The prevalence of allergic rhinoconjunctivitis in 6–12-year-old children in Budapest is higher than reported for most of the surrounding European countries. While asthma (OR = 4.398) is the most significant comorbidity, environmental factors such as birds at home in the first year of life (OR = 2.394) and living in a weedy area (OR = 1.640) seem to be the most important factors associated with AR. Strategies for preventive measures should be implemented. Trial registration number: KUT-19/2019. The study was approved by the Ethics Committee at Heim Pál National Pediatric Institute

Background Digital tomosynthesis (DTS) might be a low-dose/low-cost alternative to computed tomography (CT). Purpose To investigate DTS relative to CT for surveillance of incidental, solid pulmonary nodules. Material and Methods Recruited from a population study, 106 participants with indeterminate solid pulmonary nodules on CT underwent surveillance with concurrently performed CT and DTS. Nodule size on DTS was assessed by manual diameter measurements and semi-automatic nodule segmentations were independently performed on CT. Measurement agreement was analyzed according to Bland–Altman with 95% limits of agreement (LoA). Detection of nodule volume change > 25% by DTS in comparison to CT was evaluated with receiver operating characteristics (ROC). Results A total of 81 nodules (76%) were assessed as measurable on DTS by two independent observers. Inter- and intra-observer LoA regarding change in average diameter were ± 2 mm. Calculation of relative volume change on DTS resulted in wide inter- and intra-observer LoA in the order of ± 100% and ± 50%. Comparing relative volume change between DTS and CT resulted in LoA of –58% to 67%. The area under the ROC curve regarding the ability of DTS to detect volumetric changes > 25% on CT was 0.58 (95% confidence interval [CI] = 0.40–0.76) and 0.50 (95% CI = 0.35–0.66) for the two observers. Conclusion The results of the present study show that measurement variability limits the agreement between DTS and CT regarding nodule size change for small solid nodules.

Background A cross-sectional, questionnaire-based study was conducted in primary schools located in the capital of Hungary. We aimed to evaluate the prevalence of asthma and its risk factors within a 6-12-year-old population.Methods After meeting selection criteria, 3836 eligible parent-reported questionnaires were evaluated. The survey included the ISAAC phase three core questions for asthma and assessed the association with other atopic conditions and various environmental, lifestyle and nutritional risk factors.Results Cumulative asthma had a prevalence of 12.6% among the sampled population, with a girl-boy percentage of 37.4–62.6%. The proximity of any air-polluting factories, heavy-vehicle traffic and weedy area associated with greater risk for asthma while a suburban residence showed lesser odds (odds ratios were 1.3319, 1.2883, 1.3939 and 0.6390 respectively). Indoor smoking, visible mould, and keeping a dog were defined as risk factors for asthma (odds ratios: 1.6509, 2.1282, 1.4362), while the presence of a plant in the bedroom and pet rodents associated with lower odds ratios (0.7884, 0.7231 respectively). The consumption of fast food, beverages containing additives and margarine were significantly higher in asthmatics (odds ratios 1.7488, 1.2669, 1.3549), while we found frequent sport activity (0.6883) and cereal intake (0.5403) had favorable odds ratios for asthma.Conclusions Some of the obtained results have confirmed the outcomes of previous similar epidemiological studies, while in other cases, differences were found. These differences could have been a natural consequence of regional variability and other undiscovered factors; however, the correct evaluation of these controversial results require further investigation in the future. The current data can serve as a milestone for a prospective trial. Having the findings of this study, we can articulate recommendations for the public regarding the most common risk factors of asthma that should be avoided at home and in our surroundings and how to transform our daily habits for a prosperous future.

Oropharyngeal and nasopharyngeal specimens collected by swabbing are the pillars of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics. Commercially available rapid antigen tests and self-sampling polymerase chain reaction services have made specimen collection available anytime and anywhere in nonmedical settings. In this study, we report the case of a 45-year-old man who accidentally ingested a swab during self-performed SARS-CoV-2 rapid antigen testing. Imaging studies revealed an elongated foreign body in the stomach. Urgent gastroscopy confirmed the presence of the swabbing applicator in the gastric lumen, which was retrieved using a loop without any complications. Millions of SARS-CoV-2 tests are performed daily, of which an increasing proportion are performed by laypeople. Foreign bodies account for a particular set of complications, which can be avoided by cautious sampling and using the correct technique. Radiopaque labeling of instruments would be useful. Otherwise, rare serious events can occur that may require immediate medical interventions.

Blunt trauma of the head can result in temporal bone fracture. Different classifications exist, but from a functional perspective, to distinguish otic capsule sparing and otic capsule disrupting fractures is superior to the classic nomenclature. Disruption of the otic capsule is often associated with sensorineural hearing loss, vestibular dysfunction, cerebrospinal leakage, or even intracranial consequences. Pneumolabyrinth describes the condition when air is enclosed within the inner ear. It is a result of a pathological communication between the labyrinth and the middle ear spaces that often occurs due to trauma. It is not a ubiquitous but obvious radiographic hallmark of otic capsule violation. The present case is about a young woman who suffered a temporal bone fracture that involved the right lateral semicircular canal. Multiplanar and segmentation images were generated to depict the pneumolabyrinth developed in the lateral semicircular canal. Despite the preserved hearing, vestibular dysfunction was registered during the video head impulse test and videonystagmography. Treatment of pneumolabyrinth after temporal bone fracture can be a matter of surgery or conservative therapy. In the present case, we preferred conservative therapy because of the absence of serious consequences. Nevertheless, timing and the type of therapeutic modality must be personalized.

Antihistamines are easily accessible and cover the vast majority of the medical therapy of allergic rhinitis. However, their systemic administration may more frequently associate with their well-known side-effect, sedation, which is a serious problem in persons in safety-critical jobs such as aviation. We have a poor understanding whether a non-sedative antihistamine has an impact on vigilance when hypobaric hypoxia occurs during flight.In this randomized, placebo-controlled, double-blind, cross-over study the effect of 20 mg bilastine was compared to 10 mg cetirizine and to placebo (20 mg pyridoxine) in 33 individuals at ground level and at 4,000 m altitude simulated in hypobaric chamber. Levels of vigilance, ultrashort memory, combined distributive attention, monotony tolerance and peripheral blood oxygen saturation (SpOBilastine did not impair the tested abilities in comparison with the control groups either at ground level or hypobaric hypoxia. Administration of cetirizine increased the number of errors at ground level. At the simulated altitude, already impaired results were additionally demonstrated with regards to the distributive attention test.From the two examined antihistamines, bilastine should be the preferred medication for by individuals who require constant attention and are exposed to hypobaric hypoxia.

Purpose To investigate the performance of digital tomosynthesis (DTS) for detection and characterization of incidental solid lung nodules. Materials and Methods This prospective study was based on a population study with 1111 randomly selected participants (age range, 50-64 years) who underwent a medical evaluation that included chest computed tomography (CT). Among these, 125 participants with incidental nodules 5 mm or larger were included in this study, which added DTS in conjunction with the follow-up CT and was performed between March 2012 and October 2014. DTS images were assessed by four thoracic radiologists blinded to the true number of nodules in two separate sessions according to the 5-mm (125 participants) and 6-mm (55 participants) cut-off for follow-up of incidental nodules. Pulmonary nodules were directly marked on the images by the readers and graded regarding confidence of presence and recommendation for follow-up. Statistical analyses included jackknife free-response receiver operating characteristic, receiver operating characteristic, and Cohen κ coefficient. Results Overall detection rate ranges of CT-proven nodules 5 mm or larger and 6 mm or larger were, respectively, 49%-58% and 48%-62%. Jackknife free-response receiver operating characteristics figure of merit for detection of CT-proven nodules 5 mm or larger and 6 mm or larger was 0.47 and 0.51, respectively, and area under the receiver operating characteristic curve regarding recommendation for follow-up was 0.62 and 0.65, respectively. Conclusion Routine use of DTS would result in lower detection rates and reduced number of small nodules recommended for follow-up.

Iatrogenic atrial septal defect (IASD) after catheter ablation (CA) for atrial fibrillation (AF) due to transseptal puncture (TSP) can occur. The aim of this prospective study was to describe the incidence of IASD and to detect any cerebrovascular accident (CVA) after radiofrequency (RF) and cryoballoon (CB) CA. Between July 2014 and September 2016, 94 patients (pts) (RF; 48, CB; 46, 30 (31.9%) women, mean age = 60 ± 9.7 years) with paroxysmal AF were enrolled who underwent CA procedure for the first time. During RF ablation a single (n = 30, 62.5%) or double (n = 18, 37.5%) TSP was performed. Transoesophageal echocardiography before the procedure and at the 3-month and 12-month follow-up (FU) was accomplished. During the FU period, we evaluated the occurrence of any postprocedural CVA. At the 3-month FU, IASD was detected in 17/94 (18.1%) pts; in 9/48 (18.8%) pts in the RF while in 8/46 (17.4%) pts in the CB group (p = 0.866), all of them with left-to-right shunt. In the RF group, 6/30 (20%) pts with a single TSP while 3/18 (16.7%) pts in the double TSP group had IASD (p = 0.780). 14/17 (82.4%) IASDs showed high spontaneous closure rate at the 12-month FU. None of the pts died or suffered from CVA. Persistent IASD can occur rather frequently following AF CA. No significant difference was observed between the RF and CB techniques concerning the presence of IASD at 3-month. IASDs showed a high spontaneous closure rate. No cerebral thromboembolic event was observed in the 12-month FU period.

// Istvan Kenessey 1, 2 , Krisztina Koi 1 , Orsolya Horvath 3 , Mihaly Cserepes 3, 4 , David Molnar 1 , Vera Izsak 1 , Judit Dobos 5 , Balazs Hegedűs 6 , Jozsef Tovari 3, * , Jozsef Timar 1, 6, * 1 2 nd Department of Pathology, Semmelweis University, Budapest, Hungary 2 National Cancer Registry, National Institute of Oncology, Budapest, Hungary 3 Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary 4 Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary 5 Vichem Chemie Ltd., Budapest, Hungary 6 Hungarian Academy of Sciences-Semmelweis University Molecular Oncology Research Group, Budapest, Hungary * These authors have contributed equally to this work Correspondence to: Istvan Kenessey, email: steveken12@yahoo.com Keywords: zoledronic acid, ras inhibitor, human non-small cell lung cancer, xenograft model Received: March 17, 2016 Accepted: September 27, 2016 Published: October 21, 2016 ABSTRACT Background: In non-small cell lung cancer (NSCLC) KRAS-mutant status is a negative prognostic and predictive factor. Nitrogen-containing bisphosphonates inhibit prenylation of small G-proteins (e.g. Ras, Rac, Rho) and thus may affect proliferation and migration. In our preclinical work, we investigated the effect of an aminobisphosphonate compound (zoledronic acid) on mutant and wild type KRAS-expressing human NSCLC cell lines. Results: We confirmed that zoledronic acid was unable to inhibit the prenylation of mutant K-Ras unlike in the case of wild type K-Ras. In case of in vitro proliferation, the KRAS-mutant human NSCLC cell lines showed resistance to zoledronic acid wild-type KRAS-cells proved to be sensitive. Combinatory application of zoledronic acid enhanced the cytostatic effect of cisplatin. Zoledronic acid did not induce significant apoptosis. In xenograft model, zoledronic acid significantly reduced the weight of wild type KRAS-EGFR-expressing xenograft tumor by decreasing the proliferative capacity. Futhermore, zoledronic acid induced VEGF expression and improved in vivo tumor vascularization. Materials and methods: Membrane association of K-Ras was examined by Western-blot. In vitro cell viability, apoptotic cell death and migration were measured in NSCLC lines with different molecular background. The in vivo effect of zoledronic acid was investigated in a SCID mouse subcutaneous xenograft model. Conclusions: The in vitro and in vivo inhibitory effect of zoledronic acid was based on the blockade of cell cycle in wild type KRAS-expressing human NSCLC cells. The zoledronic acid induced vascularization supported in vivo cytostatic effect. Our preclinical investigation suggests that patients with wild type KRAS-expressing NSCLC could potentially benefit from aminobisphosphonate therapy.

2018 IEEE 27th International Symposium on Industrial Electronics (ISIE), Cairns, QLD, Australia Optimizing energy usage is becoming an economic necessity for existing buildings. Non-invasive sensors and sensor networks are key technologies for efficiently achieving this goal, since it is of utmost importance that existing hydraulic systems are not changed and the engineering effort for installation remains minimal. This paper presents a data-driven approach that should allow low-cost installation of sensors at arbitrary points of the building and then retrieve the structure of the hydraulic system from the recorded sensor values. The architecture as well as first preliminary results from field test buildings are presented. Energie-Umweltmanagement Forschung Burgenland

Purpose: To investigate the potential benefit of increasing the dose per projection image in chest tomosynthesis, performed at the current standard dose level, by reducing the angular range covered or the projection image density and to evaluate the influence of the tube voltage on the image quality. Methods: An anthropomorphic chest phantom was imaged using nine different projection image configurations and ten different tube voltages with the GE VolumeRAD tomosynthesis system. The resulting image sets were representative of being acquired at the same total effective dose. This was achieved partly by applying a simulated dose reduction to the projection images due to restrictions concerning the tube load settings on the VolumeRAD system. Four observers were included in a visual grading study where the reconstructed tomosynthesis section images were rated according to a set of image quality criteria. Image quality was evaluated relative to the default configuration and default tube voltage on the VolumeRAD system. Results: Overall, the image quality decreased with decreasing projection image density. Regarding angular range covered by the projection images, the image quality increased with decreasing angular range for two of the criteria, whereas for a criterion related to the depth resolution in the section images the reduced angular ranges resulted in inferior image quality as compared to the default configuration. The image quality showed little dependence on the tube voltage. Conclusions: At the standard dose level of the VolumeRAD system, the potential benefits from increasing the dose per projection do not fully compensate for the negative effects resulting from a reduction in the number of projection images. Consequently, the default configuration consisting of 60 projection images acquired over 30° is a good alternative. The tube voltage used in tomosynthesis does not have a large impact on the image quality.

Background Postconditioning may prove to be a suitable method to decrease ischemia-reperfusion injury of intestine after mesenteric arterial occlusion. Toll-like-receptor-4 is involved in the pathophysiology of organ damage after ischemia-reperfusion; therefore, the aim of our study was to investigate the effect of postconditioning on the mucosal expression of toll-like-receptor-4. Methods Male Wistar rats ( n = 10/group) underwent 60 minutes of superior mesenteric artery occlusion followed by 6 hours of reperfusion in 3 groups: sham-operated, ischemia-reperfusion, and a postconditioned group. Postconditioning was performed by 6 alternating cycles of 10 seconds of reperfusion/reocclusion. Blood and tissue samples were collected at the end of reperfusion. Intestinal histopathologic changes and immunohistochemical expression of mucosal caspase-3, antioxidant status, and protein levels of high-mobility group box-1 and toll-like-receptor-4 were assessed. Immunofluorescent labeling and confocal microscopic analysis of toll-like-receptor-4 were performed. Mucosal and serum levels of interleukin-6 and tumor necrosis factor-α protein were measured. Results Histologic alterations in the postconditioned group were associated with decreased caspase-3 positivity, less toll-like-receptor-4 mRNA, and less protein expression of high-mobility group box-1 and toll-like-receptor-4 in the intestinal villi compared with the ischemia-reperfusion group. Furthermore, a significantly improved antioxidant state of the intestinal mucosa and less mucosal and serum protein levels of interleukin-6 and tumor necrosis factor-α were detected in the postconditioned group. Conclusion Small intestinal ischemia-reperfusion injury in male Wistar rats caused by the occlusion of the superior mesenteric artery was ameliorated by the use of postconditioning, showing a more favorable inflammatory response, which may be attributed to the decreased mucosal expression of toll-like-receptor-4.

Chest tomosynthesis may be a suitable alternative to computed tomography for the clinical task of follow up of pulmonary nodules. The aim of the present study was to investigate the detection of pulmonary nodule growth suggestive of malignancy using chest tomosynthesis. Previous studies have indicated remained levels of detection of pulmonary nodules at dose levels corresponding to that of a conventional lateral radiograph, approximately 0.04 mSv, which motivated to perform the present study this dose level. Pairs of chest tomosynthesis image sets, where the image sets in each pair were acquired of the same patient at two separate occasions, were included in the study. Simulated nodules with original diameters of approximately 8 mm were inserted in the pairs of image sets, simulating situations where the nodule had remained stable in size or increased isotropically in size between the two different imaging occasions. Four different categories of nodule growth were included, corresponding to a volume increase of approximately 21 %, 68 %, 108 % and 250 %. All nodules were centered in the depth direction in the tomosynthesis images. All images were subjected to a simulated dose reduction, resulting in images corresponding to an effective dose of 0.04 mSv. Four observers were given the task of rating their confidence that the nodule was stable in size or not on a five-level rating scale. This was done both before any size measurements were made of the nodule as well as after measurements were performed. Using Receiver operating characteristic analysis, the rating data for the nodules that were stable in size was compared to the rating data for the nodules simulated to have increased in size. Statistically significant differences between the rating distributions for the stable nodules and all of the four nodule growth categories were found. For the three largest nodule growths, nearly perfect detection of nodule growth was seen. In conclusion, the present study indicates that during optimal imaging conditions and for nodules with diameters of approximately 8 mm that grow fairly symmetrically, chest tomosynthesis performed at a dose level corresponding to that of a lateral chest radiograph can, with high sensitivity, differentiate nodules stable in size from nodules growing at rates associated with fast growing malignant nodules.

Recent findings indicate a strong correlation between the risk of future heart disease and the volume ofadipose tissue inside of the pericardium. So far, large-scale studies have been hindered by the fact that manual delin-eation of the pericardium is extremely time-consuming and that existing methods for automatic delineation strugglewith accuracy. In this paper, an efficient and fully automatic approach to pericardium segmentation and epicardial fatvolume estimation is presented, based on a variant of multi-atlas segmentation for spatial initialization and a randomforest classifier for accurate pericardium detection. Experimental validation on a set of 30 manually delineated Com-puter Tomography Angiography (CTA) volumes shows a significant improvement on state-of-the-art in terms of EFVestimation (mean absolute epicardial fat volume difference: 3.8 ml (4.7%), Pearson correlation: 0.99) with run-timessuitable for large-scale studies (52 s). Further, the results compare favorably to inter-observer variability measured on10 volumes.

Background: This study examined the predictive ability of educational background and demographic variables, available at the admission stage, to identify applicants who will graduate in 4 years from podiatric medical school. Methods: A logistic regression model was used to identify two predictors of 4-year graduation: age at matriculation and total Medical College Admission Test score. The model was cross-validated using a second independent sample from the same population. Cross-validation gives greater confidence that the results could be more generally applied. Results: Total Medical College Admission Test score was the strongest predictor of 4-year graduation, with age at matriculation being a statistically significant but weaker predictor. Conclusions: Despite the model’s capacity to predict 4-year graduation better than random assignment, a sufficient amount of error in prediction remained, suggesting that important predictors are missing from the model. Furthermore, the high rate of false-positives makes it inappropriate to use age and Medical College Admission Test score as admission screens in an attempt to eliminate attrition by not accepting at-risk students. (J Am Podiatr Med Assoc 102(6): 463–470, 2012)

Background:This study examined the success of an admission screen in identifying applicants who will fail Part I or Part II of the Podiatric Boards on the first attempt.Methods:A logistic regression model was used to predict failure on the Podiatric Boards.Results:The biology Medical College Admission Test (MCAT) score predicted failure on Part I and Part II. Adding undergraduate grade point average and the other MCAT subscores did not significantly improve the prediction. Although a screen based on the biology MCAT score can identify nearly 90% of those who fail, there are six false-positives for every true-positive.Conclusions:First-time Board failure can be predicted, but Board failure must be primarily addressed by interventions after matriculation rather than by an admission screen. (J Am Podiatr Med Assoc 102(6): 485–490, 2012)

Medical education in the United States and Canada continues to evolve. However, many of the changes in pedagogy are being made without appropriate evaluation. Here, we attempt to evaluate the effectiveness of lecture capture technology as a learning tool in Podiatric medical education. In this pilot project, student performance in an inaugural lecture capture-supported biochemistry course was compared to that in the previous academic year. To examine the impact of online lecture podcasts on student performance a within-subjects design was implemented, a two way ANCOVA with repeated measures. The use of lecture capture-supported pedagogy resulted in significantly higher student test scores, than achieved historically using traditional pedagogy. The overall course performance using this lecture capture-supported pedagogy was almost 6% higher than in the previous year. Non-native English language speakers benefitted more significantly from the lecture capture-supported pedagogy than native English language speakers, since their performance improved by 10.0 points. Given that underrepresented minority (URM) students, whose native language is not English, makes up a growing proportion of medical school matriculates, these observations support the use of lecture capture technology in other courses. Furthermore, this technology may also be used as part of an academic enrichment plan to improve performance on the American Podiatric Medical Licensing Examination, reduce the attrition of URM students and potentially address the predicted minority physician shortage in 2020.

Modern applications increasingly rely on continuous monitoring of video, audio, or other sensor data to provide their functionality, particularly in platforms such as the Microsoft Kinect and Google Glass. Continuous sensing by untrusted applications poses significant privacy challenges for both device users and bystanders. Even honest users will struggle to manage application permissions using existing approaches. We propose a general, extensible framework for controlling access to sensor data on multi-application continuous sensing platforms. Our approach, world-driven access control, allows real-world objects to explicitly specify access policies. This approach relieves the user's permission management burden while mediating access at the granularity of objects rather than full sensor streams. A trusted policy module on the platform senses policies in the world and modifies applications' "views" accordingly. For example, world-driven access control allows the system to automatically stop recording in bathrooms or remove bystanders from video frames,without the user prompted to specify or activate such policies. To convey and authenticate policies, we introduce passports, a new kind of certificate that includes both a policy and optionally the code for recognizing a real-world object. We implement a prototype system and use it to study the feasibility of world-driven access control in practice. Our evaluation suggests that world-driven access control can effectively reduce the user's permission management burden in emerging continuous sensing systems. Our investigation also surfaces key challenges for future access control mechanisms for continuous sensing applications.

Rationale and ObjectivesTo investigate the accuracy and precision of pulmonary nodule size measurements on chest tomosynthesis images.Materials and MethodsArtificial ellipsoid-shaped nodules with known sizes were inserted in clinical chest tomosynthesis images. The volume of the nodules corresponded to that of a sphere with a diameter of 4.0, 8.0, or 12.0 mm. Four thoracic radiologists were given the task to determine the longest diameter of the nodules. All nodules were measured twice. Measurement accuracy in terms of the mean measurement error was determined. Intraobserver and interobserver variabilities, as well as variability because of differences between nodules and their locations, were used as measures of precision.ResultsThe mean measurement error ranged from −0.3 to 0.1 mm for the nodule size groups and observers. Of the smallest nodules, the observers found 7–17 of total 50 nodules nonmeasurable. The intraobserver and interobserver variabilities were of similar magnitude, indicating relatively small differences between the observers. The internodule variability was in general larger, indicating that the different characteristics of the nodules and their location are sources of variability.ConclusionsThe results suggest a high accuracy and precision for manual measurements of the nodules in chest tomosynthesis images. However, small nodules (

In this paper, we investigate an approach to program synthesis that is based on crowd-sourcing. With the help of crowd-sourcing, we aim to capture the "wisdom of the crowds" to find good if not perfect solutions to inherently tricky programming tasks, which elude even expert developers and lack an easy-to-formalize specification. We propose an approach we call program boosting, which involves crowd-sourcing imperfect solutions to a difficult programming problem from developers and then blending these programs together in a way that improves their correctness. We implement this approach in a system called CROWDBOOST and show in our experiments that interesting and highly non-trivial tasks such as writing regular expressions for URLs or email addresses can be effectively crowd-sourced. We demonstrate that carefully blending the crowd-sourced results together consistently produces a boost, yielding results that are better than any of the starting programs. Our experiments on 465 program pairs show consistent boosts in accuracy and demonstrate that program boosting can be performed at a relatively modest monetary cost.

RFID technology has raised a number of both real and imagined security and privacy fears and concerns. Since roughly 2001, a number of researchers have stepped up to the plate and proposed techniques for strengthening RFID security and privacy, while others have focused on attacking (and demonstrating weaknesses in) currently deployed RFID systems. Despite a few PhD theses devoted to this topic, it remains to be seen whether there are any new long-term fundamental issues involved in RFID security & privacy. Therefore, this panel's goal is to present and debate the panelists' diverse perspectives on the future (or lack thereof) of RFID security and privacy research.One line of thought is that this topic is a mere fad. After all, RFID tags are computational amoebas, akin to dumb sensors that sense nothing. RFID tags do not network and do not collect anything; hence, the only interaction worth considering is between a tag and a reader. Is there anything challenging remaining beyond the set of cryptographically contortionist protocols and techniques already proposed in the literature?An opposing point of view is that RFID technology has opened up a new and exciting avenue for research which is here to stay. Although some basic protocols have been designed, there are several important outstanding issues, including (but not limited to) the following. One purely technical issue that remains unaddressed is how to handle revocation of rogue readers. Inherent lack of on-board clocks makes revocation checking very difficult. There is also the problem of secure pairing of personal RFID tags (e.g., in passports and transponders) with other ubiquitous devices, e.g., cell-phones, laptops or PDAs. Another is the design of inexpensive and robust privacy "shields" for protecting RFID tags -- carried by a potentially unwitting user -- from leaking information. Yet another important unexplored issue is user perception and, more generality, usability aspects of RFID tags. This is surprising since, unlike sensors/WSNs or MANETs, RFID tags are expected to be close and relevant to the average user/consumer.This international panel is composed of academic and industrial experts in cryptography, security/privacy and usability, each with a track record of research results in the respective aspects of RFID technology. The panelists' statements and the summary of the panel discussion will be available (after the conference) at: http://sconce.ics.uci.edu/wisec08-rfid-panel.

Mesenteric ischemia-reperfusion (IR) is associated with impairment of the gut barrier function and the initiation of a proinflammatory cascade with life-threatening results. Therefore methods directed to ameliorate IR injury are of great importance. We aimed at describing the effects of postconditioning (PC) on the alterations of the intestinal mucosal function and the inflammatory response upon mesenteric IR.Methods. Male Wistar rats were gavaged with green fluorescent protein-expressingE. colisuspensions. Animals were randomized into three groups (n=15), sham-operated, IR-, and PC-groups, and underwent 60 minutes of superior mesenteric artery occlusion, followed by 6 hours of reperfusion. Postconditioning was performed at the onset of reperfusion. Blood and tissue samples were taken at the end of reperfusion, for histological, bacteriological, and plasma examinations.Results. The PC-group presented a more favorable claudin-2, claudin-3, claudin-4, and zonula occludens-1 membrane expression profile, and significantly lower rates of bacterial translocation to distant organs and plasma D-lactate levels compared to the IR-group. Histopathological lesions, plasma I-FABP, IL-6, and TNF-αlevels were significantly lower in the PC-group compared to the IR-group.Conclusion. The use of postconditioning improved the integrity of the intestinal mucosal barrier upon mesenteric IR, and thus reduced the incidence of bacterial translocation and development of a systemic inflammatory response.

Background: This study examined the effect of instructional technology availability on the performance of students enrolled in a medical physiology course at a podiatric medical school. Methods: Multiple linear regression analysis was used to predict student overall test performance based on instructional technology, Medical College Admission Test score, undergraduate grade point average, and class absence. Results: The availability of instructional technology was associated with a small decline in mean test performance and a small increase in class absence. Class absence had a negative effect on test performance only when the technology was available. Total Medical College Admission Test score and grade point average were positively correlated with performance. Conclusions: Instructional technology did not enhance absentee student course performance and, indeed, hurt it. Its use as a means of providing access to additional lecture material needs to be reevaluated. (J Am Podiatr Med Assoc 102(6): 471–476, 2012)

Background:Most medical school admission committees use cognitive and noncognitive measures to inform their final admission decisions. We evaluated using admission data to predict academic success for podiatric medical students using first-semester grade point average (GPA) and cumulative GPA at graduation as outcome measures.Methods:In this study, we used linear multiple regression to examine the predictive power of an admission screen. A cross-validation technique was used to assess how the results of the regression model would generalize to an independent data set.Results:Undergraduate GPA and Medical College Admission Test score accounted for only 22% of the variance in cumulative GPA at graduation. Undergraduate GPA, Medical College Admission Test score, and a time trend variable accounted for only 24% of the variance in first-semester GPA.Conclusions:Seventy-five percent of the individual variation in cumulative GPA at graduation and first-semester GPA remains unaccounted for by admission screens that rely on only cognitive measures, such as undergraduate GPA and Medical College Admission Test score. A reevaluation of admission screens is warranted, and medical educators should consider broadening the criteria used to select the podiatric physicians of the future. (J Am Podiatr Med Assoc 102(6): 499–504, 2012)

Background Simulated pathology is a valuable complement to clinical images in studies aiming at evaluating an imaging technique. In order for a study using simulated pathology to be valid, it is important that the simulated pathology in a realistic way reflect the characteristics of real pathology. Purpose To perform a thorough evaluation of a nodule simulation method for chest tomosynthesis, comparing the detection rate and appearance of the artificial nodules with those of real nodules in an observer performance experiment. Material and Methods A cohort consisting of 64 patients, 38 patients with a total of 129 identified pulmonary nodules and 26 patients without identified pulmonary nodules, was used in the study. Simulated nodules, matching the real clinically found pulmonary nodules by size, attenuation, and location, were created and randomly inserted into the tomosynthesis section images of the patients. Three thoracic radiologists and one radiology resident reviewed the images in an observer performance study divided into two parts. The first part included nodule detection and the second part included rating of the visual appearance of the nodules. The results were evaluated using a modified receiver-operating characteristic (ROC) analysis. Results The sensitivities for real and simulated nodules were comparable, as the area under the modified ROC curve (AUC) was close to 0.5 for all observers (range, 0.43–0.55). Even though the ratings of visual appearance for real and simulated nodules overlapped considerably, the statistical analysis revealed that the observers to were able to separate simulated nodules from real nodules (AUC values range 0.70–0.74). Conclusion The simulation method can be used to create artificial lung nodules that have similar detectability as real nodules in chest tomosynthesis, although experienced thoracic radiologists may be able to distinguish them from real nodules.

We empirically analyzed sanitizer use in a shipping web ap- plication with over 400,000 lines of code and over 23,244 methods, the largest empirical analysis of sanitizer use of which we are aware. Our analysis reveals two novel classes of errors: context-mismatched sanitization and inconsistent multiple sanitization. Both of these arise not because sanitizers are incorrectly implemented, but rather because they are not placed in code correctly. Much of the work on crosssite scripting detection to date has focused on finding missing sanitizers in programs of average size. In large legacy applications, other sanitization issues leading to cross-site scripting emerge. To address these errors, we propose ScriptGard, a system for ASP.NET applications which can detect and repair the incorrect placement of sanitizers. ScriptGard serves both as a testing aid to developers as well as a runtime mitigation technique. While mitigations for cross site scripting attacks have seen intense prior research, we consider both server and browser context, none of them achieve the same degree of precision, and many other mitigation techniques require major changes to server side code or to browsers. Our approach, in contrast, can be incrementally retrofitted to legacy systems with no changes to the source code and no browser changes. With our optimizations, when used for mitigation, ScriptGard incurs virtually no statistically significant overhead.

Researchers have recently begun to study the economics of the markets for illicit digital goods to better understand how to invest resources in the most effective mitigations. This line of work in security economics can greatly benefit from data gathering methodologies used for the study of another underground economy, which has been analyzed for the better part of a century: the illicit drug trade. We describe "promises" and "puzzles" in the use of observational data for computer security research, that have been encountered previously in drug policy research, and highlight possible lessons we can learn from this different field. We then outline potential opportunities for security research to avoid pitfalls in data collection that drug policy studies have uncovered. Finally, we argue that failure to tackle problems with observational data runs the risk of creating incorrect "mythical numbers" that can have lasting effects on public policy surrounding computer security.

Within the next year, travelers from dozens of nations may be carrying a new form of passport in response to a mandate by the United States government. The e-passport, as it is sometimes called, represents a bold initiative in the deployment of two new technologies: Radio-Frequency Identification (RFID) and biometrics. Important in their own right, e-passports are also the harbinger of a wave of next-generation ID cards: several national governments plan to deploy identity cards integrating RFID and biometrics for domestic use. We explore the privacy and security implications of this impending worldwide experiment in next-generation authentication technology. We describe privacy and security issues that apply to e-passports, then analyze these issues in the context of the International Civil Aviation Organization (ICAO) standard for e-passports.

We introduce new methods for detecting control-flow side channel attacks, transforming C source code to eliminate such attacks, and checking that the transformed code is free of control-flow side channels. We model control-flow side channels with a program counter transcript, in which the value of the program counter at each step is leaked to an adversary. The program counter transcript model captures a class of side channel attacks that includes timing attacks and error disclosure attacks. Further, we propose a generic source-to-source transformation that produces programs provably secure against control-flow side channel attacks. We implemented this transform for C together with a static checker that conservatively checks x86 assembly for violations of program counter security; our checker allows us to compile with optimizations while retaining assurance the resulting code is secure. We then measured our technique's effect on the performance of binary modular exponentiation and real-world implementations in C of RC5 and IDEA: we found it has a performance overhead of at most 5× and a stack space overhead of at most 2×. Our approach to side channel security is practical, generally applicable, and provably secure against an interesting class of side channel attacks.

The ability to link two different sightings of the same Radio Frequency Identification (RFID) tag enables invasions of privacy. The problem is aggravated when an item, and the tag attached to it, changes hands during the course of its lifetime. After such an ownership transfer, the new owner should be able to read the tag but the old owner should not. We address these issues through an RFID pseudonym protocol. Each time it is queried, the RFID tag emits a different pseudonym using a pseudo-random function. Without consent of a special Trusted Center that shares secrets with the tag, it is infeasible to map the pseudonym to the tag's real identity. We present a scheme for RFID pseudonyms that works with legacy, untrusted readers, requires only one message from tag to reader, and is scalable: decoding tag pseudonyms takes work logarithmic in the number of tags. Our scheme further allows for time-limited delegation, so that we can give an RFID reader the power to disambiguate a limited number of pseudonyms without further help from the Trusted Center. We show how RFID pseudonyms facilitate the transfer of ownership of RFID tags between mutually distrustful parties. Our scheme requires only limited cryptographic functionality from the tag: we need a pseudo-random function (PRF) and the ability to update tag state or to generate random numbers. Tag storage and communication requirements are modest: we give example parameters for a deployment of one million tags in which each tag stores only 128 bits, makes 6 PRF evaluations, and sends 158 bits each time it is read.

Radio Frequency Identification (RFID) technology raises significant privacy issues because it enables tracking of items and people possibly without their knowledge or consent. One of the biggest challenges for RFID technology is to provide privacy protection without raising tag production and management cost. We introduce a new architecture that uses trusted computing primitives to solve this problem. Our design splits the RFID reader into three software modules: a Reader Core with basic functionality, a Policy Engine that controls the use of RFID-derived data, and a Consumer Agent that performs privacy audits on the RFID reader and exports audit results to third party auditors. Readers use remote attestation to prove they are running a specific Reader Core, Policy Engine, and Consumer Agent. As a result, remote attestation allows concerned individuals to verify that RFID readers comply with privacy regulations, while also allowing the reader owner to verify that the reader has not been compromised.Furthermore, industry standards bodies have suggested several mechanisms to protect privacy in which authorized readers use a shared secret to authenticate themselves to the tag. These standards have not fully addressed issues of key management. First, how is the shared secret securely provided to the legitimate reader? Second, how do we guarantee that the reader will comply with a specific privacy policy? We show how, with remote attestation, the key-issuing authority can demand such a proof before releasing shared secrets to the reader. We also show how sealed storage can protect secrets even if the reader is compromised. Finally, we sketch how our design could be implemented today using existing RFID reader hardware.

Mobile devices consider energy to be a limiting resource. Over the past decade significant research has gone into how one can reduce energy consumption at the hardware level, network protocol level, operating system level, and compiler level. In almost all algorithm analysis, a single resource such as time or communication is often taken as a proxy for energy. We address this problem by defining an algorithmic model for energy, designing algorithm variants that reduce energy cost in this model, and then performing preliminary experiments to test the model.Our starting point is an algorithmic energy model inspired by work from the compilers community [26]. Augmenting and simplifying this model motivates the need to consider an algorithm's "switching" complexity; this measure captures the extent to which one switches between different functional units during execution. We carry out preliminary experiments on the Itsy pocket computer, which contains a StrongARM SA-1100 processor running Linux, to compare "high-switch" versions of bubble sort and other algorithms to optimized "low-switch" versions. Our preliminary results show that switching does not appear to affect energy consumption at the algorithmic level.We then look at a factor that does not appear to have been studied, namely the cost of generating (pseudo)random bits. Derandomization is a goal in cryptography and complexity theory. To our knowledge the energy cost of randomness itself has not been studied. Nonetheless, many mobile protocols and algorithms might utilize randomness, for example to handle contention resolution, generate cryptographic keys, or to accomplish efficient sorting. We consider three common mechanisms for generating randomness: the standard C library random number generator, and the Linux /dev/random, and /dev/urandom generators. We perform tests that compare the energy consumed by these generators compared to thecost of performing basic arithmetic instructions. We use Quicksort as an example of a classic basic application-level algorithm to understand the energy cost of randomness, and compare the energy consumed by randomized Quicksort to standard Quicksort. Our preliminary results show that generating randomness does in fact incur a significant energy cost, and /dev/random is the most expensive of the three mechanisms.We conclude that understanding energy consumption at the algorithmic level is an important but overlooked area of investigation, and discuss the implications of our results. We end with directions for for further work.

Most prior designated confirmer signature schemes either prove security in the random oracle model (ROM) or use general zero-knowledge proofs for NP statements (making them impractical). By slightly modifying the definition of designated confirmer signatures, Goldwasser and Waisbard presented an approach in which the Confirm and ConfirmedSign protocols could be implemented without appealing to general zero-knowledge proofs for NP statements (their “Disavow” protocol still requires them). The Goldwasser-Waisbard approach could be instantiated using Cramer-Shoup, GMR, or Gennaro-Halevi-Rabin signatures. In this paper, we provide an alternate generic transformation to convert any signature scheme into a designated confirmer signature scheme, without adding random oracles. Our key technique involves the use of a signature on a commitment and a separate encryption of the random string used for commitment. By adding this “layer of indirection,” the underlying protocols in our schemes admit efficient instantiations (i.e., we can avoid appealing to general zero-knowledge proofs for NP statements) and furthermore the performance of these protocols is not tied to the choice of underlying signature scheme. We illustrate this using the Camenisch-Shoup variation on Paillier’s cryptosystem and Pedersen commitments. The confirm protocol in our resulting scheme requires 10 modular exponentiations (compared to 320 for Goldwasser-Waisbard) and our disavow protocol requires 41 modular exponentiations (compared to using a general zero-knowledge proof for Goldwasser-Waisbard). Previous schemes use the “encryption of a signature” paradigm, and thus run into problems when trying to implement the “confirm” and “disavow” protocols efficiently.

We expose privacy issues related to Radio Frequency Identification (RFID) in libraries, describe current deployments, and suggest novel architectures for library RFID. Libraries are a fast growing application of RFID; the technology promises to relieve repetitive strain injury, speed patron self-checkout, and make possible comprehensive inventory. Unlike supply-chain RFID, library RFID requires item-level tagging, thereby raising immediate patron privacy issues. Current conventional wisdom suggests that privacy risks are negligible unless an adversary has access to library databases. We show this is not the case. In addition, we identify private authentication as a key technical issue: how can a reader and tag that share a secret efficiently authenticate each other without revealing their identities to an adversary? Previous solutions to this problem require reader work linear in the number of tags. We give a general scheme for building private authentication with work logarithmic in the number of tags, given a scheme with linear work as a sub protocol. This scheme may be of independent interest beyond RFID applications. We also give a simple scheme that provides security against a passive eavesdropper using XOR alone, without pseudo-random functions or other heavy crypto operations.

Consumers want to interact with web sites, but they also want to keep control of their private information. Asymmetric information about whether web sites will sell private information or not leads to a lemons market for privacy. We discuss privacy policies as signals in a lemons market and ways in which current realizations of privacy policies may fail to be effective signals. As a result of these shortcomings, we consider a "lemons market with testing," where consumers have a cost of determining whether a site meets their privacy requirement. Our model explains empirical data concerning privacy policies and privacy seals. We end by discussing cyclic instability in the number of web sites that sell consumer information.

Mass immunization programs have proven to be a primary preventive measure to limit the spread of many infectious diseases worldwide. Nurses are trained to be leaders in preventing potential global health problems, but they are one of the groups with the lowest rates of compliancy in receiving influenza vaccination. Since nursing faculty are important role models in molding attitudes and behaviors of future nurses (their students), we set out to explore the knowledge, attitudes and beliefs of the nursing faculty and their students regarding influenza vaccine decision making. Our study included an assessment of the knowledge, attitudes and beliefs (KABs) of the nursing faculty and students related to influenza vaccination and whether their KABs influence the decision to receive or decline the vaccination. A cross-sectional survey was conducted using an anonymous questionnaire and our study indicated that personal experiences—either positive or negative—had a direct effect on influenza vaccine decision-making. Additionally, personal experiences influenced beliefs, and beliefs were shown to influence decision-making regarding vaccination. While beliefs and personal experiences had a direct effect on vaccine decision-making, knowledge had only an indirect effect through beliefs. Our study demonstrated that even though nursing practice is supposed to be driven by evidence-based medical practices, personal practices by nurses may be more influenced by personal beliefs than medical knowledge.

We describe a design for a reputation system that increases the reliability and thus efficiency of remailer services. Our reputation system uses a MIX-net in which MIXes give receipts for intermediate messages. Together with a set of witnesses, these receipts allow senders to verify the correctness of each MIX and prove misbehavior to the witnesses.

A tiny variation of a single metal nanoparticle's dielectric properties has only a weak influence on the light field. We demonstrate, using antenna concepts, how plasmon hybridization helps to increase the particle's influence.