18 research outputs found
Unscripted Practices for Uncertain Events:Organizational Problems in Cybersecurity Incident Management
Full text linkScripts can help us understand the designer–user relationship, by offering analysis of designers’ intent in technological objects and examination of users’ behaviors through willingness (and unwillingness) to take on scripts. But how are we to understand these relationships in the context of cybersecurity, in the face of adversaries determined to gain unauthorized access to computer systems by actively subverting scripts? In effect, cybersecurity attacks involve re-scripting of computing systems to gain unauthorized access through unscripted features of these systems. Cybersecurity attacks are always uncertain events: attackers can never be certain when re-scripting will be successful, and defenders can never be certain when or where to expect an attack, as unscripted features are difficult to know until they are exploited. In this paper, I study practices of cybersecurity incident response to examine how cybersecurity engineers respond to the novel attacks they encounter daily. I show how these are fundamentally unscripted practices emerging in response to unstable scripts, structured through the uncertainties inherent in cybersecurity engineering practice. The improvised practices and changing networks of social relations which I trace demonstrate the limits of stable scripts and provide new tools for analyzing unstable scripts
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Where in the World is the Internet? Locating Political Power in Internet Infrastructure
Full text linkWith the rise of global telecommunications networks, and especially with the worldwide spread of the Internet, the world is considered to be becoming an information society: a society in which social relations are patterned by information, transcending time and space through the use of new information and communications technologies. Much of the popular press and academic literature on the information society focuses on the dichotomy between the technologically-enabled virtual space of information, and the physical space of the material world. My examination of Internet infrastructure focuses on the system of interconnections amongst the networks which make up the Internet, which is called the inter-domain routing system. For all that the Internet is spoken of as a singular entity, it is in fact a complex distributed system of over 47,000 interconnected networks spanning the world. It is these interconnections which allow the Internet to appear to be a single entity, and provide the means through which the apparent placelessness of virtual space is produced. I approach the problem of understanding the production of virtual space by examining the mechanisms involved in the maintenance of order within the Internet's inter-domain routing system. To examine the mechanisms involved in maintaining order in the inter-domain routing system, I study the technology and practices involved in the interconnection of networks. The technology which enables network interconnection is the Border Gateway Protocol (BGP), which allows the establishment of network interconnections without any need for centralized oversight. In the absence of centralized oversight, I found that the practices involved in operating BGP rely on coordination and collaboration amongst the technical personnel responsible for managing the interconnection of networks. Coordination and collaboration are enabled amongst the Internet's technical personnel through social relationships of trust, running across corporate and state boundaries. Even though the inter-domain routing system operates without centralized oversight, it does rely on centralized institutional structures for specialized functions, such as standards-setting activity, and the allocation of unique numbering resources required to identify networks in the inter-domain routing system, and to identify computers within networks. I argue that order is maintained within the inter-domain routing system through a distributed system of trust relationships, which are anchored by centralized institutional structures. As an arrangement of mechanisms for maintaining order, I consider this to be a governance arrangement, which I term "distributed governance". Distributed governance is an unusual, and possibly unique, model of governance. It has three distinguishing features which mark it off from hierarchical and market-based models of governance. First, in its reliance on a distributed system of trust relationships. These are produced and reproduced in the practice of interconnecting networks, and through professional communities of the technical personnel responsible for managing network interconnections. Second, in its centralized institutional structures, which are uniquely organized amongst global governance institutions. None of these centralized institutional structures are formed by international treaty, and all of them are strongly committed to openness and participation. Third, in its operation over the particular technological form of BGP which emphasizes coordination and collaboration. To change the technology of inter-domain routing would be to change the range of governance possibilities for inter-domain routing, modifying the nature of distributed governance itself. These distinguishing features are sites of contestation. Although technical personnel do owe allegiance to their professional communities, and to one another through trust relationships, they are also employees of corporations which invest in Internet infrastructure, and citizens of nation states which regulate Internet infrastructure in their territories. Distributed governance is accordingly complicated by market relationships, the interests of nation states, and international relations amongst nation states, just as markets, nation states and international relations are complicated by distributed governance. To make sense of distributed governance as a global system, I study its instantiation in professional communities of the Internet's technical personnel, centralized institutional arrangements, and state and market interests across two different regions: North America, which is relatively central to the global Internet, and South Asia, which is relatively peripheral. This provides the opportunity to perform a comparison between these two cases, to understand at once how distributed governance varies under different conditions, and how different articulations of distributed governance are linked into a single global system of governance. The range of social possibilities within a society are shaped by the model of governance which provides it with order. To understand the nature of the information society, it is essential to understand the mechanisms of distributed governance. Indeed, I argue that the social values of "freedom" and "democracy" which are often ascribed to the Internet are only made possible through distributed governance. (Abstract shortened by UMI.
Structural Parameterizations with Modulator Oblivion
No full textIt is known that problems like Vertex Cover, Feedback Vertex Set and Odd Cycle Transversal are polynomial time solvable in the class of chordal graphs. We consider these problems in a graph that has at most k vertices whose deletion results in a chordal graph when parameterized by k. While this investigation fits naturally into the recent trend of what is called ‘structural parameterizations’, here we assume that the deletion set is not given. One method to solve them is to compute a k-sized or an approximate (f(k) sized, for a function f) chordal vertex deletion set and then use the structural properties of the graph to design an algorithm. This method leads to at least kO(k)nO(1) running time when we use the known parameterized or approximation algorithms for finding a k-sized chordal deletion set on an n vertex graph. In this work, we design 2 O(k)nO(1) time algorithms for these problems. Our algorithms do not compute a chordal vertex deletion set (or even an approximate solution). Instead, we construct a tree decomposition of the given graph in 2 O(k)nO(1) time where each bag is a union of four cliques and O(k) vertices. We then apply standard dynamic programming algorithms over this special tree decomposition. This special tree decomposition can be of independent interest. Our algorithms are, what are sometimes called permissive in the sense that given an integer k, they detect whether the graph has no chordal vertex deletion set of size at most k or output the special tree decomposition and solve the problem. We also show lower bounds for the problems we deal with under the strong exponential time hypothesis. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature
Arthroscopic Biopin Fixation for Paediatric Knee OCD – A Case Report.
Full text linkIntroduction: Osteochondritis dissecans (OCD) represents a significant cause of knee pain and dysfunction in paediatric patients.
Methods: We present a case of successful arthroscopic bioabsorbable pin fixation in a skeletally immature patient with unstable knee OCD.
Result: This minimally invasive approach demonstrated excellent clinical and radiographic outcomes with complete lesion healing at follow-up.
Conclusion: The case illustrates the efficacy of bioabsorbable pin fixation as a preferred treatment modality for unstable juvenile OCD lesions
Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019
No full textChronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly.
© 2025. The Author(s)
A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy
No full textThe Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries
No full textBackground Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. Methods We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1,2017, and Dec 31,2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. Findings The cohort included 4064 children from 149 countries. The median age at diagnosis was 23.2 months (IQR 11.0-36.5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0.8%) of 636 children from high-income countries, 55 (5.4%) of 1027 children from upper-middle-income countries, 342 (19. 7%) of 1738 children from lower-middle-income countries, and 196 (42.9%) of 457 children from low-income countries. Enudeation surgery was available for all children and intravenous chemotherapy was available for 4014 (98.8%) of 4064 children. The 3-year survival rate was 99.5% (95% CI 98.8-100.0) for children from high-income countries, 91.2% (89.5-93.0) for children from upper-middle-income countries, 80.3% (78.3-82.3) for children from lower-middle-income countries, and 57.3% (524-63-0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16.67; 95% CI 4.76-50.00), cT4 advanced tumour compared to cT1 (8.98; 4.44-18.18), and older age at diagnosis in children up to 3 years (1.38 per year; 1.23-1.56). For children aged 3-7 years, the mortality risk decreased slightly (p=0.0104 for the change in slope). Interpretation This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Y
Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019
No full textBackground: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital ( 2022QN38). © 2023 The Author(s
A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy
Full text linkBackground: Hypertrophic cardiomyopathy is the leading cause of sudden cardiac death (SCD) in children and young adults. Our objective was to develop and validate a SCD risk prediction model in pediatric hypertrophic cardiomyopathy to guide SCD prevention strategies. Methods: In an international multicenter observational cohort study, phenotype-positive patients with isolated hypertrophic cardiomyopathy 70% prediction accuracy and incorporates risk factors that are unique to pediatric hypertrophic cardiomyopathy. An individualized risk prediction model has the potential to improve the application of clinical practice guidelines and shared decision making for implantable cardioverter defibrillator insertion. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT0403679
Steering Taste: Ernest Marsh, a study of private collecting in England in the early 20th Century
Full text linkThe primary aim of this thesis is to focus attention on the bourgeois, 'un-named' collector. The driving force behind most museum and art gallery collections of the Victorian and Edwardian period. British museum and art gallery records of gifted collections, bequests and loans usually note their donors. However, with a few notable exceptions, little is known about the collectors, their activities and motivation in making such presentations.
Using the interests and activities of the Quaker miller and collector Ernest Marsh (1843-1945) as a case study, this thesis explores how in the period 1890-1945 a collector came to be a key agent in the construction and manifestation of taste in British Applied Arts and to a lesser degree in the Fine Arts. Through primary visual and documentary evidence of the Marsh home, and reference to contemporary and later commentaries it considers the relative influences of husband and wife on decorating and furnishing the domestic interior, the evolution of taste, and, for Ernest Marsh, its impact upon his artistic interests within the public arena.
By examination of private papers, metropolitan and provincial art gallery and museum archives it also considers evidence of the inter-relationships between donors and curators, and the mutual advantages and disadvantages accruing to both, particularly focussing on the processes in bringing about changes in individual and institutional collecting policy. Further, by review of records of, in particular, the Contemporary Art Society and the Greenslade archive, it examines the degree to which private benefactors and those in public or semi-public office, acting as fund-raisers and spenders exercise influence through patronage of particular practitioners, choice of works and initiating new designs
