Electronic Voting System Using an Enterprise Blockchain

Conventional electronic voting systems use a centralized scheme. A central administration of these systems manages the entire voting process and has partial or total control over the database and the system itself. This creates some problems, accidental or intentional, such as possible manipulation of the database and double voting. Many of these problems have been solved thanks to permissionless blockchain technologies in new voting systems; however, the classic consensus method of such blockchains requires specific computing power during each voting operation. This has a significant impact on power consumption, compromises the efficiency and increases the system latency. However, using a permissioned blockchain improves efficiency and reduces system energy consumption, mainly due to the elimination of the typical consensus protocols used by public blockchains. The use of smart contracts provides a secure mechanism to guarantee the accuracy of the voting result and make the counting procedure public and protected against fraudulent actions, and contributes to preserving the anonymity of the votes. Its adoption in electronic voting systems can help mitigate part of these problems. Therefore, this paper proposes a system that ensures high reliability by applying enterprise blockchain technology to electronic voting, securing the secret ballot. In addition, a flexible network configuration is presented, discussing how the solution addresses some of the security and reliability issues commonly faced by electronic voting system solutions.

A core outcome set for damage control laparotomy via modified Delphi method

ObjectivesDamage control laparotomy (DCL) remains an important tool in the trauma surgeon’s armamentarium. Inconsistency in reporting standards have hindered careful scrutiny of DCL outcomes. We sought to develop a core outcome set (COS) for DCL clinical studies to facilitate future pooling of data via meta-analysis and Bayesian statistics while minimizing reporting bias.MethodsA modified Delphi study was performed using DCL content experts identified through Eastern Association for the Surgery of Trauma (EAST) ‘landmark’ DCL papers and EAST ad hoc COS task force consensus.ResultsOf 28 content experts identified, 20 (71%) participated in round 1, 20/20 (100%) in round 2, and 19/20 (95%) in round 3. Round 1 identified 36 potential COS. Round 2 achieved consensus on 10 core outcomes: mortality, 30-day mortality, fascial closure, days to fascial closure, abdominal complications, major complications requiring reoperation or unplanned re-exploration following closure, gastrointestinal anastomotic leak, secondary intra-abdominal sepsis (including anastomotic leak), enterocutaneous fistula, and 12-month functional outcome. Despite feedback provided between rounds, round 3 achieved no further consensus.ConclusionsThrough an electronic survey-based consensus method, content experts agreed on a core outcome set for damage control laparotomy, which is recommended for future trials in DCL clinical research. Further work is necessary to delineate specific tools and methods for measuring specific outcomes.Level of evidenceV, criteria

A Glance into MTHFR Deficiency at a Molecular Level

MTHFR deficiency still deserves an investigation to associate the phenotype to protein structure variations. To this aim, considering the MTHFR wild type protein structure, with a catalytic and a regulatory domain and taking advantage of state-of-the-art computational tools, we explore the properties of 72 missense variations known to be disease associated. By computing the thermodynamic ΔΔG change according to a consensus method that we recently introduced, we find that 61% of the disease-related variations destabilize the protein, are present both in the catalytic and regulatory domain and correspond to known biochemical deficiencies. The propensity of solvent accessible residues to be involved in protein-protein interaction sites indicates that most of the interacting residues are located in the regulatory domain, and that only three of them, located at the interface of the functional protein homodimer, are both disease-related and destabilizing. Finally, we compute the protein architecture with Hidden Markov Models, one from Pfam for the catalytic domain and the second computed in house for the regulatory domain. We show that patterns of disease-associated, physicochemical variation types, both in the catalytic and regulatory domains, are unique for the MTHFR deficiency when mapped into the protein architecture.

Distributed Finite-Time Consensus Control of Second-Order Multiagent Systems Subject to Communication Time Delay

This paper studies the consensus problem of a second-order multiagent system (MAS) with fixed communication delay under the structure of leaderless and leader-following systems. By using graph theory and finite-time control scheme, a distributed control protocol is proposed for each agent to reach consensus in a finite time. In practical application, the time delay of states is unavoidable, and for this, the consensus method is supposed to be extended to solve the time-delay problem. Thus, a finite-time consensus protocol with communication time delay is proposed in this paper. Compared with the general consensus method, the reliability and convergence speed of the system are increased by using the finite-time control. In addition, the protocol is distributed, and all agents have only local interactions. Finally, the effectiveness of the proposed protocol is verified by two numerical simulations.

The Impact of COVID-19: Perspectives of Recreational Therapists Working with Older Adults

This study explored the perspectives of recreational therapists (RT) from Pennsylvania and Michigan and how COVID-19 has impacted older adults and their roles in various settings. COVID-19 safety restrictions limiting social interaction with both peers and families had the potential for negatively impacting the social and emotional well-being of older adults (Van Orden et al., 2020) and the roles of therapists who work with them. Because peer socialization and physical activity programs prevent falls (Cameron et al., 2018) and improve depressive symptoms (Harvey et al., 2015), a better understanding of COVID-19 impact is significant. From a qualitative viewpoint, 14 RTs from various levels of care were interviewed to better understand their perspective on the impacts of COVID on older adults and their own practice. Hour long interviews conducted via zoom focused on organizational changes, role changes, and impact on older adults. After recordings were transcribed, multiple researchers classified, summarized, and tabulated the data. A consensus method determined common themes. From the RT’s perspective, older adults have not only been negatively impacted in the social domain. While many older adults showed resilience, others were impacted physically, emotionally, and cognitively. Moreover, an increased importance on meaningful engagement, recreation, and leisure emerged. Technology became an essential tool in interpersonal connection. Teamwork, personal self-care, and coping were integral to providing effective care. Post pandemic, RTs are concerned about the challenge of reengaging older adults in groups but are certain that technology will continue to be used in a more expansive way in programs.

Fully Distributed Control for a Class of Uncertain Multi-Agent Systems with a Directed Topology and Unknown State-Dependent Control Coefficients

To address the control of uncertain multi-agent systems (MAS) with completely unknown system nonlinearities and unknown control coefficients, a global consensus method is proposed by constructing novel filters and barrier function-based distributed controllers. The main contributions are as follows. Firstly, a novel two-order filter is designed for each agent to produce informational estimates from the leader, such that a connectivity matrix is not used in the controller's design, solving the difficultly caused by the time-varying control coefficients in a MAS with a directed graph. Secondly, combined with the novel filters, barrier functions are used to construct the distributed controller to deal with the completely unknown system nonlinearities, resulting in the global consensus of the MAS. Finally, it is rigorously proved that the consensus of the MAS is achieved while guaranteeing the prescribed tracking-error performance. Two examples are given to verify the effectiveness of the proposed method, in which the simulation results demonstrate the claims.

Identification of Research Priorities For Suicide Prevention In Nepal: A Delphi Study

Background: Suicide is a significant public health concern in Nepal and there is a need for an evidence-based suicide prevention programme to facilitate stakeholders working towards suicide prevention in Nepal. Collaborative research between stakeholders focussing on shared priorities can help to prevent and control suicide. Hence, we aimed to develop a consensus list of research priorities for suicide prevention in Nepal. Methods: The Delphi expert consensus method was used to elicit the prioritized research questions for suicide prevention in Nepal. Participants comprised suicide prevention experts (psychologists, psychiatrists, psychiatric nurses, researchers and advocates) and people with lived experience. Three rounds of Delphi were conducted; round 1: constituted one to one interview involving open-ended questions used to generate research questions; round 2: ranking of the research questions using a 5-point Likert scale, and round 3: re-ranking of research questions in light of individual and group responses.Results: 42 participants participated in round 1 followed by 38 in round 2 and 39 in round 3. 522 research questions were generated through round 1 which were grouped together and reduced to 33 research questions sent for ranking in round 2. Using a cut off of at least 70% of the panel ranking questions as ‘very important’ or ‘important’, 22 questions were retained. These research questions were sent for re-rating in round 3 generating a final list of prioritized research questions.Conclusions: This is the first expert consensus study to identify the top research priorities for suicide prevention in Nepal and used experts in suicide prevention and those with lived experience. A consensus was reached regarding the research needed to improve suicide data quality, assess the burden and identify factors associated with suicide. A priority-driven approach to suicide prevention research may ensure that the research endeavour provides the most useful information for those whose day-t- day work involves trying to prevent suicide.

Synchronous online nominal group sessions in times of COVID-19: recommendations for researchers based on a Fishbone analysis (Preprint)

BACKGROUND In times of COVID-19, we are challenged to experiment with alternative platforms or software to connect people. In particular, the struggle in health research arose to interact with patients and care professionals. The latter is additionally faced with an extreme workload to fight the pandemic crisis. Creative strategies are developed to continue research among patients and care professionals to improve quality of care. This paper addresses the issue of synchronous online nominal group sessions, a common consensus method used for group brainstorming. OBJECTIVE The purpose of this study is to share our experiences with performing online nominal group sessions using the video conference software Microsoft® Teams. In addition, we aim to create a practical guide with recommendations for researchers. METHODS We critically analysed data collection of online nominal group sessions, according to the Fishbone methodology. RESULTS Performing synchronous online nominal group sessions is challenging but offers opportunities. Although interaction with and among the attendees complicates the process, the major advantage of online sessions is their accessibility and low time investment. The role of the moderators is of major importance and good preparation beforehand is required. Recommendations for future online nominal research were formulated. CONCLUSIONS Online nominal group sessions seem to be a promising alternative for the real-life commonly used technique. Especially during the COVID-19 pandemic, the benefits must be highlighted. More expertise is needed to further refine the practical guide for using digital software in research and to achieve optimal performance.