INTRODUCTION:Breathlessness is common and impairs the quality of life of people with idiopathic pulmonary fibrosis (IPF) and non-IPF fibrotic interstitial lung diseases (ILD). We report the findings of a multicentre, fast-track (wait-list), mixed-methods, randomised controlled, feasibility study of a complex breathlessness intervention in breathless IPF and non-IPF fibrotic ILD patients. METHODS:Breathless IPF and non-IPF fibrotic ILD patients were randomised to receive the intervention within 1 week (fast-track) or after 8 weeks (wait-list). The intervention comprised two face-to-face and one telephone appointment during a 3-week period covering breathing control, handheld fan-use, pacing and breathlessness management techniques, and techniques to manage anxiety. Feasibility and clinical outcomes were assessed to inform progression to, and optimal design for, a definitive trial. A qualitative substudy explored barriers and facilitators to trial and intervention delivery. RESULTS:47 patients (M:F 38:9, mean (SD) age 73.9 (7.2)) were randomised with a recruitment rate of 2.5 participants per month across three sites. The adjusted mean differences (95% CI) for key clinical outcomes at 4 weeks post randomisation were as follows: Chronic Respiratory Questionnaire breathlessness mastery domain (0.45 (-0.07, 0.97)); and numerical rating scales for 'worst' (-0.93 (-1.95, 0.10)), 'best' (-0.19 (-1.38, 1.00)), 'distress caused by' (-1.84 (-3.29, -0.39)) and 'ability to cope with' (0.71 (-0.57, 1.99)) breathlessness within the past 24 hours. The qualitative substudy confirmed intervention acceptability and informed feasibility and acceptability of study outcome measures. CONCLUSION:A definitive trial of a complex breathlessness intervention in patients with IPF and non-IPF fibrotic ILD is feasible with preliminary data supporting intervention effectiveness. TRIAL REGISTRATION NUMBER:ISRCTN13784514.

Attack trees and attack graphs are both examples of what one might term attack modelling techniques. The primary purpose of such techniques is to help establish and enumerate the ways in which a system could be compromised; as such, they play a key role in the (security) risk analysis process. Given their role and the consequent need to ensure that they are correct, there are good reasons for capturing such artefacts in a formal manner. We describe such a formal approach, which has been motivated by a desire to model attacks from the perspectives of attackers, to support economic analysis. As an illustration, we consider exploitation cost.

BackgroundInducible laryngeal obstruction (ILO) describes inappropriate laryngeal closure during respiration, with airflow obstruction occurring at the glottic and/or supraglottic level, leading to breathlessness.ObjectiveThere is a paucity of data describing the demographics and impact of ILO. We aimed to report the clinical and demographic features of ILO in individuals entered prospectively in the UK national ILO registry.MethodsData were entered into a Web-based registry from participants with endoscopically confirmed ILO who were attending four established UK-wide specialist ILO centers between March 2017 and November 2019. All patients provided written informed consent.ResultsData from 137 individuals were included. Most (87%) had inspiratory ILO and required provocation during endoscopy to induce symptoms. There was a female predominance (80%), mean age 47 years (SD, 15 years). The most common comorbidities included asthma (68%) and reflux (57%). Health care use was high: 88% had attended emergency health care with symptoms at least once in the previous 12 months and nearly half had been admitted to the hospital. A fifth had required admission to critical care owing to ILO symptoms. Patient morbidity was substantial; 64% reported impaired functional capacity (≥3 on the Medical Research Council Dyspnoea Scale) and a third stated that symptoms affected working capability.ConclusionWe describe the first multicenter prospective characterization of individuals with endoscopically diagnosed ILO. Analysis of our multicenter data set identified ILO as associated with a high burden of morbidity and health care use, comparable to severe asthma. These data will support the development of health care resources in the future and guide research priorities.

In recent years there have been efforts to bring a degree of quantification to the task of security risk analysis. Various arguments in favour of such developments have been offered: 'checklist'- or 'tickbox'-based security is insufficiently dynamic; risk matrices are flawed; quantitative approaches must (somehow) be better than qualitative ones; it makes sense to leverage advances in data science, AI, and machine learning in concert with the increasing abundance of data; there is merit in leveraging lessons from economics. While some notes of caution have been offered in the literature (with data availability and quality being prominent concerns), we argue that greater consideration and recognition of the relationship between risk and uncertainty-and, indeed, unawareness-would be of value to the community. In doing so, we look to recent critiques of the prevailing economics orthodoxy before considering potential sources of possible help.

Cyber security advice is a broad church: it is thematically expansive, comprising expert texts, user-generated data consumed by individual users via informal learning, and much in-between. While there is evidence that cyber security news articles play a role in disseminating cyber security advice, the nature and extent of that role are not clear. We present a corpus of cyber security advice generated from mainstream news articles. The work was driven by two research objectives. The first objective was to ascertain what kind of actionable advice is being disseminated; the second was to explore ways of determining the efficacy potential of news-mediated security advice. The results show an increase in the generation of cyber security news articles, together with increases in vocabulary complexity and reading difficulty. We argue that these could present challenges for vulnerable users. We believe that this corpus and the accompanying analysis have the potential to inform future efforts to quantify and improve the efficacy potential of security advice dissemination.

Journal Article Effect of intravitreal anti-vascular endothelial growth factor treatment for neovascular age-related macular degeneration on renal function Get access James E Neffendorf, James E Neffendorf King's Ophthalmology Research Unit, King's College Hospital, London, UK Correspondence to: James E. Neffendorf; E-mail: james.neffendorf@nhs.net Search for other works by this author on: Oxford Academic PubMed Google Scholar Tracey Mare, Tracey Mare Synnovis, King's College Hospital, London, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Andrew R H Simpson, Andrew R H Simpson King's Ophthalmology Research Unit, King's College Hospital, London, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Cristina Soare, Cristina Soare King's Ophthalmology Research Unit, King's College Hospital, London, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Varo Kirthi, Varo Kirthi King's Ophthalmology Research Unit, King's College Hospital, London, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Claire C Sharpe, Claire C Sharpe Faculty of Life Sciences and Medicine, King's College London, London, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Timothy L Jackson Timothy L Jackson King's Ophthalmology Research Unit, King's College Hospital, London, UKFaculty of Life Sciences and Medicine, King's College London, London, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Nephrology Dialysis Transplantation, Volume 38, Issue 7, July 2023, Pages 1770–1772, https://doi.org/10.1093/ndt/gfad035 Published: 10 February 2023 Article history Received: 05 December 2022 Published: 10 February 2023 Corrected and typeset: 25 April 2023

Introduction Coronavirus disease 2019 (COVID-19) has caused worldwide mass hospitalisation. The need for multidisciplinary post-hospitalisation rehabilitation is becoming increasingly apparent, and telerehabilitation has been endorsed. The aim of study was to investigate the feasibility and efficacy of pulmonary telerehabilitation for COVID-19 survivors. Methods This was a single-centre, mixed-methods, fast-track (wait-list), randomised controlled trial of telerehabilitation for patients who had been hospitalised with COVID-19. 40 patients discharged from two university teaching hospitals in the north of England were recruited. Telerehabilitation consisted of 12 exercise classes, six education events and opportunity for peer support. Patients commenced telerehabilitation 14 days after randomisation in the fast-track group and 56 days after randomisation in the wait-list group. Outcome measures and results Descriptive and statistical improvements were noted in several clinical outcome measures. Exercise capacity increased from a median (interquartile range) 20 (14–24) sit-to-stand repetitions in 1 min at baseline to 25 (24–30) post-telerehabilitation. Breathlessness rated using the Medical Research Council dyspnoea scale changed from 3.5 (3–4) at baseline to 2 (1.5–3) post-telerehabilitation, with additional favourable outcomes noted in respiratory symptoms measured using numerical rating scales and visual analogue scales (VAS). Quality of life measured using the EuroQol VAS improved from 55 (60–70) units at baseline to 70 (55–80) units following telerehabilitation. Improvements in fatigue (modified Functional Assessment of Chronic Illness Therapy: Fatigue) and mood (Hospital Anxiety and Depression Scale – Depression) were also observed. Natural recovery was observed in the wait-list group prior to receiving telerehabilitation; however, improvements were accelerated by early telerehabilitation in the fast-track group. Conclusions We have shown that group-based telerehabilitation is feasible, safe, beneficial and well-received in this population.

Federated learning (FL), a variant of distributed learning (DL), supports the training of a shared model without accessing private data from different sources. Despite its benefits with regard to privacy preservation, FL's distributed nature and privacy constraints make it vulnerable to data poisoning attacks. Existing defenses, primarily designed for DL, are typically not well adapted to FL. In this paper, we study such attacks and defenses. In doing so, we start from the perspective of DL and then give consideration to a real-world FL scenario, with the aim being to explore the requisites of a desirable defense in FL. Our study shows that (i) the batch size used in each training round affects the effectiveness of defenses in DL, (ii) the defenses investigated are somewhat effective and moderately influenced by batch size in FL settings and (iii) the non-IID data makes it more difficult to defend against data poisoning attacks in FL. Based on the findings, we discuss the key challenges and possible directions in defending against such attacks in FL. In addition, we propose detect and suppress the potential outliers(DSPO), a defense against data poisoning attacks in FL scenarios. Our results show that DSPO outperforms other defenses in several cases.

Student expectations are complex constructs that can influence adaptability, engagement, achievement, satisfaction and retention. A number of individual studies have been published on the expectations of students when starting university, however none that synthesise student expectations of teaching and learning. Therefore, the aim of this systematic review was to understand student expectations of teaching and learning when starting university. A systematic search strategy identified 2950 studies, of which nine met all eligibility criteria. Relevant data was extracted and a narrative synthesis conducted, revealing four key themes: additional study, self-managing learning, teaching and learning activities, and accessibility. Students expect to complete additional study and take responsibility for their own learning, but may be unsure how to manage this. They expect to have to attend all sessions and commonly expect lectures, but thoughts on other methods of teaching and learning vary. Students also have high expectations of teaching staff, particularly with regards to access and resources. This knowledge is important in enabling teaching staff to better align preconceived ideas of university teaching and learning with reality, support a positive university experience, and improve satisfaction and retention. Future research should further investigate student expectations of teaching and learning independently, perhaps from a qualitative perspective, as well as exploring interventions to help manage these expectations when necessary.

PURPOSE:To demonstrate MR T1 mapping in vivo as a method to non-invasively estimate vitreous oxygen concentration in ischemic eye disease. METHODS:Patients with ischemic eye disease (central retinal vein occlusion, ocular ischemic syndrome, and proliferative diabetic retinopathy) were prospectively recruited. MRI was performed on each patient before any treatment, with T1 mapping acquired using an inversion recovery TrueFISP sequence at several inversion times, from a single slice positioned through the center of both eyes in the axial oblique plane. A phantom study measuring seven different concentrations of vitronectin, a protein released in ischemic eye disease, was undertaken to determine its potential confounding effect on T1 . RESULTS:Ten participants were recruited (eight central retinal vein occlusion, one ocular ischemic syndrome, and one proliferative diabetic retinopathy). Of the eight central retinal vein occlusion cases, there was a statistically different vitreous T1 in the diseased eye compared to the healthy control eye (4.306 vs. 4.518 s, p = 0.008). T1 times did not significantly alter across the range of vitronectin concentrations. CONCLUSIONS:Ischemic eye disease decreases vitreous T1 , potentially implying an increase in vitreous partial pressure of oxygen (pO2 ) concentration given what is known from the relationship between 1/T1 and pO2 . Potential theories for this unexpected result are discussed. This study provides further data on this technique, with potential clinical application in eye disease.

Bug bounty programmes and vulnerability disclosure programmes, collectively referred to as Coordinated Vulnerability Disclosure (CVD) programmes, open up an organisation’s assets to the inquisitive gaze of (often eager) white-hat hackers. Motivated by the question What information do organisations convey to hackers through public CVD policy documents? , we aim to better understand the information available to hackers wishing to participate in the search for vulnerabilities. As such, in this article we consider three key issues. First, to address the differences in the legal language communicated to hackers, it is necessary to understand the formal constraints by which hackers must abide. Second, it is beneficial to understand the variation that exists in the informal constraints that are communicated to hackers through a variety of institutional elements. Third, for organisations wishing to better understand the commonplace elements that form current policy documents, we offer broad analysis of the components frequently included therein and identify gaps in programme policies. We report the results of a quantitative study, leveraging deep learning based natural language processing models, providing insights into the policy documents that accompany the CVD programmes of thousands of organisations, covering both stand-alone programmes and those hosted on 13 bug bounty programmes. We found that organisations often inadequately convey the formal constraints that are applicable to hackers, requiring hackers to have a deep understanding of the laws that underpin safe and legal security research. Furthermore, a lack of standardisation across similar policy components is prevalent, and may lead to a decreased understanding of the informal constraints placed upon hackers when searching for and disclosing vulnerabilities. Analysis of the institutional elements included in the policy documents of organisations reveals insufficient inclusion of many key components. Namely, legal information and information pertaining to restrictions on the backgrounds of hackers is found to be absent in a majority of policies analysed. Finally, to assist ongoing research, we provide novel annotated policy datasets that include human-labelled annotations at both the sentence and paragraph level, covering a broad range of CVD programme backgrounds.

Exercise is one of the most commonly reported symptom triggers for people with asthma. However, a growing body of evidence indicates that regular exercise and physical activity are associated with improved clinical and patient reported outcomes. In this article, we summarise and consolidate recent original studies evaluating exercise and physical activity profiles in people with asthma and provide an up-to-date perspective concerning the role of exercise training and physical activity promotion in the context of asthma management. To conclude, we identify key unmet needs and provide directions for future research.

PURPOSE The aim of this qualitative study was to explore the views of participants of a group-based, supervised, telerehabilitation programme, following discharge from hospital with Covid-19. This study was part of a single-centre, fast-track (wait-list), randomised, mixed-methods, feasibility trial of telerehabilitation (Registration: Clinicaltrials.gov reference:285205). METHODS Semi-structured interviews were conducted over a virtual teleconference platform with 10 participants who took part in a telerehabilitation programme following Covid-19 after discharge from an acute hospital. Data were transcribed verbatim and analysed using thematic analysis. RESULTS Five themes were important from the participant perspective: telerehabilitation programme as part of the Covid-19 journey; the telerehabilitation programme design and delivery; peer aspects; the role of the instructor; and the role of technology and online delivery. CONCLUSIONS Overall, the telerehabilitation programme was a positive experience for participants. The instructors were central to this positive view as was the group nature of the programme. The group aspect was particularly important in supporting the broader perceived wellbeing gains, such as the sense of enjoyment and reduced social isolation. Several participants would have liked to have continued with the exercises beyond the six-week intervention indicating that the programme could be a way to help people sustain a physically active lifestyle.IMPLICATIONS FOR REHABILITATIONParticipants who were recovering from Covid-19 following hospital admission perceived the telerehabilitation to be a positive experience overall.The group aspect of the telerehabilitation programme was important in supporting the broader perceived wellbeing gains such as the sense of enjoyment and reduced social isolation.Telerehabilitation programmes for Covid-19 may need to include pathways for participants to continue to engage in exercise beyond the time-limited six-week intervention to support ongoing self-management.

While specific aesthetic philosophies may differ across cultures, all human societies have used aesthetics to support communication and learning. Within the fields of usability and usable security, aesthetics have been deployed for such diverse purposes as enhancing students' e-learning experiences and optimising user interface design. In this paper, we seek to understand how individual users perceive the visual assets that accompany cyber security information, and how these visual assets and user perceptions underwrite a distinct \emph{cyber security aesthetic}. We ask, (1) What constitutes cyber security aesthetics, from the perspective of an individual user? and (2) How might these aesthetics affect users' perceived self-efficacy as they informally learn cyber security precepts? To begin answering these questions, we compile an image-set from cyber security web articles and analyse the distinct visual properties and sentiments of these images.

Data protection legislation, such as the EU’s General Data Protection Regulation (GDPR), obliges data controllers to address risks to personal data. Risk assessment rules for data protection stipulate taking into account instances where the processing of personal data may affect other rights of the individual. It is acknowledged that engineering systems in order to address all risks is challenging and there is a need for prioritisation of risks. Previously decided decisions regarding personal data may provide insight to facilitate this. To this end, we ask: (i) in what context has data protection legislation been invoked in courts? and (ii) what other legal concerns were affected by these cases? To answer these questions, we use structural topic modelling (STM) to extract topics from the case judgements related to the United Kingdom’s Data Protection Act, incorporating covariate information related to the case outcomes, such as court type and year. The outputs of the model can be utilised to provide topics which relate to context; they can also examine how the other associated variables relate to the resultant topics. We demonstrate the utility of unsupervised text clustering for context and risk identification in legal texts. In our application, we find that STM provides clear topics and allows for the analysis of trends regarding the topics, clearly showing where data protection issues succeed and fail in courts.

Background: Tele-rehabilitation has been proposed as a post-hospitalisation rehabilitation pathway for Covid-19 survivors, however patients' willingness and ability to engage with this online intervention remains unknown.Objectives: The aim of this study is to determine the feasibility of tele-rehabilitation in this population, specifically with regards to recruitment, intervention acceptability and adherence, data quality and primary outcome measure selection.Methods: A protocol for a single centre, fast-track (wait-list), randomised mixed-methods, feasibility trial of tele-rehabilitation for patients that have been hospitalised with Covid-19 is presented. The tele-rehabilitation programme is based on pulmonary rehabilitation principles and will encompass an initial assessment followed by twice-weekly exercise classes and education sessions for 6 weeks. Six educational sessions on the topics of rehabilitation from Covid-19; coping with breathlessness; exercise; nutrition; return to work; and fatigue management will be delivered by a multi-disciplinary team of healthcare professionals. A series of feasibility, clinical and safety outcomes will be quantitively described and patient experiences and opinions explored using thematic analysis of semi-structured interviews.Discussion: We anticipate that results from the study will inform a multi-centre randomised controlled trial for post-Covid-19 tele-rehabilitation and the results from the qualitative analysis may provide guidance to improve participant experience.

A necessary step in conducting offensive cyber operations is developing or acquiring an exploit, i.e., a means for taking advantage of a software vulnerability or security deficiency. While these can be developed within government agencies, they can also be procured from private actors. Studying these private markets present an opportunity to understand offensive cyber operations, especially as markets break from the secretive culture of intelligence agencies. This article provides novel evidence of such opportunities by collecting data in the form of the prices quoted by an exploit broker who claims to sell to governments. We find exploit price inflation of 44% per annum, and higher prices for exploits targeting mobile devices relative to desktop devices. Ex-ploits requiring additional capabilities like physical access to the device are quoted at a discount, and no-click remote access vulnerabilities carry a heavy premium. The broker does not quote prices for any exploits that specifically target industrial control systems or IoT devices. We conclude by discussing how these results inform the future of offensive cyber.

As the adoption and diversity of threat intelligence solutions continue to grow, questions about their effectiveness, particularly in regards to the quality of the data they provide, remain unanswered. Several studies have highlighted data quality issues as one of the most common barriers to effective threat intelligence sharing. Furthermore, research and practice lack a common understanding of the expected quality of threat intelligence. To investigate these issues, our research utilised a systematic literature review followed by a modified Delphi study that involved 30 threat intelligence experts in Europe. We identified a set of threat intelligence quality dimensions along with revised definitions for threat data, information, and intelligence.

Bug bounty programmes employ the skills and curiosity of independent security researchers (hackers) to support pre- and postdeployment security. Driven by the question How effective are bug bounty platforms at retaining the interest of hackers?, this paper aims to address two issues concerning hackers' behaviour. First, to resolve the information asymmetry between programme and platform operators, it is necessary to measure the number of active hackers on a platform. Second, to assist programme operators' understanding, we identify the archetypal behaviours of hackers across a platform. We found that 6,813 hackers (with public accounts) have successfully submitted at least one vulnerability report on Bugcrowd. Of these, approximately 45% (with an account age greater than 9 months) can be considered inactive. We conclude that a significant number of inactive and unproductive hackers may contribute, in part, to the difficulties faced by programme operators. In particular, difficulties in retaining the focus of hackers can lead to underwhelming returns from the resources invested.

0-day brokers are market makers who serve both adversaries seeking to exploit computer systems and researchers who develop the means to do so. This involves searching for buyers/sellers, negotiating prices and con-tracts, and monitoring the contract. In this paper we characterise the search aspect of 0-day broking. We extracted longitudinal data on two brokers who list prices on a public website and then plotted how the price of different types of exploit and targeted systems changed over time. As the data is not updated sufficiently regularly or frequently to build a time-series model, we conducted a regression analysis of the most recent snapshot of prices. The results suggest that properties of the exploit (e.g. the functionality it achieves) provide the most explanatory power, and that the system targeted by the exploit provides less explanatory power. We compare the price of exploit to three metrics (number of CVEs, detected 0-days, and user base) over time. Finally, we discuss what inferences we can make about systems security and the operations of adversaries, hy-pothesising a trade-off between secrecy and the competitiveness of the supply-side. 0-day brokers who publicly advertise prices offer cheap exploits but little secrecy. This paper will be presented at the 21 st Workshop on the Economics of Information Security (WEIS’22) in Tulsa, Oklahoma, USA.