SCA-Safe Implementation of Modified SaMAL2R Algorithm in FPGA.

Cryptographic algorithms (RSA, DSA, and ECC) use modular exponentiation as part of the principal operation. However, Non-profiled Side Channel Attacks such as Simple Power Analysis and Differential Power Analysis compromise cryptographic algorithms that use such operation. In this work, we present a modification of a modular exponentiation algorithm implemented in programmable devices, such as the Field Programmable Gate Array, for which we use Virtex-6 and Artix-7 evaluation boards. It is shown that this proposal is not vulnerable to the attacks mentioned previously. Further, a comparison was made with other related works, which use the same family of FPGAs. These comparisons show that this proposal not only defeats physical attack but also reduces the number of resources. For instance, the present work reduces the Look-Up Tables by 3550 and the number of Flip-Flops was decreased by 62,583 compared with other works. Besides, the number of memory blocks used is zero in the present work, in contrast with others that use a large number of blocks. Finally, the clock cycles (latency) are compared in different programmable devices to perform operations.

Our 12 year experience with Montgomery T-tube in the management of acute blunt laryngotracheal trauma patients / Nossa experiência de 12 anos com o tubo T de Montgomery no tratamento de pacientes com trauma laringotraqueal contuso agudo

Abstract Introduction The Montgomery T-tube is a device used as a combined tracheal stent and tracheostomy tube to prevent post-operative tracheal stenosis. Objectives The purpose of this retrospective study is to evaluate the outcome following Montgomery T-tube stenting performed in for neck and airway injury in patients with acute blunt laryngotracheal trauma over a period of 12 years. Methods Between 2005 and 2017, 19 patients with acute blunt laryngotracheal trauma underwent Montgomery T-tube stenting. All 19 laryngotracheal trauma patients had undergone a preoperative tracheostomy in the emergency department by an ENT surgeon. Montgomery T-tube stenting was done later through an external approach. The follow up period ranged from 2 to 10 years. The Montgomery T-tube was removed after a period ranging from 6 months to 1½ year. Results The majority of patients in the study were in the age group of 21-30 years. A preoperative tracheostomy was done in all 19 patients. All patients except 3 underwent successful decannulation, and experienced long-term satisfactory result. Conclusion Management of acute blunt laryngotracheal trauma is a challenging problem that demands a multidisciplinary approach. The ideal treatment option should be individualized according to the patient's condition and characteristics of injury. According to our study we suggest that cases of acute blunt laryngotracheal trauma patients should be managed following the protocol as mentioned in our study, and we strongly emphasize that Montgomery T-tube should be left for at least 1 complete year in the airway as it results in negligible chances of post-traumatic stenosis of airway later.

Resumo Introdução O tubo T de Montgomery é um dispositivo usado como stent traqueal combinado com tubo de traqueostomia para evitar estenose traqueal pós-operatória. Objetivo Avaliar o resultado do procedimento cirúrgico feito para lesões no pescoço e nas vias aéreas em pacientes com trauma laringotraqueal contuso agudo e o resultado da colocação do tubo T de Montgomery nesses pacientes por 12 anos. Método Entre 2005 e 2017, 19 pacientes com trauma laringotraqueal contuso agudo foram submetidos ao implante do tubo T de Montgomery. Todos os 19 pacientes com trauma laringotraqueal foram submetidos a uma traqueostomia pré-operatória no pronto-socorro por um cirurgião otorrinolaringologista. O implante do tubo T de Montgomery foi feito posteriormente através de uma abordagem externa. O período de seguimento variou de dois a 10 anos. O tubo T de Montgomery foi removido após um período que variou de seis meses a um ano e meio. Resultados A maioria dos pacientes do estudo estava na faixa de 21 a 30 anos. A traqueostomia pré-operatória foi feita em todos os 19 pacientes. Todos, exceto três, tiveram decanulação bem-sucedida e resultado satisfatório em longo prazo. Conclusão O tratamento do trauma laringotraqueal contuso agudo é um desafio que exige uma abordagem multidisciplinar. A opção de tratamento ideal deve ser individualizada de acordo com a condição do paciente e as características da lesão. De acordo com nosso estudo, sugerimos que os casos de pacientes com trauma laringotraqueal contuso agudo sejam tratados de acordo com o protocolo mencionado em nosso estudo e enfatizamos fortemente que o implante do tubo T de Montgomery deve ser mantido por pelo menos um ano completo nas vias aéreas, pois resulta em chances insignificantes de posterior estenose pós-traumática das vias aéreas.

Our 12 year experience with Montgomery T-tube in the management of acute blunt laryngotracheal trauma patients.

INTRODUCTION: The Montgomery T-tube is a device used as a combined tracheal stent and tracheostomy tube to prevent post-operative tracheal stenosis. OBJECTIVES: The purpose of this retrospective study is to evaluate the outcome following Montgomery T-tube stenting performed in for neck and airway injury in patients with acute blunt laryngotracheal trauma over a period of 12 years. METHODS: Between 2005 and 2017, 19 patients with acute blunt laryngotracheal trauma underwent Montgomery T-tube stenting. All 19 laryngotracheal trauma patients had undergone a preoperative tracheostomy in the emergency department by an ENT surgeon. Montgomery T-tube stenting was done later through an external approach. The follow up period ranged from 2 to 10 years. The Montgomery T-tube was removed after a period ranging from 6 months to 1½ year. RESULTS: The majority of patients in the study were in the age group of 21-30 years. A preoperative tracheostomy was done in all 19 patients. All patients except 3 underwent successful decannulation, and experienced long-term satisfactory result. CONCLUSION: Management of acute blunt laryngotracheal trauma is a challenging problem that demands a multidisciplinary approach. The ideal treatment option should be individualized according to the patient's condition and characteristics of injury. According to our study we suggest that cases of acute blunt laryngotracheal trauma patients should be managed following the protocol as mentioned in our study, and we strongly emphasize that Montgomery T-tube should be left for at least 1 complete year in the airway as it results in negligible chances of post-traumatic stenosis of airway later.

An agency model of consent and the standards of disclosure in health care: Knowing-how to reach respectful shared decisions among real persons.

OBJECTIVE: In this article, we evaluate and compare the frailties of two different standards of disclosure of information regarding the risks of medical procedures applied in recent judicial decisions in the United Kingdom. As an alternative, we present the tenets and philosophical grounds of an agency model of consent and a person-based standard of disclosure. METHODS: Critical philosophical analysis of the background assumptions of two standards of disclosure and their relative "tests of negligence" applied in recent legal judgements in the United Kingdom. RESULTS: Both standards, the "Professional Practice Standard" (the traditional standard employed in Sidaway versus Board of Governors of the Bethlem Royal Hospital, 1985) and the allegedly new "Reasonable Person Standard" (mentioned in Montgomery versus Lanarkshire Health Board, 2015), can lead to malpractice if the medical-patient relationship is not guided by attitudes of respectful care. The traditional standard is disrespectful as it does not take patients as full agents, presupposing that the patient's right is only a negative right to refuse what was deliberated only by the practitioner. The "new" standard can be disrespectful if the practitioner, concerned only with what a hypothetical reasonable individual would take as relevant for choosing between alternatives of treatment, does not know how to respect their real patient in a genuine shared decision-making process. CONCLUSION: We conclude that in order to know how to obtain valid informed consent, doctors need to engage in real conversations with their patients, revealing as much information as they, taken as real persons, need to be part of a genuine shared and respectful decision-making process.

Ultrasound Characteristics of the Hair Follicles and Tracts, Sebaceous Glands, Montgomery Glands, Apocrine Glands, and Arrector Pili Muscles.

OBJECTIVES: To explore the capability of very high-frequency ultrasound (US; 50-71 MHz) to detect the normal morphologic characteristics of the hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles. METHODS: A retrospective study, approved by the Institutional Review Board, evaluated the normal US morphologic characteristics of the hair and adnexal structures in a database of very high-frequency US images extracted from the perilesional or contralateral healthy skin of 1117 consecutive patients who underwent US examinations for localized lesions of the skin and 10 healthy individuals from December 2017 to June 2018. These images were matched with their counterparts from the database of normal histologic images according to the corporal region. The Cohen concordance test and regional mean diameters of the hair follicles and adnexal structures were analyzed. RESULTS: The normal hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles were observed on US images and matched their histological counterparts in all the corporal regions. There was significant US concordance (κ = 0.82; P = .0001) among observers. Regional mean diameters (millimeters) of the hair follicles, sebaceous glands, and apocrine glands are provided. CONCLUSIONS: The hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles are detectable with very high-frequency US, including some regional and anatomic variants. Knowledge of their normal US appearances is a requisite for detecting subclinical changes, understanding the physiopathologic characteristics, and supporting the early diagnosis and management of common dermatologic diseases.