Many important cryptographic primitives offer probabilistic guarantees of\nsecurity that can be specified as quantitative hyperproperties; these are\nspecifications that stipulate the existence of a certain number of traces in\nthe system satisfying certain constraints. Verification of such hyperproperties\nis extremely challenging because they involve simultaneous reasoning about an\nunbounded number of different traces. In this paper, we introduce a technique\nfor verification of quantitative hyperproperties based on the notion of trace\nenumeration relations. These relations allow us to reduce the problem of\ntrace-counting into one of model-counting of formulas in first-order logic. We\nalso introduce a set of inference rules for machine-checked reasoning about the\nnumber of satisfying solutions to first-order formulas (aka model counting).\nPutting these two components together enables semi-automated verification of\nquantitative hyperproperties on infinite state systems. We use our methodology\nto prove confidentiality of access patterns in Path ORAMs of unbounded size,\nsoundness of a simple interactive zero-knowledge proof protocol as well as\nother applications of quantitative hyperproperties studied in past work.\n
In this article, we propose the first self-tallying decentralized e-voting protocol for a ranked-choice voting system based on Borda count. Our protocol does not need any trusted setup or tallying authority to compute the tally. The voters interact through a publicly accessible bulletin board for executing the protocol in a way that is publicly verifiable. Our main protocol consists of two rounds. In the first round, the voters publish their public keys, and in the second round they publish their randomized ballots. All voters provide Non-interactive Zero-Knowledge (NIZK) proofs to show that they have been following the protocol specification honestly without revealing their secret votes. At the end of the election, anyone including a third-party observer will be able to compute the tally without needing any tallying authority. We provide security proofs to show that our protocol guarantees the maximum privacy for each voter. We have implemented our protocol using Ethereum's blockchain as a public bulletin board to record voting operations as publicly verifiable transactions. The experimental data obtained from our tests show the protocol's potential for the real-world deployment.
Alexandros Bampoulidis, A. Bruni, Lukas Helminger, Daniel Kales · 6 authors
Recent work has shown that cell phone mobility data has the unique potential to create accurate models for human mobility and consequently the spread of infected diseases [74]. While prior studies have exclusively relied on a mobile network operator’s subscribers’ aggregated data in modelling disease dynamics, it may be preferable to contemplate aggregated mobility data of infected individuals only. Clearly, naively linking mobile phone data with health records would violate privacy by either allowing to track mobility patterns of infected individuals, leak information on who is infected, or both. This work aims to develop a solution that reports the aggregated mobile phone location data of infected individuals while still maintaining compliance with privacy expectations. To achieve privacy, we use homomorphic encryption, validation techniques derived from zero-knowledge proofs, and differential privacy. Our protocol’s open-source implementation can process eight million subscribers in 70 minutes.
Alexandros Bampoulidis, A. Bruni, Lukas Helminger, Daniel Kales · 6 authors
Recent work has shown that cell phone mobility data has the unique potential\nto create accurate models for human mobility and consequently the spread of\ninfected diseases. While prior studies have exclusively relied on a mobile\nnetwork operator's subscribers' aggregated data in modelling disease dynamics,\nit may be preferable to contemplate aggregated mobility data of infected\nindividuals only. Clearly, naively linking mobile phone data with health\nrecords would violate privacy by either allowing to track mobility patterns of\ninfected individuals, leak information on who is infected, or both. This work\naims to develop a solution that reports the aggregated mobile phone location\ndata of infected individuals while still maintaining compliance with privacy\nexpectations. To achieve privacy, we use homomorphic encryption, validation\ntechniques derived from zero-knowledge proofs, and differential privacy. Our\nprotocol's open-source implementation can process eight million subscribers in\n70 minutes.\n
Sean Bowe, Alessandro Chiesa, Matthew Green, Ian Miers · 6 authors
Ledger-based systems that support rich applications often suffer from two limitations. First, validating a transaction requires re-executing the state transition that it attests to. Second, transactions not only reveal which application had a state transition but also reveal the application's internal state.We design, implement, and evaluate ZEXE, a ledger-based system where users can execute offline computations and subsequently produce transactions, attesting to the correctness of these computations, that satisfy two main properties. First, transactions hide all information about the offline computations. Second, transactions can be validated in constant time by anyone, regardless of the offline computation.The core of ZEXE is a construction for a new cryptographic primitive that we introduce, decentralized private computation (DPC) schemes. In order to achieve an efficient implementation of our construction, we leverage tools in the area of cryptographic proofs, including succinct zero knowledge proofs and recursive proof composition. Overall, transactions in ZEXE are 968 bytes regardless of the offline computation, and generating them takes less than 1min plus a time that grows with the offline computation.We demonstrate how to use ZEXE to realize privacy-preserving analogues of popular applications: private user-defined assets and private decentralized exchanges for these assets.
Jiaheng Zhang, Tiancheng Xie, Yupeng Zhang, Dawn Song
We present a new succinct zero knowledge argument scheme for layered arithmetic circuits without trusted setup. The prover time is O(C + nlogn) and the proof size is O(D logC +log2n) for a D-depth circuit with n inputs and C gates. The verification time is also succinct, O(D logC + log2n), if the circuit is structured. Our scheme only uses lightweight cryptographic primitives such as collision-resistant hash functions and is plausibly post-quantum secure. We implement a zero knowledge argument system, Virgo, based on our new scheme and compare its performance to existing schemes. Experiments show that it only takes 53 seconds to generate a proof for a circuit computing a Merkle tree with 256 leaves, at least an order of magnitude faster than all other succinct zero knowledge argument schemes. The verification time is 50ms, and the proof size is 253KB, both competitive to existing systems.Underlying Virgo is a new transparent zero knowledge verifiable polynomial delegation scheme with logarithmic proof size and verification time. The scheme is in the interactive oracle proof model and may be of independent interest.
The paper deals with the concept of homomorphic encryption and the possibility of its use in the mechanism of electronic voting. One of the problematic requirements for electronic voting systems is voter anonymity. On the one hand, each voter must be identified, and on the other, the content of his or her vote must be unknown. Currently, the methods and mechanisms used in real voting systems do not provide real anonymity. Therefore, both theoretical and practical content is an urgent and necessary problem of developing mechanisms for anonymous counting of votes with the protection of their distortion. The paper also provides a general analysis of the security level of prospective homomorphic encryption schemes. The essence of homomorphic encryption is that there is some set of operations whose result of executing over ciphertexts (with subsequent decryption) coincides with similar actions over plaintexts. Homomorphic encryption allows you to perform some calculations on information without having access to the information itself. However, there are a number of problems when trying to apply such calculations. The main ones are the choice of the method of asymmetric encryption, which provides the necessary cryptographic stability from both classical and quantum attacks, the identification of possible candidates for asymmetric cryptotransformations in homomorphic encryption, their evaluation of comparison with each other, and, of course, the choice of the most rational for a given multiple restrictions. The asymmetric schemes of homomorphic encryption are compared using the hierarchy analysis process. The method of asymmetric encryption with zero knowledge is substantiated. The objective of this article is to substantiate the possibilities, conditions, and constraints on the use of standardized asymmetric cryptotransformations in the creation of modern homomorphic encryption-type transformations, when anonymity of electronic voting and practical implementation of anonymous voting based on proof of zero knowledge must be guaranteed.
Securing the traceability of products in the supply chain is an urgent issue. Recently, supply chain systems that use public blockchain (PBC) have been proposed. In these systems, PBC is used as a common database shared between supply chain parties to secure the integrity and reliability of distribution information such as ownership transfer records. Thus, these systems secure a high level of traceability in the supply chain. However, the distribution information, which can be private information, is made public since the information recorded in PBC can be read by anyone. In this paper, we propose a method for preserving privacy while securing traceability in a supply chain system using PBC. The proposed method preserves privacy by concealing the distribution information via encryption. In addition, the proposed method ensures distribution among legitimate supply chain parties while concealing their blockchain address by using a zero-knowledge proof to prove their authenticity. We implement the proposed method on Ethereum smart contracts and evaluate cost performance based on transaction fees. The results show that the fee per party is at most 2.6 USD.
Resource constraints have prevented comprehensive cryptography and multifactor authentication in numerous Internet of Things (IoT) connectivity scenarios. Existing IoT systems generally adopt lightweight security protocols that lead to compromise and privacy leakage. Edge computing enables better access control and privacy protection, furthermore, blockchain architecture has achieved a trusted store of value by open-source and distributed consensus mechanisms. To embrace these new paradigms, we propose a scheme that employs one-time association multitasking proofs for peer to local authentication (OTMP-P2L). The scheme chooses relevant nondeterministic polynomial (NP) problem tasks, and manages localized trust and anonymity by using smart devices such as phones and pads, thereby enabling IoT devices to autonomously perform consensus validation with an enhanced message authentication code. This nested code is a one-time zero-knowledge proof that comprises multiple logic verification arguments. To increase diversity and reduce the workload of each one, these arguments are chained by a method that establishes some of the inputs of the following task from the output of previous tasks. We implemented a smart lock system and confirmed that the scheme outperforms IoT authentication methods. The result demonstrates superior flexibility through dynamic difficulty strategies and succinct non-interactive peer-to-peer (P2P) verification.
Xun Yi, Russell Paulet, Elisa Bertino, Fang-Yu Rao
In this paper we consider the problem where a client wishes to subscribe to some product or service provided by a server, but maintain their anonymity. At the same time, the server must be able to authenticate the client as a genuine user and be able to discontinue (or revoke) the client's access if the subscription fees are not paid. Current solutions for this problem are typically constructed using some combination of blind signature or zero-knowledge proof techniques, which do not directly support client revocation (that is, revoking a user before expiry of their secret value). In this paper, we present a solution for this problem on the basis of the broadcast encryption scheme, suggested by Boneh et al., by which the server can broadcast a secret to a group of legitimate clients. Our solution allows the registered client to log into the server anonymously and also supports client revocation by the server. Our solution can be used in many applications, such as location-based queries. We formally define a model for our anonymous subscription protocol and prove the security of our solution under this model. In addition, we present experimental results from an implementation of our protocol. These experimental results demonstrate that our protocol is practical.
A key communication technology in smart cities and smart buildings for automation is RFID. Proving the simultaneous presence of a group of RFID-tagged objects is a practical need in many application areas within this domain. Some examples of this include vehicle fleets, smart parking, safety in public places (smart cities), security and access control (smart buildings), and asset location (supply chain system, health care industry). Security, privacy, and efficiency are central issues when designing such a grouping-proof protocol. This work is motivated by Sundaresan et al.'s grouping-proof protocol, which applies zero-knowledge techniques. In this paper, we propose a lightweight, offline, serial-dependency grouping-proof protocol. Compared to existing grouping-proof protocols, our scheme improves on efficiency, scalability, security, and communication cost. It resists well-known attacks on grouping-proofs including tag/reader impersonation, tracking, replay, desynchronization, and message integrity.
With the development of precise positioning technology, a growing number of location-based services (LBS) emerge. For example, visit a specific place to get the corresponding reward. This also leads to location fraud by illegal users in order to gain benefits. Thus, it is necessary to verify location certificates provided by users. However, present proof of location systems are deficient in verifying users’ location certificates while protecting users’ privacy. Users do not flexibly control their location certificates either. Based on blockchain, a kind of distributed proof of location system architecture was proposed and based on the proposed system architecture, a kind of proof of location protocol with zero-knowledge proof was proposed further. With the proposed architecture and the protocol, the proposed proof of location system allows users to freely select disclosed certificate parameters and positional accuracy according to their needs so that hierarchical location privacy protection was achieved.
Hanumantharaju R, K. N. Shreenath, K. G. Srinivasa, Swetha Namburu
Mobile edge computing is a recent trend to complement the Internet of Things (IoT) ecosystem in the computing sector. IoT is the internet connected communications related to physical devices and everyday objects. The emergence of intelligent living spaces has been due to the rapid development of IoT technologies. Blockchain is one such technology that expands the list of information also referred to like records that are saved as blocks in the Blockchain which are connected using cryptographic algorithms. Within a Blockchain IoT environment, when data or device authentication information is stored in a Blockchain, authentication information can be displayed when verifying Block chain’s transactions, which are also referred to as proof of work. A principle of Zero-knowledge proof (ZKF) is implemented in this paper which is a way of proving that knowledge is known without exposing any data to the user. The proposed model uses a Mobile application where users can prove without revealing users' passwords. Blockchain stores client information that can prevent data from being manipulated. The results of applying the ZKF theory for data security are shown through a web application and NFC.
Lei Xu, Lin Chen, Zhimin Gao, Keshav Kasichainula · 7 authors
Bitcoin introduces a new type of cryptocurrency that does not rely on a central system to maintain transactions. Inspired by the success of Bitcoin, all types of alt cryptocurrencies were invented in recent years. Some of the new cryptocurrencies focus on privacy enhancement, where transaction information such as value and sender/receiver identity can be hidden, such as Zcash and Monero. However, there are few schemes to support multiple types of cryptocurrencies/assets and offer privacy enhancement at the same time. The major challenge for a multiple asset system is that it needs to support two-way assets exchange between participants besides one-way asset transfer. Thus, we propose a privacy-preserving exchange scheme, PrivateEx, which preserves the privacy of the exchange of different assets. PrivateEx utilizes zero-knowledge proof and a novel way to "lock" assets involved in the exchange to guarantee the correctness, fairness, and privacy of exchange of assets in the system. We also implement a prototype of PrivateEx and evaluate its performance to show that it is practical with modern computers.
Financial Technology (FinTech) has transformed Capital Markets, Payments, Lending and Risk Management through faster processing of financial decisions in real-time and expanding access to financial services digitally. Beneath these user-friendly applications, FinTech platforms rely on foundational Data Structures and Algorithms to provide consistent Latency, Scalable Throughput, Auditing capabilities, and Resilience under adversarial conditions. The purpose of this paper is to review which core Data Structures (Arrays, Linked Lists, Hash Tables, Balanced Trees, Heaps and Graphs) are used to support key FinTech Workload applications (Algorithmic Trading, Fraud Detection, Credit Risk Assessment and Blockchain-based Recordkeeping). In addition, this paper will review the Algorithmic Foundations used to enable common tasks across all these workload applications including Sorting/Searching, Optimization, Statistical Learning and Cryptography, and how Asymptotic Complexity must be evaluated with respect to practical system constraints including Caching Behavior, Concurrency and Failure Modes. There is evidence from the academic literature that Algorithmic Trading can increase liquidity in certain Market Structures while also introducing Systemic Fragility during Stress [1],[2],[3]. And, similarly, there is evidence that Fraud Detection is an inherently adversarial domain where Models and Features must evolve as Attacker Behavior evolves [4],[5]. Lastly, the Paper will discuss several open challenges associated with Scale, Security, Model Governance and Privacy; and evaluate Future-Facing Directions such as Privacy-Preserving Analytics (Federated Learning and Zero-Knowledge Proofs) and Cryptographic Agility to prepare for post-Quantum risk.
The posthoc verification protocol [J. F. Fitzsimons, M. Hajdu{\v s}ek, and T. Morimae, Physical Review Letters {\bf120}, 040501 (2018)] enables an information-theoretically-sound non-interactive verification of quantum computing, but the message from the prover to the verifier is quantum and the verifier has to do single-qubit measurements. The Mahadev protocol removes these quantum parts, but the soundness becomes the computational one. In this paper, we construct an information-theoretically-sound non-interactive classical verification protocol for quantum computing with a trusted center. The trusted center sends random BB84 states to the prover, and the classical descriptions of these BB84 states to the verifier. The messages from the center to the prover and the verifier are independent of the instance. By slightly modifying our protocol, we also construct a non-interactive statistical zero-knowledge proof system for QMA with the trusted center.
With the rapid popularity of blockchain, decentralized human intelligence tasks (HITs) are proposed to crowdsource human knowledge without relying on vulnerable third-party platforms. However, the inherent limits of blockchain cause decentralized HITs to face a few "new" challenges. For example, the confidentiality of solicited data turns out to be the sine qua non, though it was an arguably dispensable property in the centralized setting. To ensure the "new" requirement of data privacy, existing decentralized HITs use generic zero-knowledge proof frameworks (e.g. SNARK), but scarcely perform well in practice, due to the inherently expensive cost of generality. We present a practical decentralized protocol for HITs, which also achieves the fairness between requesters and workers. At the core of our contributions, we avoid the powerful yet highly-costly generic zk-proof tools and propose a special-purpose scheme to prove the quality of encrypted data. By various non-trivial statement reformations, proving the quality of encrypted data is reduced to efficient verifiable decryption, thus making decentralized HITs practical. Along the way, we rigorously define the ideal functionality of decentralized HITs and then prove the security due to the ideal-real paradigm. We further instantiate our protocol to implement a system called Dragoon, an instance of which is deployed atop Ethereum to facilitate an image annotation task used by ImageNet. Our evaluations demonstrate its practicality: the on-chain handling cost of Dragoon is even less than the handling fee of Amazon's Mechanical Turk for the same ImageNet HIT.
Secret sharing has been study for many years and has had a number of real-word applications. There are several methods to construct the secret-sharing schemes. One of them is based on coding theory. In this work, we construct a secret-sharing scheme that realizes an access structure by using linear codes, in which any element of the access structure can reconstruct the secret key. We prove that our scheme is a multiprover zero-knowledge proof system in the random oracle model, which shows that a passive adversary gains no information about the secret key. Our scheme is also a leakage-resilient secret-sharing scheme (LRSS) in the bounded-leakage model, which remain provably secure even if the adversary learns a bounded amount of leakage information about their secret key. As an application, we propose a new group identification protocol (GID-scheme) from our LRSS. We prove that our GID-scheme is a leakage-resilient scheme. In our leakage-resilient GID-scheme, the verifier believes the validity of qualified group members and tolerates l bits of adversarial leakage in the distribution protocol, whereas for unqualified group members, the verifier cannot believe their valid identifications in the proof protocol.
Decentralized marketplace applications demand fast, cheap and easy-to-use cryptocurrency payment mechanisms to facilitate high transaction volumes. The standard solution for off-chain payments, state channels, are optimized for frequent transactions between two entities and impose prohibitive liquidity and capital requirements on payment senders for marketplace transactions. We propose PayPlace, a scalable off-chain protocol for payments between consumers and sellers. Using PayPlace, consumers establish a virtual unidirectional payment channel with an intermediary operator to pay for their transactions. Unlike state channels, however, the PayPlace operator can reference the custodial funds accrued off-chain in these channels to in-turn make tamper-proof off-chain payments to merchants, without locking up corresponding capital in channels with merchants. Our design ensures that new payments made to merchants are guaranteed to be safe once notarized and provably mitigates well-known drawbacks in previous constructions like the data availability attack and ensures that neither consumers nor merchants need to be online to ensure continued safety of their notarized funds. We show that the on-chain monetary and computational costs for PayPlace is O(1) in the number of payment transactions processed, and is near-constant in other parameters in most scenarios. PayPlace can hence scale the payment throughput for large-scale marketplaces at no marginal cost and is orders of magnitude cheaper than the state-of-art solution for non-pairwise off-chain payments, Zero Knowledge Rollups.
We consider the zero-range process with arbitrary bounded monotone rates on the complete graph, in the regime where the number of sites diverges while the density of particles per site converges. We determine the asymptotics of the mixing time from any initial configuration, and establish the cutoff phenomenon. The intuitive picture is that the system separates into a slowly evolving solid phase and a quickly relaxing liquid phase: as time passes, the solid phase dissolves into the liquid phase, and the mixing time is essentially the time at which the system becomes completely liquid. Our proof uses the path coupling technique of Bubley and Dyer, and the analysis of a suitable hydrodynamic limit. To the best of our knowledge, even the order of magnitude of the mixing time was unknown, except in the special case of constant rates.
Di Wang, Xiangyu Guo, Chaowen Guan, Shi Li · 5 authors
Recently, many machine learning and statistical models such as non-linear regressions, the Single Index, Multi-index, Varying Coefficient Index Models and Two-layer Neural Networks can be reduced to or be seen as a special case of a new model which is called the \textit{Stochastic Linear Combination of Non-linear Regressions} model. However, due to the high non-convexity of the problem, there is no previous work study how to estimate the model. In this paper, we provide the first study on how to estimate the model efficiently and scalably. Specifically, we first show that with some mild assumptions, if the variate vector $x$ is multivariate Gaussian, then there is an algorithm whose output vectors have $\ell_2$-norm estimation errors of $O(\sqrt{\frac{p}{n}})$ with high probability, where $p$ is the dimension of $x$ and $n$ is the number of samples. The key idea of the proof is based on an observation motived by the Stein's lemma. Then we extend our result to the case where $x$ is bounded and sub-Gaussian using the zero-bias transformation, which could be seen as a generalization of the classic Stein's lemma. We also show that with some additional assumptions there is an algorithm whose output vectors have $\ell_\infty$-norm estimation errors of $O(\frac{1}{\sqrt{p}}+\sqrt{\frac{p}{n}})$ with high probability. We also provide a concrete example to show that there exists some link function which satisfies the previous assumptions. Finally, for both Gaussian and sub-Gaussian cases we propose a faster sub-sampling based algorithm and show that when the sub-sample sizes are large enough then the estimation errors will not be sacrificed by too much. Experiments for both cases support our theoretical results. To the best of our knowledge, this is the first work that studies and provides theoretical guarantees for the stochastic linear combination of non-linear regressions model.
Lloyd W. Klein, James A. Goldstein, David E. Haines, Charles E. Chambers · 8 authors
Renewed attention has focused on the occupational health hazards posed by working in the fluoroscopic laboratory.1-6 Accumulated occupational radiation exposure is associated with health risks to physicians, nurses, and technologists working in this environment. Health care workers are subject to insidious health effects of radiation exposure over many years. Adverse effects include the established predilection to posterior subcapsular cataracts, as well as worrisome signals of lifetime risks of cancer induction, particularly in the unprotected brain.7-12 A further consequence is the extensively documented incidence of orthopedic illnesses reported in physicians as well as nurses and technologists and injuries linked to the cumulative burden of bearing the weight of only partly protective lead aprons mandatory to reduce radiation risk.13-16 The increased volume and complexity of procedures, together with the physical stresses inherent in procedural performance, have exacerbated the prevalence and magnitude of such orthopedic injuries.17 The high prevalence of orthopedic afflictions not only affects individual health but also could be potential career ending, with workforce implications for both the profession as well as for society.15 Advances in interventional imaging techniques and treatments over the last three decades have achieved significant success with clear benefits to our patients18; yet protective measures for workers have unfortunately lagged the pace, magnitude, and impact of this therapeutic progress. The purpose of this position statement is to review the data documenting occupational health injuries, summarize current equipment and processes that can be widely applied to optimize protection, emphasize the importance of investment by hospitals and health systems in protective equipment established to enhance workplace safety, examine barriers that need to be overcome to spur advances to enhance the occupational safety of the fluoroscopic laboratory environment, and propose enhanced advocacy for innovation. Future processes and proposals to improve the fluoroscopic laboratory environment should be based on the following precepts: (a) there is ample clinical data documenting the prevalence of serious occupational health risks engendered by the fluoroscopic laboratory environment; (b) sufficient attention to these occupational health issues has been drawn in annual meetings and published clinical scientific studies; (c) despite these data and advocacy efforts, advances to improve worker safety in the fluoroscopic laboratory remain inadequate; and (d) a concerted effort by all stakeholders (physicians, catheterization laboratory nurses, and technologists, sonographers, hospitals, professional societies, and industry) in the fluoroscopic laboratory is necessary to further advance occupational safety and health. Radiation exposure is inherent to procedural performance in the fluoroscopic laboratory. Exposure to ionizing radiation imposes health risks to both patients and operators, resulting in an increased likelihood of numerous illnesses and diseases.1-8 The association with posterior subcapsular cataracts is well documented.11, 12 There are growing concerns for cancer induction,7, 8 with recent reports of a cluster of predominantly left-sided brain cancers in interventionists,9, 10 as well as a signal for increased breast19-22 and skin cancers.23-26 Radiation exposure generally, not necessarily as part of occupational exposure, is associated with leukemia/lymphoma, myeloma, numerous gastrointestinal and bone cancers, and thyroid and parathyroid adenomas. These disquieting signals fuel the increasing anxiety regarding radiation exposure-related oncogenesis, though no mortality impact has been proven.27 Recent studies have also suggested that occupational radiation exposure is associated with hypertension, hypercholesterolemia, and possibly atherosclerosis.28-30 Evidence of lengthening sarcomere length and early vascular aging in epidemiologic studies suggests that workers who are occupationally exposed to radiation during interventional procedures may be at increased risk to develop these same illnesses.30, 31 There is now overwhelming evidence demonstrating that working in the interventional laboratory is associated with an increased incidence of orthopedic illnesses, particularly those related to the cervical and lumbar spine. These orthopedic injuries have been linked to the cumulative effects of bearing the weight of leaded aprons.5, 15, 16 Additionally, the design of the catheterization laboratory environment promotes awkward orthopedic ergonomic postures (e.g., monitors placed out of the line of natural working sight views). As procedures become increasingly complex and prolonged, and their volume increase in number, it should not be surprising that interventional practice is attended by a high rate (40–50%) of occupational-induced orthopedic injuries.15-17 Over a career's duration, the likelihood of suffering such illnesses are 2–7 times27, 28 higher than other medical occupations. Studies report substantial differences in orthopedic injuries between those wearing lead aprons working in the fluoroscopic laboratory compared to colleagues working in the same department not working in the fluoroscopic laboratory and thus not bearing the burden of wearing lead aprons.27-29 These occupational-related injuries not uncommonly result in missed days of work, surgery, and, in some cases, curtailed careers. This issue has significant implications for the interventional workforce, particularly in view of the aging of the population and anticipated increased procedural demand concomitant with aging of the operators who pioneered these advances.17, 27-29 These occupational health concerns potentially affect several medical specialties, including cardiologists, radiologists, and surgeons working with fluoroscopy, as well as pain management specialists performing nonvascular fluoroscopic procedures. Importantly, all such issues also pertain to the other personnel who are essential members of the “interventional team” (e.g., nurses and technologists, interventional imagers, and cardiac anesthesiologists) who are exposed to the harmful effects of scattered ionizing radiation.30-33 Electrophysiologists and their team are also exposed to radiologic risks and orthopedic injury34 and perhaps even more so, given the duration of their procedures and lack of upper torso shielding during device cases (e.g., implantable defibrillators and cardiac resynchronization therapy). These issues also have particular importance to women; although radiation effects on the fetus have not been demonstrated, women report concerns for adverse effects during reproduction as an obstacle to choice of an interventional career. These radiation exposure concerns have sometimes been considered a reason for disproportionately low representation of women in the field.35 As noninvasive cardiologists specialized in imaging are now required to guide interventions in the catheterization and electrophysiology laboratories, pursuing career in imaging is no longer radiation free and a safer choice for women. This may result in shifts in gender distribution in various cardiology subspecialties, further impacting strategies to improve diversity and inclusion in out profession. The past three decades have witnessed astounding progress in interventional equipment, technique, therapeutics, and the clinical research that catalyzed these advances. Progress in interventional laboratory protection and safety has comparatively lagged, despite the growing mounting data emphasizing occupational health concerns. A paradigm shift to dramatically improve the occupational safety for all stakeholders in the fluoroscopic laboratory (members of the interventional team, professional societies, hospitals, and industry) is required. In particular, there is an opportunity and obligation for industry and hospitals, who clearly benefit from the workers' commitment to their profession, to play a leadership role in correcting these deficiencies. A template exists based on the collaboration established by recent FDA-led efforts aimed to reduce patient exposure.36 Leveraging the concept and practice of the “Image Wisely” and “Image Gently” campaigns codified by Radiological Society of North America37 and Pediatric Cardiology community38 to minimize radiation exposure to patients, in 2010, the FDA Center for Devices and Radiological Health launched an Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging. As part of this initiative, the FDA held a public meeting on ways to improve devices to reduce unnecessary radiation exposure to help the agency decide on any new, targeted requirements for manufacturers of computed tomographic and fluoroscopic devices. This effort resulted in an industry-driven enhanced awareness, with mandates to recognize both the needs for and market potential of innovations focused on minimizing patient radiation exposure. These initiatives rapidly resulted in dramatic changes to improve the X-ray systems. Examples of these improvements include minimizing radiation exposure through lower emission X-ray systems as well as monitoring, recording of each procedure's patient exposure, and standardization in laboratory reports and patient charts. These efforts have also stimulated industry to develop X-ray systems that provide high-quality imaging at low-radiation exposure dose levels. Hospitals should be encouraged to invest in adopting such platforms that have potential to mitigate occupational risk. Physicians working with our professional societies should strive to establish a culture of safety encompassing both patients and catheterization laboratory personnel (Table 1). The pathway forward should be focused to assure: (1) consistent application and adherence to established and procedural processes; (2) widespread adoption and utilization of novel commercially available protection systems; and (3) encouragement and support to further develop even more effective equipment and processes that facilitate enhanced safety and protection in the workspace. Our professional societies must support individual physicians, teams, and practices, especially those that are hospital owned. It is critical that clinician leaders speak authoritatively to hospital administration and industry partners regarding these concerns without fear of reprisal; societal support could be influential in these situations. The following specific steps should be endorsed by our professional societies to enhance hospital and physician compliance: Whether or not to comply with appropriate shielding and other safety measures should not be at the discretion of the operator. The imaging team (physician, sonographer, radiologic technologist, physicist, and other medical personnel) should be responsible for developing optimized protocols, implementing regular equipment quality control tests, and monitoring radiation doses to patients and members of the team. This group and their products should be recognized as an essential part of the quality assurance program, present in all laboratories, for emphasizing radiation management. Operator dose is directly proportional to patient dose; thus, reducing the dose to the patient will benefit the operator. Knowledge of radiation and methods to reduce risk should be stressed to all operators who perform fluoroscopically guided interventions, practiced routinely, and all staff educated in these measures and assuring they are adhered. These methods and concepts have been well described previously.1-7 Recently, publications from the Society of Cardiovascular Angiography and Interventions, The Heart Rhythm Society, and the American College of Cardiology/multi-society consensus document18 articulate detailed procedural systems and processes, as well as practical approaches, to assist cardiac catheterization laboratories in establishing optimal radiation safety program. The components of a radiation safety program include essential personnel, radiation monitoring, protective shielding (at minimum strict adherence to protective aprons and leaded glasses), imaging equipment, and training/education.39-41 Fundamental principles of radiation safety teach the tenet that radiation exposure should be “as low as reasonably achievable (ALARA)”, with monitoring to assure individuals do not exceed annual or lifetime “safe limits.” Unfortunately, the term “reasonably achievable” is ambiguous and not actionable, and may unintentionally inhibit innovative strides to improve safety both for patients who require medically necessary procedures and for workers in radiation-exposed environments. The phrase might incorrectly imply that as long as one's exposure is “minimized,” then that is all that need to be accomplished. Rather, the ultimate goal of innovation efforts should strive to achieve a completely safe environment wherein the ultimate definition of ALARA translates to as close to a zero radiation exposure work environment as possible. Meticulous application of established prudent radiation techniques is obvious and essential. Standard shielding combines laboratory based (e.g., movable ceiling suspended and fixed table-side shielding). Personal protective aprons and eyewear should be properly fitted and maintained, and hospitals should finance these protective devices for all of their employees, including trainees. Newer personal protective choices, including two-piece aprons that are much lighter, may be beneficial; accessory sleeves for arm protection are also available. Despite these advances, the orthopedic burden of only partially protective leaded apparel continues. Institutions and operators must partner to develop a program specific for their laboratory that will result in the adoption of appropriate recent innovations to reduce radiation exposure. Strategies should also include usage of adjunctive devices for which there is substantial data documenting their capability to reduce exposure. Specifically, there is now compelling data demonstrating reductions in exposure with accessory drapes42 (Supplementary Tables); such disposable radiation shielding pads should NOT be refused by hospitals due to their expense. The use of leaded caps has been proposed with mixed results regarding reduction in exposure.43, 44 Simple accessory mobile shields afford significant protection to both nurses and technologists45 as well as to the interventional imaging team.30 More expansive and encompassing lead shielding systems are commercially available,46 and there is a need for more clinical research data supporting their capabilities to reduce exposure. Robotic systems developed to enhance procedural performance also provide protection from radiation exposure to the physician and reduce leaded apron orthopedic burden.47 Thus far, robotics has had limited adoption, due mostly to cost considerations but also fear from the loss of a “hands-on” sensibility. In electrophysiology, intracardiac navigation systems48 have shown efficacy to navigate catheters for ablation procedures with lesser exposure. Simultaneously, industry and physicians must partner to expedite development of a fluoroless catheterization laboratory, using echocardiography, magnetic resonance imaging, 3D mapping, or other technologies. Removing the necessity of lead aprons should be the ultimate goal. Although the proximate cause of many orthopedic complications may be wearing lead, there are other important factors, such as screen height and position, and other ergonometric considerations, which may account for much cervical spine pathology.49 This growing portfolio of enhanced/innovative protective technology will continue to yield a growing pipeline of solutions providing optimism for a healthier work environment. Table 1 summarizes the responsibilities of professional societies going forward. A direct role is a necessity to coordinate the policy matters raised in this document. Table 2 lists the specific future directions recommended for all stakeholders to achieve. It is essential to emphasize that the operator has the responsibility to understand how to use protective equipment optimally to minimize exposure to both patients and personnel.50 Education in this area is already part of cardiology trainee education and is tested in certification exams. Nevertheless, formal training for those who are planning to be interventional operators and imagers should be considered, and compliance monitored on site. Real-time radiation dose monitoring should become standard. Further, physicians must accept the challenge to adopt new technologies for the reduction of occupational hazards. Expense is one reason that new innovations are often not adopted, as it is difficult to advocate for expensive nonrevenue-enhancing equipment in the current fiscal environment. Other obstacles to overcome include potential discomfort with the design modifications and the resistance to making changes in familiar techniques even if there are improvements. The question always arises as to “proof” as to whether the changes are really beneficial, which sometimes become a justification to maintain an unsatisfactory status quo. Therefore, it is incumbent on our profession to continue to produce high-quality clinical research that documents the capabilities of novel imaging equipment, protective devices, and processes designed to improve workplace safety and health. As previously discussed, structural heart interventions depend on procedural image guidance/interventional echocardiography using transthoracic (TTE) or transesophageal echocardiography (TEE) in addition to fluoroscopy. Interventional imagers who operate the TTE or TEE probe and echo console are highly exposed to the harmful effects of scattered ionizing radiation. Protection for these workers also needs to be incorporated and mandated.30, 45, 46 Professional societies should develop programs to assist hospitals and health systems to address occupational safety. It is in everyone's interest to assure the health of medical caregivers.17 The establishment of new, and coordination with existing, comprehensive programs for clinician health in the catheterization and electrophysiology laboratories consistent with recommended wellness programs are an opportunity to highlight this problem. This may include an on-site physical or massage therapist, programs for core strengthening and stretching, and improved posture techniques to prevent orthopedic injury.34 Moreover, this issue can be an opportunity for societies to share and collaborate with international colleagues, who face similar problems. Since the inception of radiologic imaging, the biomedical industry has taken primary responsibility for development and refinement of catheterization laboratory equipment with associated financial benefits. As this equipment engenders intrinsic radiation exposure hazards, industry should assume a level of fiduciary responsibility to optimize the safety of the equipment they design and sell. It is our role to communicate the cardiology community's widespread support for innovations and catheterization laboratory design reformation. Though definite progress has occurred in the past two decades, particularly the advent of high-quality X-ray systems that produce high-quality imaging at lower radiation dose, further innovations are needed to achieve maximal operator radiation protection. The goal is a laboratory design that achieves a completely environment that the need for personal protective apparel and the orthopedic progress has been by the FDA to industry and medical to improve equipment and processes designed to achieve radiation exposure to are that efforts can be to enhance operator safety by providing a template by which this may be innovation will be that market are to such of worker health to increase worker is both the to and a workforce (physicians, nurses, and Hospitals and health care systems should recognize that protective equipment and wellness processes to at the of the health of their workers is more it increased more and increased training Hospitals have the responsibility to and assure worker safety and optimal occupational radiation exposure. radiation provide training and monitoring of personnel and It that hospitals have a responsibility for those working in their and an responsibility not only to maintain and present imaging systems but also to catheterization laboratories with the equipment and established to benefits to the safety and of their of the X-ray with of imaging and equipment are the responsibilities of the will if (e.g., Health and might in on these occupational safety issues and issue that require a for of imaging and protective In this of and commitment on the part of hospitals is critical to industry to invest in research and development of in the that there is an and In our professional societies play a role to help establish is considered and necessary for practice in radiation safety and clinician The is not responsible for the or of any supporting by the than should be to the for the
Numberlink is a logic puzzle with an objective to connect all pairs of cells with the same number by non-crossing paths in a rectangular grid. In this paper, we propose a physical protocol of zero-knowledge proof for Numberlink using a deck of cards, which allows a prover to convince a verifier that he/she knows a solution without revealing it. In particular, the protocol shows how to physically count the number of elements in a list that are equal to a given secret value without revealing that value, the positions of elements in the list that are equal to it, or the value of any other element in the list. Finally, we show that our protocol can be modified to verify a solution of the well-known $k$ vertex-disjoint paths problem, both the undirected and directed settings.
Applying watermarking protocols can effectively support the copyright protection to identify illegal distributors over the World Wide Web. Several schemes have been developed for copyright protection of the web based digital contents distributed over the internet. However, these protocols are often needs more complex security actions to be performed by the web based content providers for preserving the integrity of their content. In this paper, we propose a new secure web-based watermarking scheme based on the combination of the security of the public key cryptosystem (PKI) and the watermarking based on threshold cryptography. The proposed watermarking protocol solve the collude problem for the trusted certificate authority (CA) and applies the idea of the zero knowledge proof for verification purposes. Implementation and analysis of the proposed scheme has been conducted.