Design of the Bastei OS Architecture

In the software world, high complexity of a problem solution comes along with a high risk for bugs and vulnerabilities. This correlation is particular perturbing for todays commodity operating systems with their tremendous complexity. The numerous approaches to increase the user’s confidence in the correct functioning of software comprise exhaustive tests, code auditing, static code analysis, and formal verification. Such quality-assurance measures are either rather shallow or they scale badly with increasing complexity. The operating-system design presented in this paper focuses on the root of the problem by providing means to minimize the underlying system complexity for each security-sensitive application individually. On the other hand, we want to enable multiple applications to execute on the system at the same time whereas each application may have different functional requirements from the operating system. Todays operating systems provide a functional superset of the requirements of all applications and thus, violate the principle of minimalism for each single application. We resolve the conflict between the principle of minimalism and the versatility of the operating system by decomposing the operating system into small components and by providing a way to execute those components isolated and independent from each other. Components can be device drivers, protocol stacks such as file systems and network stacks, native applications, and containers for executing legacy software. Each application depends only on the functionality of a bounded set of components that we call application-specific trusted computing base (TCB). If the TCBs of two applications are executed completely isolated and independent from each other, we consider both TCBs as minimal. In practice however, we want to share physical resources between multiple applications without sacrificing their independence. Therefore, the operating-system design has to enable the assignment of physical resources to each application and its TCB to maintain independence from other applications. Furthermore, rather than living in complete isolation, components require to communicate with each other to cooperate. The operating-system design must enable components to create other components and get them to know each other while maintaining isolation from uninvolved parts of the system. First, we narrow our goals and pose our mayor challenges in Section 1. Section 2 introduces our fundamental concepts and protocols that apply to each component in the system. In Section 3, we present the one component that is mandatory part of each TCB, enables the bootstrapping of the system, and provides abstractions for the lowest-level resources. We exercise the composition of the presented mechanisms by the means of process creation in Section 4

Paraneoplastic cerebellar degeneration associated with lymphoepithelial carcinoma of the tonsil

Background: Paraneoplastic cerebellar degeneration (PCD) is a classical tumor-associated, immune-mediated disease typically associated with gynecological malignancies, small-cell lung-cancer or lymphoma. Case presentation: Here we present the case of a 38-year old male with an over 12 months rapidly progressive cerebellar syndrome. Extensive diagnostic workup revealed selective hypermetabolism of the right tonsil in whole-body PET. Histological examination after tonsillectomy demonstrated a lymphoepithelial carcinoma of the tonsil and the tongue base strongly suggesting a paraneoplastic cause of the cerebellar syndrome. To the best of our knowledge this is the first case of an association of a lymphoepithelial carcinoma, a rare pharyngeal tumor, with PCD. Conclusions: In cases of classical paraneoplastic syndromes an extensive search for neoplasms should be performed including whole-body PET to detect tumors early in the course of the disease

Blood levels of Glial Fibrillary Acidic Protein (GFAP) in patients with neurological diseases

Background and Purpose: The brain-specific astroglial protein GFAP is a blood biomarker candidate indicative of intracerebral hemorrhage in patients with symptoms suspicious of acute stroke. Comparably little, however, is known about GFAP release in other neurological disorders. In order to identify potential “specificity gaps” of a future GFAP test used to diagnose intracerebral hemorrhage, we measured GFAP in the blood of a large and rather unselected collective of patients with neurological diseases. Methods: Within a one-year period, we randomly selected in-patients of our university hospital for study inclusion. Patients with ischemic stroke, transient ischemic attack and intracerebral hemorrhage were excluded. Primary endpoint was the ICD-10 coded diagnosis reached at discharge. During hospital stay, blood was collected, and GFAP plasma levels were determined using an advanced prototype immunoassay at Roche Diagnostics. Results: A total of 331 patients were included, covering a broad spectrum of neurological diseases. GFAP levels were low in the vast majority of patients, with 98.5% of cases lying below the cut-off that was previously defined for the differentiation of intracerebral hemorrhage and ischemic stroke. No diagnosis or group of diagnoses was identified that showed consistently increased GFAP values. No association with age and sex was found. Conclusion: Most acute and chronic neurological diseases, including typical stroke mimics, are not associated with detectable GFAP levels in the bloodstream. Our findings underline the hypothesis that rapid astroglial destruction as in acute intracerebral hemorrhage is mandatory for GFAP increase. A future GFAP blood test applied to identify patients with intracerebral hemorrhage is likely to have a high specificity

No influence of dabigatran anticoagulation on hemorrhagic transformation in an experimental model of ischemic stroke

Background: Dabigatran etexilate (DE) is a new oral direct thrombin inhibitor. Clinical trials point towards a favourable risk-to-benefit profile of DE compared to warfarin. In this study, we evaluated whether hemorrhagic transformation (HT) occurs after experimental stroke under DE treatment as we have shown for warfarin. Methods: 44 male C57BL/6 mice were pretreated orally with 37.5 mg/kg DE, 75 mg/kg DE or saline and diluted thrombin time (dTT) and DE plasma concentrations were monitored. Ischemic stroke was induced by transient middle cerebral artery occlusion (tMCAO) for 1 h or 3 h. We assessed functional outcome and HT blood volume 24 h and 72 h after tMCAO. Results: After 1 h tMCAO, HT blood volume did not differ significantly between mice pretreated with DE 37.5 mg/kg and controls (1.5±0.5 µl vs. 1.8±0.5 µl, p>0.05). After 3 h tMCAO, DE-anticoagulated mice did also not show an increase in HT, neither at the dose of 37.5 mg/kg equivalent to anticoagulant treatment in the therapeutic range (1.3±0.9 µl vs. control 2.3±0.5 µl, p>0.05) nor at 75 mg/kg, clearly representing supratherapeutic anticoagulation (1.8±0.8 µl, p>0.05). Furthermore, no significant increase in HT under continued anticoagulation with DE 75 mg/kg could be found at 72 h after tMCAO for 1 h (1.7±0.9 µl vs. control 1.6±0.4 µl, p>0.05). Conclusion: Our experimental data suggest that DE does not significantly increase hemorrhagic transformation after transient focal cerebral ischemia in mice. From a translational viewpoint, this indicates that a continuation of DE anticoagulation in case of an ischemic stroke might be safe, but clearly, clinical data on this question are warranted

How to Assess Sustainable Planning Processes of Buildings? A Maturity Assessment Model Approach for Designers

Over the past decades, it has become apparent that increasing demands in the construction industry have repeatedly led to project delays and increased project costs in practice. These demands have increased as a result of international and national action plans that have been developed to achieve the climate target paths and, therefore, the necessary reduction of CO2 emissions in the construction industry. We address this problem by developing a sustainable construction maturity model (SCOMM) to answer the following research question: “What is a holistic quality assurance tool for the early design phase of buildings to monitor (sustainable) planning practices in order to achieve better certification results?”. The model includes a self-assessment procedure for the building design process, based on Software Process Improvement and Capability dEtermination (SPiCE) and the German Sustainable Building Council (DGNB) building certification system. The results show that systemic interactions between sustainability criteria can be identified in the early design phase, allowing the quality of planning practices to be evaluated and early project management to be implemented to achieve the best certification results. Our findings will enable clients and users of the construction industry to better manage the complexity of the sustainable design process and avoid undesirable developments in building projects

Mid-term results of autoinjection therapy for erectile dysfunction

Of over 300 patients with erectile dysfunction, 186 were selected for intracavernosal autoinjection therapy with a standardized papaverine-phentolamine mixture. A total of 156 patients performed 4,813 protocol autoinjections with a minimum of 10 and a maximum of 230 per patient. The dose that induced a full erection at the hospital could be reduced under home conditions by a mean of 35 per cent. Systemic side effects were not observed. The most inconvenient local side effects were prolonged erections in 24 patients in diagnostic use and in 3 patients in therapeutic use. These were treated easily without further consequences

The impact of intertidal areas on the carbonate system of the southern North Sea

The coastal ocean is strongly affected by ocean acidification because of its shallow water depths, low volume, and the closeness to terrestrial dynamics. Earlier observations of dissolved inorganic carbon (DIC) and total alkalinity (TA) in the southern part of the North Sea, a northwest European shelf sea, revealed lower acidification effects than expected. It has been assumed that anaerobic degradation and subsequent TA release in the adjacent back-barrier tidal areas (Wadden Sea) in summertime is responsible for this phenomenon. In this study the exchange rates of TA and DIC between the Wadden Sea tidal basins and the North Sea and the consequences for the carbonate system in the German Bight are estimated using a 3D ecosystem model. The aim of this study is to differentiate the various sources contributing to observed high summer TA in the southern North Sea. Measured TA and DIC in the Wadden Sea are considered as model boundary conditions. This procedure acknowledges the dynamic behaviour of the Wadden Sea as an area of effective production and decomposition of organic material. According to the modelling results, 39 Gmol TA yr−1 were exported from the Wadden Sea into the North Sea, which is less than a previous estimate but within a comparable range. The interannual variabilities in TA and DIC, mainly driven by hydrodynamic conditions, were examined for the years 2001–2009. Dynamics in the carbonate system are found to be related to specific weather conditions. The results suggest that the Wadden Sea is an important driver for the carbonate system in the southern North Sea. On average 41 % of TA inventory changes in the German Bight were caused by riverine input, 37 % by net transport from adjacent North Sea sectors, 16 % by Wadden Sea export, and 6 % were caused by internal net production of TA. The dominant role of river input for the TA inventory disappears when focusing on TA concentration changes due to the corresponding freshwater fluxes diluting the marine TA concentrations. The ratio of exported TA versus DIC reflects the dominant underlying biogeochemical processes in the Wadden Sea. Whereas aerobic degradation of organic matter played a key role in the North Frisian Wadden Sea during all seasons of the year, anaerobic degradation of organic matter dominated in the East Frisian Wadden Sea. Despite the scarcity of high-resolution field data, it is shown that anaerobic degradation in the Wadden Sea is one of the main contributors of elevated summer TA values in the southern North Sea

FTY720 treatment in the convalescence period improves functional recovery and reduces reactive astrogliosis in photothrombotic stroke

Background: The Sphingosine-1-phosphate (S1P) signaling pathway is known to influence pathophysiological processes within the brain and the synthetic S1P analog FTY720 has been shown to provide neuroprotection in experimental models of acute stroke. However, the effects of a manipulation of S1P signaling at later time points after experimental stroke have not yet been investigated. We examined whether a relatively late initiation of a FTY720 treatment has a positive effect on long-term neurological outcome with a focus on reactive astrogliosis, synapses and neurotrophic factors. Methods: We induced photothrombotic stroke (PT) in adult C57BL/6J mice and allowed them to recover for three days. Starting on post-stroke day 3, mice were treated with FTY720 (1 mg/kg b.i.d.) for 5 days. Behavioral outcome was observed until day 31 after photothrombosis and periinfarct cortical tissue was analyzed using tandem mass-spectrometry, TaqMan®analysis and immunofluorescence. Results: FTY720 treatment results in a significantly better functional outcome persisting up to day 31 after PT. This is accompanied by a significant decrease in reactive astrogliosis and larger post-synaptic densities as well as changes in the expression of vascular endothelial growth factor α (VEGF α). Within the periinfarct cortex, S1P is significantly increased compared to healthy brain tissue. Conclusion: Besides its known neuroprotective effects in the acute phase of experimental stroke, the initiation of FTY720 treatment in the convalescence period has a positive impact on long-term functional outcome, probably mediated through reduced astrogliosis, a modulation in synaptic morphology and an increased expression of neurotrophic factors

Algoritmos generales para simuladores de cirugía laparoscópica

Recent advances in fields such as modeling of deformable objects, haptic technologies, immersive technologies, computation capacity and virtual environments have created the conditions to offer novel and suitable training tools and learning methods in the medical area. One of these training tools is the virtual surgical simulator, which has no limitations of time or risk, unlike conventional methods of training. Moreover, these simulators allow for the quantitative evaluation of the surgeon performance, giving the possibility to create performance standards in order to define if the surgeon is well prepared to execute a determined surgical procedure on a real patient. This paper describes the development of a virtual simulator for laparoscopic surgery. The simulator allows the multimodal interaction between the surgeon and the surgical virtual environment using visual and haptic feedback devices. To make the experience of the surgeon closer to the real surgical environment a specific user interface was developed. Additionally in this paper we describe some implementations carried out to face typical challenges presented in surgical simulators related to the tradeoff between real-time performance and high realism; for instance, the deformation of soft tissues are simulated using a GPU (Graphics Processor Unit) -based implementation of the mass-spring model. In this case, we explain the algorithms developed taking into account the particular case of a cholecystectomy procedure in laparoscopic surgery.Recientes avances en áreas tales como modelación computacional de objetos deformables, tecnologías hápticas, tecnologías inmersivas, capacidad de procesamiento y ambiente virtuales han proporcionado las bases para el desarrollo de herramientas y métodos de aprendizaje confiables en el entrenamiento médico. Una de estas herramientas de entrenamiento son los simuladores quirúrgicos virtuales, los cuales no tienen limitaciones de tiempo o riesgos a diferencia de los métodos convencionales de entrenamiento. Además, dichos simuladores permiten una evaluación cuantitativa del desempeño del cirujano, dando la posibilidad de crear estándares de desempeño con el fin de definir en qué momento un cirujano está preparado para realizar un determinado procedimiento quirúrgico sobre un paciente. Este artículo describe el desarrollo de un simulador virtual para cirugía laparoscópica. Este simulador permite la interacción multimodal entre el cirujano y el ambiente virtual quirúrgico usando dispositivos de retroalimentación visual y háptica. Para hacer la experiencia del cirujano más cercana a la de una ambiente quirúrgico real se desarrolló una interfaz cirujano-simulador especial. Adicionalmente en este artículo se describen algunas implementaciones que solucionan los problemas típicos cuando se desarrolla un simulador quirúrgico, principalmente relacionados con lograr un desempeño en tiempo real mientras se sacrifica el nivel de realismo de la simulación: por ejemplo, la deformación de los tejidos blandos simulados usando una implementación del modelo masa-resorte en la unidad de procesamiento gráfico. En este caso se describen los algoritmos desarrollados tomando en cuenta la simulación de un procedimiento laparoscópico llamado colecistectomía