Tech Report: Inerial HSMs Thwart Advanced Physical Attacks

In this tech report, we introduce a novel countermeasure against physical attacks: Inertial hardware security modules (iHSMs). Conventional systems have in common that they try to detect attacks by crafting sensors responding to increasingly minute manipulations of the monitored security boundary or volume. Our approach is novel in that we reduce the sensitivity requirement of security meshes and other sensors and increase the complexity of any manipulations by rotating the security mesh or sensor at high speed—thereby presenting a moving target to an attacker. Attempts to stop the rotation are easily monitored with commercial MEMS accelerometers and gyroscopes. Our approach leads to a HSM that can easily be built from off-the-shelf parts by any university electronics lab, yet offers a level of security that is comparable to commercial HSMs

Early and late outcomes after minimally invasive direct coronary artery bypass vs. full sternotomy off-pump coronary artery bypass grafting

ObjectivesMinimally-invasive direct coronary artery bypass (MIDCAB) is a less-invasive alternative to full sternotomy off-pump coronary artery bypass (FS-OPCAB) revascularization of the left anterior descending artery (LAD). Some studies suggested that MIDCAB is associated with a greater risk of graft occlusion and repeat revascularization than FS-OPCAB LIMA-to-LAD grafting. Data comparing MIDCAB to FS-OPCAB with regard to long-term follow-up is scarce. We compared short- and long-term results of MIDCAB vs. FS-OPCAB revascularization over a maximum follow-up period of 10 years.Patients and methodsFrom December 2009 to June 2020, 388 elective patients were included in our retrospective study. 229 underwent MIDCAB, and 159 underwent FS-OPCAB LIMA-to-LAD grafting. Inverse probability of treatment weighting (IPTW) was used to adjust for selection bias and to estimate treatment effects on short- and long-term outcomes. IPTW-adjusted Kaplan–Meier estimates by study group were calculated for all-cause mortality, stroke, the risk of repeat revascularization and myocardial infarction up to a maximum follow-up of 10 years.ResultsMIDCAB patients had less rethoracotomies (n = 13/3.6% vs. n = 30/8.0%, p = 0.012), fewer transfusions (0.93 units ± 1.83 vs. 1.61 units ± 2.52, p < 0.001), shorter mechanical ventilation time (7.6 ± 4.7 h vs. 12.1 ± 26.4 h, p = 0.005), and needed less hemofiltration (n = 0/0% vs. n = 8/2.4%, p = 0.004). Thirty-day mortality did not differ significantly between the two groups (n = 0/0% vs. n = 3/0.8%, p = 0.25). Long-term outcomes did not differ significantly between study groups. In the FS-OPCAB group, the probability of survival at 1, 5, and 10 years was 98.4%, 87.8%, and 71.7%, respectively. In the MIDCAB group, the corresponding values were 98.4%, 87.7%, and 68.7%, respectively (RR1.24, CI0.87–1.86, p = 0.7). In the FS group, the freedom from stroke at 1, 5, and 10 years was 97.0%, 93.0%, and 93.0%, respectively. In the MIDCAB group, the corresponding values were 98.5%, 96.9%, and 94.3%, respectively (RR0.52, CI0.25–1.09, p = 0.06). Freedom from repeat revascularization at 1, 5, and 10 years in the FS-OPCAB group was 92.2%, 84.7%, and 79.5%, respectively. In the MIDCAB group, the corresponding values were 94.8%, 90.2%, and 81.7%, respectively (RR0.73, CI0.47–1.16, p = 0.22).ConclusionMIDCAB is a safe and efficacious technique and offers comparable long-term results regarding mortality, stroke, repeat revascularization, and freedom from myocardial infarction when compared to FS-OPCAB

Can’t Touch This: Inertial HSMs Thwart Advanced Physical Attacks

In this paper, we introduce a novel countermeasure against physical attacks: Inertial Hardware Security Modules (IHSMs). Conventional systems have in common that their security requires the crafting of fine sensor structures that respond to minute manipulations of the monitored security boundary or volume. Our approach is novel in that we reduce the sensitivity requirement of security meshes and other sensors and increase the complexity of any manipulations by rotating the security mesh or sensor at high speed—thereby presenting a moving target to an attacker. Attempts to stop the rotation are easily monitored with commercial MEMS accelerometers and gyroscopes. Our approach leads to an HSM that can easily be built from off-the-shelf parts by any university electronics lab, yet offers a level of security that is comparable to commercial HSMs. We have built a proof-of-concept hardware prototype that demonstrates solutions to the concept’s main engineering challenges. As part of this proof-of-concept, we have found that a system using a coarse security mesh made from commercial printed circuit boards and an automotive high-g-force accelerometer already provides a useful level of security

Ripples in the Pond: Transmitting Information through Grid Frequency Modulation

The growing heterogenous ecosystem of networked consumer devices such as smart meters or IoT-connected appliances such as air conditioners is difficult to secure, unlike the utility side of the grid which can be defended effectively through rigorous IT security measures such as isolated control networks. In this paper, we consider a crisis scenario in which an attacker compromises a large number of consumer-side devices and modulates their electrical power to destabilize the grid and cause an electrical outage [9, 26, 27, 47, 50, 55]. In this paper propose a broadcast channel based on the modulation of grid frequency through which utility operators can issue commands to devices at the consumer premises both during an attack for mitigation and in its wake to aid recovery. Our proposed grid frequency modulation (GFM) channel is independent of other telecommunication networks. It is resilient towards localized blackouts and it is operational immediately after power is restored. Based on our GFM broadcast channel we propose a “safety reset” system to mitigate an ongoing attack by disabling a device’s network interfaces and resetting its control functions. It can also be used in the wake of an attack to aid recovery by shutting down non-essential loads to reduce strain on the grid. To validate our proposed design, we conducted simulations based on measured grid frequency behavior. Based on these simulations, we performed an experimental validation on simulated grid voltage waveforms using a smart meter equipped with a prototype safety reset system based on a commodity microcontroller

Early and late outcomes after minimally invasive direct coronary artery bypass vs. full sternotomy off-pump coronary artery bypass grafting

$\bf Objectives:$ Minimally-invasive direct coronary artery bypass (MIDCAB) is a less-invasive alternative to full sternotomy off-pump coronary artery bypass (FS-OPCAB) revascularization of the left anterior descending artery (LAD). Some studies suggested that MIDCAB is associated with a greater risk of graft occlusion and repeat revascularization than FS-OPCAB LIMA-to-LAD grafting. Data comparing MIDCAB to FS-OPCAB with regard to long-term follow-up is scarce. We compared short- and long-term results of MIDCAB vs. FS-OPCAB revascularization over a maximum follow-up period of 10 years. $\textbf {Patients and methods:}$ From December 2009 to June 2020, 388 elective patients were included in our retrospective study. 229 underwent MIDCAB, and 159 underwent FS-OPCAB LIMA-to-LAD grafting. Inverse probability of treatment weighting (IPTW) was used to adjust for selection bias and to estimate treatment effects on short- and long-term outcomes. IPTW-adjusted Kaplan–Meier estimates by study group were calculated for all-cause mortality, stroke, the risk of repeat revascularization and myocardial infarction up to a maximum follow-up of 10 years. $\bf Results:$ MIDCAB patients had less rethoracotomies ($\it n$ = 13/3.6% vs. $\it n$ = 30/8.0%, $\it p$ = 0.012), fewer transfusions (0.93 units $\pm$ 1.83 vs. 1.61 units $\pm$ 2.52, $\it p$ < 0.001), shorter mechanical ventilation time (7.6 $\pm$ 4.7 h vs. 12.1 $\pm$ 26.4 h,$\it p$p = 0.005), and needed less hemofiltration ($\it n$ = 0/0% vs. $\it n$ = 8/2.4%, $\it p$ = 0.004). Thirty-day mortality did not differ significantly between the two groups ($\it n$ = 0/0% vs. $\it n$ = 3/0.8%, $\it p$ = 0.25). Long-term outcomes did not differ significantly between study groups. In the FS-OPCAB group, the probability of survival at 1, 5, and 10 years was 98.4%, 87.8%, and 71.7%, respectively. In the MIDCAB group, the corresponding values were 98.4%, 87.7%, and 68.7%, respectively (RR1.24, CI0.87–1.86, $\it p$ = 0.7). In the FS group, the freedom from stroke at 1, 5, and 10 years was 97.0%, 93.0%, and 93.0%, respectively. In the MIDCAB group, the corresponding values were 98.5%, 96.9%, and 94.3%, respectively (RR0.52, CI0.25–1.09, $\it p$ = 0.06). Freedom from repeat revascularization at 1, 5, and 10 years in the FS-OPCAB group was 92.2%, 84.7%, and 79.5%, respectively. In the MIDCAB group, the corresponding values were 94.8%, 90.2%, and 81.7%, respectively (RR0.73, CI0.47–1.16, $\it p$ = 0.22). $\bf Conclusion:$ MIDCAB is a safe and efficacious technique and offers comparable long-term results regarding mortality, stroke, repeat revascularization, and freedom from myocardial infarction when compared to FS-OPCAB