Non-destructive collection survey of the historical Classense Library. Part I: Paper characterisation

An innovative survey was conducted of the collections of the historical Biblioteca Classense, located in the urban area of Ravenna (Northern Italy). The survey aimed to evaluate the current conservation state of the book collections, where 297 paper-based items, including incunabula, manuscripts and books, dating from the 14th to the 20th century, were selected for analysis. This innovative survey was carried out non-destructively by assessing degradation visually and by measuring NIR spectral data followed by multivariate data analysis. Chemical and physical paper properties, important for paper characterisation and implementation of conservation strategies were determined, including paper type, pH, degree of polymerisation (DP), tensile strength, lignin, protein, and rosin content. This survey provided a significant quantitative dataset for rag paper covering a 600-year period. The analysis of DP changes over time allowed the first experimental estimation of the rate constant for historical rag paper, i.e., (4.2 ± 0.6)·10−7 year−1, which was validated with predictions based on the Collections Demography dose response function for historic paper taking into account the past climate in Ravenna. Statistical methods were employed to describe the correlations between the measured variables and different features of the books, suggesting that the degree of polymerisation can be used as a general proxy for rag paper mechanical strength

{SoK}: {An} Analysis of Protocol Design: Avoiding Traps for Implementation and Deployment

Today's Internet utilizes a multitude of different protocols. While some of these protocols were first implemented and used and later documented, other were first specified and then implemented. Regardless of how protocols came to be, their definitions can contain traps that lead to insecure implementations or deployments. A classical example is insufficiently strict authentication requirements in a protocol specification. The resulting Misconfigurations, i.e., not enabling strong authentication, are common root causes for Internet security incidents. Indeed, Internet protocols have been commonly designed without security in mind which leads to a multitude of misconfiguration traps. While this is slowly changing, to strict security considerations can have a similarly bad effect. Due to complex implementations and insufficient documentation, security features may remain unused, leaving deployments vulnerable. In this paper we provide a systematization of the security traps found in common Internet protocols. By separating protocols in four classes we identify major factors that lead to common security traps. These insights together with observations about end-user centric usability and security by default are then used to derive recommendations for improving existing and designing new protocols---without such security sensitive traps for operators, implementors and users

{SoK}: {An} Analysis of Protocol Design: Avoiding Traps for Implementation and Deployment

Today's Internet utilizes a multitude of different protocols. While some of these protocols were first implemented and used and later documented, other were first specified and then implemented. Regardless of how protocols came to be, their definitions can contain traps that lead to insecure implementations or deployments. A classical example is insufficiently strict authentication requirements in a protocol specification. The resulting Misconfigurations, i.e., not enabling strong authentication, are common root causes for Internet security incidents. Indeed, Internet protocols have been commonly designed without security in mind which leads to a multitude of misconfiguration traps. While this is slowly changing, to strict security considerations can have a similarly bad effect. Due to complex implementations and insufficient documentation, security features may remain unused, leaving deployments vulnerable. In this paper we provide a systematization of the security traps found in common Internet protocols. By separating protocols in four classes we identify major factors that lead to common security traps. These insights together with observations about end-user centric usability and security by default are then used to derive recommendations for improving existing and designing new protocols---without such security sensitive traps for operators, implementors and users

The Impact of Breathing Hypoxic Gas and Oxygen on Pulmonary Hemodynamics in Patients With Pulmonary Hypertension

BackgroundPure oxygen breathing (hyperoxia) may improve hemodynamics in patients with pulmonary hypertension (PH) and allows to calculate right-to-left shunt fraction (Qs/Qt), whereas breathing normobaric hypoxia may accelerate hypoxic pulmonary vasoconstriction (HPV). This study investigates how hyperoxia and hypoxia affect mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) in patients with PH and whether Qs/Qt influences the changes of mPAP and PVR.Study Design and MethodsAdults with pulmonary arterial or chronic thromboembolic PH (PAH/CTEPH) underwent repetitive hemodynamic and blood gas measurements during right heart catheterization (RHC) under normoxia [fractions of inspiratory oxygen (FiO$_{2}$) 0.21], hypoxia (FiO$_{2}$ 0.15), and hyperoxia (FiO$_{2}$ 1.0) for at least 10 min.ResultsWe included 149 patients (79/70 PAH/CTEPH, 59% women, mean ± SD 60 ± 17 years). Multivariable regressions (mean change, CI) showed that hypoxia did not affect mPAP and cardiac index, but increased PVR [0.4 (0.1–0.7) WU, p = 0.021] due to decreased pulmonary artery wedge pressure [−0.54 (−0.92 to −0.162), p = 0.005]. Hyperoxia significantly decreased mPAP [−4.4 (−5.5 to −3.3) mmHg, p < 0.001] and PVR [−0.4 (−0.7 to −0.1) WU, p = 0.006] compared with normoxia. The Qs/Qt (14 ± 6%) was >10 in 75% of subjects but changes of mPAP and PVR under hyperoxia and hypoxia were independent of Qs/Qt.ConclusionAcute exposure to hypoxia did not relevantly alter pulmonary hemodynamics indicating a blunted HPV-response in PH. In contrast, hyperoxia remarkably reduced mPAP and PVR, indicating a preserved vasodilator response to oxygen and possibly supporting the oxygen therapy in patients with PH. A high proportion of patients with PH showed increased Qs/Qt, which, however, was not associated with changes in pulmonary hemodynamics in response to changes in FiO$_{2}$

Influence of Upright Versus Supine Position on Resting and Exercise Hemodynamics in Patients Assessed for Pulmonary Hypertension

Background The aim of the present work was to study the influence of body position on resting and exercise pulmonary hemodynamics in patients assessed for pulmonary hypertension (PH). Methods and Results Data from 483 patients with suspected PH undergoing right heart catheterization for clinical indications (62% women, age 61±15 years, 246 precapillary PH, 48 postcapillary PH, 106 exercise PH, 83 no PH) were analyzed; 213 patients (main cohort, years 2016-2018) were examined at rest in upright (45°) and supine position, such as under upright exercise. Upright exercise hemodynamics were compared with 270 patients (historical cohort) undergoing supine exercise with the same protocol. Upright versus supine resting data revealed a lower mean pulmonary artery pressure 31±14 versus 32±13 mm Hg, pulmonary artery wedge pressure 11±4 versus 12±5 mm Hg, and cardiac index 2.9±0.7 versus 3.1±0.8 L/min per m2, and higher pulmonary vascular resistance 4.1±3.1 versus 3.9±2.8 Wood P<0.001. Exercise data upright versus supine revealed higher work rates (53±26 versus 33±22 watt), and adjusting for differences in work rate and baseline values, higher end-exercise mean pulmonary artery pressure (52±19 versus 45±16 mm Hg, P=0.001), similar pulmonary artery wedge pressure and cardiac index, higher pulmonary vascular resistance (5.4±3.7 versus 4.5±3.4 Wood units, P=0.002), and higher mean pulmonary artery pressure/cardiac output (7.9±4.7 versus 7.1±4.1 Wood units, P=0.001). Conclusions Body position significantly affects resting and exercise pulmonary hemodynamics with a higher pulmonary vascular resistance of about 10% in upright versus supine position at rest and end-exercise, and should be considered and reported when assessing PH. Keywords: body position; exercise; hemodynamic; pulmonary hypertension; right heart catheterization

A view of Internet Traffic Shifts at {ISP} and {IXPs} during the {COVID}-19 Pandemic

Due to the COVID-19 pandemic, many governments imposed lockdowns that forced hundreds of millions of citizens to stay at home. The implementation of confinement measures increased Internet traffic demands of residential users, in particular, for remote working, entertainment, commerce, and education, which, as a result, caused traffic shifts in the Internet core. In this paper, using data from a diverse set of vantage points (one ISP, three IXPs, and one metropolitan educational network), we examine the effect of these lockdowns on traffic shifts. We find that the traffic volume increased by 15-20% almost within a week – while overall still modest, this constitutes a large increase within this short time period. However, despite this surge, we observe that the Internet infrastructure is able to handle the new volume, as most traffic shifts occur outside of traditional peak hours. When looking directly at the traffic sources, it turns out that, while hypergiants still contribute a significant fraction of traffic, we see (1) a higher increase in traffic of non-hypergiants, and (2) traffic increases in applications that people use when at home, such as Web conferencing, VPN, and gaming. While many networks see increased traffic demands, in particular, those providing services to residential users, academic networks experience major overall decreases. Yet, in these networks, we can observe substantial increases when considering applications associated to remote working and lecturing.EC/H2020/679158/EU/Resolving the Tussle in the Internet: Mapping, Architecture, and Policy Making/ResolutioNe

Hypoxia-altitude simulation test to predict altitude-related adverse health effects in COPD patients

Background/aims: Amongst numerous travellers to high altitude (HA) are many with the highly prevalent COPD, who are at particular risk for altitude-related adverse health effects (ARAHE). We then investigated the hypoxia-altitude simulation test (HAST) to predict ARAHE in COPD patients travelling to altitude. Methods: This prospective diagnostic accuracy study included 75 COPD patients: 40 women, age 58±9 years, forced expiratory volume in 1 s (FEV$_{1}$) 40–80% pred, oxygen saturation measured by pulse oximetry (S$_{pO_{2}}$) ≥92% and arterial carbon dioxide tension (P$_{aCO_{2}}$) 30 min or 75% for >15 min) or intercurrent illness was observed. Results: ARAHE occurred in 50 (66%) patients and 23 out of 75 (31%) were positive on HAST according toS$_{pO_{2}}$, and 11 out of 64 (17%) according toP$_{aO_{2}}$. ForS$_{pO_{2}}$/P$_{aO_{2}}$we report a sensitivity of 46/25%, specificity of 84/95%, positive predictive value of 85/92% and negative predictive value of 44/37%. Conclusion: In COPD patients ascending to HA, ARAHE are common. Despite an acceptable positive predictive value of the HAST to predict ARAHE, its clinical use is limited by its insufficient sensitivity and overall accuracy. Counselling COPD patients before altitude travel remains challenging and best focuses on early recognition and treatment of ARAHE with oxygen and descent

Change in Right-to-Left Shunt Fraction in Patients with Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Endarterectomy

Background: Pulmonary endarterectomy (PEA) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH) with accessible lesions. Breathing pure oxygen (hyperoxia) during right heart catheterization (RHC) allows for the calculation of the right-to-left shunt fraction (Qs/Qt). In the absence of intracardiac shunt, Qs/Qt can be used as a marker of ventilation–perfusion mismatch in patients with CTEPH. This study involved investigating Qs/Qt after PEA and its relation to other disease-specific outcomes. Study design and Methods: This study is a retrospective study that focuses on patients with operable CTEPH who had Qs/Qt assessment during RHC before and 1 year after PEA. Additionally, 6 min walking distance (6MWD), WHO functional class (WHO-FC), and NT-proBNP were assessed to calculate a four-strata risk score. Results: Overall, 16 patients (6 females) with a median age of 66 years (quartiles 55; 74) were included. After PEA, an improvement in mean pulmonary artery pressure (38 [32; 41] to 24 [18; 28] mmHg), pulmonary vascular resistance (5.7 [4.0; 6.8] to 2.5 [1.4; 3.8] WU), oxygen saturation (92 [88; 93]% to 94 [93; 95]%), WHO-FC, and risk score was observed (all p < 0.05). No improvement in median Qs/Qt could be detected (13.7 [10.0; 17.5]% to 13.0 [11.2; 15.6]%, p = 0.679). A total of 7 patients with improved Qs/Qt had a significant reduction in risk score compared to those without improved Qs/Qt. Conclusion: PEA did not alter Qs/Qt assessed after 1 year in operable CTEPH despite an improvement in hemodynamics and risk score, potentially indicating a persistent microvasculopathy. In patients whose shunt fraction improved with PEA, the reduced shunt was associated with an improvement in risk score

DDoS Hide &amp; Seek:On the effectiveness of a booter services takedown

Booter services continue to provide popular DDoS-as-a-service platforms and enable anyone irrespective of their technical ability, to execute DDoS attacks with devastating impact. Since booters are a serious threat to Internet operations and can cause significant financial and reputational damage, they also draw the attention of law enforcement agencies and related counter activities. In this paper, we investigate booter-based DDoS attacks in the wild and the impact of an FBI takedown targeting 15 booter websites in December 2018 from the perspective of a major IXP and two ISPs. We study and compare attack properties of multiple booter services by launching Gbps-level attacks against our own infrastructure. To understand spatial and temporal trends of the DDoS traffic originating from booters we scrutinize 5 months, worth of inter-domain traffic. We observe that the takedown only leads to a temporary reduction in attack traffic. Additionally, one booter was found to quickly continue operation by using a new domain for its website