HIL: designing an exokernel for the data center

We propose a new Exokernel-like layer to allow mutually untrusting physically deployed services to efficiently share the resources of a data center. We believe that such a layer offers not only efficiency gains, but may also enable new economic models, new applications, and new security-sensitive uses. A prototype (currently in active use) demonstrates that the proposed layer is viable, and can support a variety of existing provisioning tools and use cases.Partial support for this work was provided by the MassTech Collaborative Research Matching Grant Program, National Science Foundation awards 1347525 and 1149232 as well as the several commercial partners of the Massachusetts Open Cloud who may be found at http://www.massopencloud.or

Thoughts on Current and Future Research on Agile and Lean: Ensuring Relevance and Rigor

Over the past two decades, research in the area of agile and lean software development has mirrored the strong growth of the use of agile and lean methodologies. However, while these research streams have made a significant contribution in the use of agile and lean methodologies, much of the recent research lacks the rigor and relevance to make an impact in research and practice. For example, many of the studies have not measured the actual use of agile or lean methods nor had a significant theoretical grounding. Furthermore, agile research has not expanded to fully cover emerging opportunities and challenges. A deeper theoretical motivation on agile and lean software development can help demonstrate how the principles of, for example, agile software development, may be transferred to these other areas, and hence, broaden the research’s relevance. This paper provides commentary intended to help push the agile and lean research agenda forward, and outlines three key critieria that future researchers should consider when conducting research on the phenomenon of agile. The paper also provides an example for the use of the criteria, and presents several initial, open research questions that could help increase the use of agile, including the use of agile and lean concepts in other IT and non-IT contexts

Towards the Model Driven Organization

Modern organizations are faced with the need to rapidly respond to frequent changes arising from external business pressures. The effect of such continuous evolution eventually leads to organizational misalignment, that is, situations in which sub-optimal configurations of underlying systems significantly reduce an organization's ability to meet its strategic goals. Ensuring alignment of an organization's systems and its goals has been a concern of researchers and practitioners in the enterprise architecture (EA) domain. Unfortunately, current approaches do not adequately address alignment problems that modern organizations face. In this paper we propose that alignment concerns can be better addressed by making models the primary entities that stakeholders within and outside of an organization use to interact with the organization. We call an organization that maintains and uses an integrated set of models to manage alignment concerns a Model Driven Organization (MDO). In this paper we characterize the alignment problem, discuss the shortcomings of current alignment management approaches and present our MDO vision

Report: Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis

Background: Tackling problematic polypharmacy requires tailoring the use of medicines to individual needs and circumstances. This may involve stopping medicines (deprescribing) but patients and clinicians report uncertainty on how best to do this. The TAILOR medication synthesis sought to help understand how best to support deprescribing in older people living with multimorbidity and polypharmacy. Objectives: We identified two research questions: (1) what evidence exists to support the safe, effective and acceptable stopping of medication in this patient group, and (2) how, for whom and in what contexts can safe and effective tailoring of clinical decisions related to medication use work to produce desired outcomes? We thus described three objectives: (1) to undertake a robust scoping review of the literature on stopping medicines in this group to describe what is being done, where and for what effect; (2) to undertake a realist synthesis review to construct a programme theory that describes ‘best practice’ and helps explain the heterogeneity of deprescribing approaches; and (3) to translate findings into resources to support tailored prescribing in clinical practice. Data sources: Experienced information specialists conducted comprehensive searches in MEDLINE, Cumulative Index to Nursing and Allied Health Literature,Web of Science, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials), Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, Google (Google Inc., Mountain View, CA, USA) and Google Scholar (targeted searches). Review methods: The scoping review followed the five steps described by the Joanna Briggs Institute methodology for conducting a scoping review.The realist review followed the methodological and publication standards for realist reviews described by the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) group. Patient and public involvement partners ensured that our analysis retained a patient-centred focus. Results: Our scoping review identified 9528 abstracts: 8847 were removed at screening and 662 were removed at full-text review. This left 20 studies (published between 2009 and 2020) that examined the effectiveness, safety and acceptability of deprescribing in adults (aged ≥ 50 years) with polypharmacy (five or more prescribed medications) and multimorbidity (two or more conditions). Our analysis revealed that deprescribing under research conditions mapped well to expert guidance on the steps needed for good clinical practice. Our findings offer evidence-informed support to clinicians regarding the safety, clinician acceptability and potential effectiveness of clinical decision-making that demonstrates a structured approach to deprescribing decisions. Our realist review identified 2602 studies with 119 included in the final analysis. The analysis outlined 34 context–mechanism–outcome configurations describing the knowledge work of tailored prescribing under eight headings related to organisational, health-care professional and patient factors, and interventions to improve deprescribing. We conclude that robust tailored deprescribing requires attention to providing an enabling infrastructure, access to data, tailored explanations and trust. Limitations: Strict application of our definition of multimorbidity during the scoping review may have had an impact on the relevance of the review to clinical practice. The realist review was limited by the data (evidence) available. Conclusions: Our combined reviews recognise deprescribing as a complex intervention and provide support for the safety of structured approaches to deprescribing, but also highlight the need to integrate patient-centred and contextual factors into best practice models