Behaviour-based Virus Analysis and Detection

Every day, the growing number of viruses causes major damage to computer systems, which many antivirus products have been developed to protect. Regrettably, existing antivirus products do not provide a full solution to the problems associated with viruses. One of the main reasons for this is that these products typically use signature-based detection, so that the rapid growth in the number of viruses means that many signatures have to be added to their signature databases each day. These signatures then have to be stored in the computer system, where they consume increasing memory space. Moreover, the large database will also affect the speed of searching for signatures, and, hence, affect the performance of the system. As the number of viruses continues to grow, ever more space will be needed in the future. There is thus an urgent need for a novel and robust detection technique. One of the most encouraging recent developments in virus research is the use of formulae, which provides alternatives to classic virus detection methods. The proposed research uses temporal logic and behaviour-based detection to detect viruses. Interval Temporal Logic (ITL) will be used to generate virus specifications, properties and formulae based on the analysis of the behaviour of computer viruses, in order to detect them. Tempura, which is the executable subset of ITL, will be used to check whether a good or bad behaviour occurs with the help of ITL description and system traces. The process will also use AnaTempura, an integrated workbench tool for ITL that supports our system specifications. AnaTempura will offer validation and verification of the ITL specifications and provide runtime testing of these specifications

GT2004-53828 Instrumentation Selection and Uncertainty Analysis for Performance Test of Small Centrifugal Compressors

ABSTRACT In the design phase of centrifugal compressors, it is essential to have some experimental results on performance. The extent of usefulness of the experiments depends on quality and accuracy of the results. Part of proper experimental procedure is the correct selection of instrumentation leading to lower uncertainty in the final results. ASME PTC 10 (Performance Test Code on Compressors and Exhausters) requires fluctuation limits on the measured performance parameters. This does not guarantee limits for accuracy of performance parameters. Also, different experimental setup will affect uncertainty of the results, even with similar instrumentation accuracy. The present research deals with uncertainty analysis for performance evaluation of small-scale centrifugal compressor. The instrumentation errors are accommodated in the relation to ASME PTC 19.1 (test uncertainty). The analysis takes into consideration the correlated bias limits. Selection of proper type of instruments for measuring associated parameters is based on literature review. A case study is included as an example to illustrate the selection on instrumentation accuracy and preferred bias correlations. The analysis is a useful tool in designing experiments for testing compressor and optimizing accuracy of results

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

GT2004-53821 Design of Small Centrifugal Compressors Performance Test Facility

ABSTRACT Improper selection of the instrumentation for a single test rig may lead to inaccurate reading, increase cost or even failure in the system, such as the failure of the mass flow measurement at the venture nozzle, Colantuoni and Colella Actual performance testing is a key element in the design stage, development and troubleshooting of centrifugal compressors. The present work discusses the procedure for designing the experimental setup and the selection of drive unit for variable centrifugal compressors sizes. It starts with setting criteria of selection. A survey over different types of drive units and facility setup was conducted. It was found that the electric drive unit with the aid of transmission for stepping-up the speeds is the most suitable type. This is due mainly to the excellent control property of electric motors allowing for wide range of operational speed and power. A new methodology was developed for selecting operational power and speeds of the drive unit for different sizes of impellers. The code, used for the analysis, was developed by the authors. It calculates the range of input power, input torque, and rotational speeds, as well as, the mass flow rate, total pressure and temperature ratios for different sizes of impellers. This will aid in selecting the proper instrumentation for the experiments. The code used for design methodology is based on one dimensional through flow formulation and validated with experimental results in the literature. It is expected that the present methodology will enhance selection procedure for designing compressor test facility. Some commercial codes are available and designed to estimate the operating conditions of the centrifugal compressors. However, most of them are for industrial applications and used to evaluate conditions during operation and not for the designing purposes, such as, Centrifugal Compressor Tracking Program developed by Ronald, P. Lapina. On the other hand, there are limited codes that can calculate the operating conditions of the compressor for designing purposes. An example of that is the codes developed by PCA Engineering and Concepts Incs. However, these codes do not show on the same figure the effect of changing impeller size or configuration. The present work involves the development of a code that predicts centrifugal compressor performance at different sizes and configurations. Presentation of results is designed such as the selection of drive unit characteristics can be done in a very efficient manner. On the other hand, one of the main requirements in designing the test facility is selecting the proper type of driver unit. For instance, in the present study, the driver has to be flexible to test different types of compressors with good control system on the rotational speed, especially near the surge condition

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit