Burn after reading: A shadow stack with microsecond-level runtime rerandomization for protecting return addresses

Return-oriented programming (ROP) is an effective code-reuse attack in which short code sequences (i.e., gadgets) ending in a ret instruction are found within existing binaries and then executed by taking control of the call stack. The shadow stack, control flow integrity (CFI) and code (re)randomization are three popular techniques for protecting programs against return address overwrites. However, existing runtime rerandomization techniques operate on concrete return addresses, requiring expensive pointer tracking. By adding one level of indirection, we introduce BarRA, the first shadow stack mechanism that applies continuous runtime rerandomization to abstract return addresses for protecting their corresponding concrete return addresses (protected also by CFI), thus avoiding expensive pointer tracking. As a nice side-effect, BarRA naturally combines the shadow stack, CFI and runtime rerandomization in the same framework. The key novelty of BarRA, however, is that once some abstract return addresses are leaked, BarRA will enforce the burn-after-reading property by rerandomizing the mapping from the abstract to the concrete return address space in the order of microseconds instead of seconds required for rerandomizing a concrete return address space. As a result, BarRA can be used as a superior replacement for the shadow stack, as demonstrated by comparing both using the 19 C/C++ benchmarks in SPEC CPU2006 (totalling 2,047,447 LOC) and analyzing a proof-of-concept attack, provided that we can tolerate some slight binary code size increases (by an average of 29.44%) and are willing to use 8MB of dedicated memory for holding up to 220 return addresses (on a 64-bit platform). Under an information leakage attack (for some return addresses), the shadow stack is always vulnerable but BarRA is significantly more resilient (by reducing an attacker's success rate to 1 220 on average). In terms of the average performance overhead introduced, both are comparable: 6.09% (BarRA) vs. 5.38% (the shadow stack)

Efficacy, safety and impact on antimicrobial resistance of duration and dose of amoxicillin treatment for young children with Community-Acquired Pneumonia: A protocol for a randomIsed controlled Trial (CAP-IT)

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. Introduction Community-acquired pneumonia (CAP) is a common indication for antibiotic treatment in young children. Data are limited regarding the ideal dose and duration of amoxicillin, leading to practice variation which may impact on treatment failure and antimicrobial resistance (AMR). Community-Acquired Pneumonia: a randomIsed controlled Trial (CAP-IT) aims to determine the optimal amoxicillin treatment strategies for CAP in young children in relation to efficacy and AMR. Methods and analysis The CAP-IT trial is a multicentre, randomised, double-blind, placebo-controlled 2×2 factorial non-inferiority trial of amoxicillin dose and duration. Children are enrolled in paediatric emergency and inpatient environments, and randomised to receive amoxicillin 70-90 or 35-50 mg/kg/day for 3 or 7 days following hospital discharge. The primary outcome is systemic antibacterial treatment for respiratory tract infection (including CAP) other than trial medication up to 4 weeks after randomisation. Secondary outcomes include adverse events, severity and duration of parent-reported CAP symptoms, adherence and antibiotic resistance. The primary analysis will be by intention to treat. Assuming a 15% primary outcome event rate, 8% non-inferiority margin assessed against an upper one-sided 95% CI, 90% power and 15% loss to follow-up, 800 children will be enrolled to demonstrate non-inferiority for the primary outcome for each of duration and dose. Ethics and dissemination The CAP-IT trial and relevant materials were approved by the National Research Ethics Service (reference: 16/LO/0831; 30 June 2016). The CAP-IT trial results will be published in peer-reviewed journals, and in a report published by the National Institute for Health Research Health Technology Assessment programme. Oral and poster presentations will be given to national and international conferences, and participating families will be notified of the results if they so wish. Key messages will be constructed in partnership with families, and social media will be used in their dissemination. Trial registration number ISRCTN76888927, EudraCT2016-000809-36

JEFET SCHWILI ERZÄHLT. Hundertneunundsechzig jemenitische Volkserzählungen aufgeszeichnet in Israel 1957 - 1960. Herausgegeben von DOV NOY. Supplement - Serie zu Fabula , Reihe A, Band 4. Walter de Gruyter, Berlin 1963.

Precautionary conservation and cooperative global governance are needed to protect Antarctic blue carbon: the world’s largest increasing natural form of carbon storage with high sequestration potential. As patterns of ice‐loss around Antarctica become more uniform, there is an underlying increase in carbon capture‐to‐storage‐to‐sequestration on the seafloor. The amount of carbon captured per unit area is increasing and the area available to blue carbon is also increasing. Carbon sequestration could further increase under moderate (+1 °C) ocean warming, contrary to decreasing global blue carbon stocks elsewhere. For example, in warmer waters, mangroves and seagrasses are in decline and benthic organisms are close to their physiological limits, so a 1°C increase in water temperature could push them above their thermal tolerance (e.g. bleaching of coral reefs). In contrast, on the basis of past change and current research we expect that Antarctic blue carbon could increase by orders of magnitude.The Antarctic seafloor is biophysically unique and the site of carbon sequestration, the benthos, faces less anthropogenic disturbance than any other ocean continental shelf environment. This isolation imparts both vulnerability to change, and an avenue to conserve one of the world’s last biodiversity refuges. In economic terms, the value of Antarctic blue carbon is estimated at between £0.65 billion and £1.76 billion (~2.27 billion USD), for sequestered carbon in the benthos around the continental shelf. To balance biodiversity protection against society’s economic objectives, this paper builds on a proposal incentivising protection by building a ‘non‐market framework’ via the 2015 Paris Agreement to the United Nations Framework Convention on Climate Change. This could be connected and coordinated through the Antarctic Treaty System to promote and motivate member states to value Antarctic blue carbon and maintain scientific integrity and conservation for the positive societal values ingrained in the Antarctic Treaty System

Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Despite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers) in pediatric emergency departments (PEDs) for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs.</p> <p>Methods</p> <p>Using a comparative case study design, we classified nine tertiary care pediatric hospital PEDs based on their stage of implementation. Data were collected using focus group interviews with physicians, registered nurses (RNs), and respiratory therapists (RTs), and individual interviews with both patient care and medical directors at each site. Initial coding was based on the Ottawa Model of Research Use (OMRU) categories of elements known to influence the uptake of innovations.</p> <p>Results</p> <p>One hundred and fifty healthcare professionals from nine different healthcare institutions participated in this study. Lack of leadership in the form of a research champion, a lack of consensus about the benefits of MDI/spacers among staff, perceived resistance from patients/parents, and perceived increased cost and workload associated with MDI/spacer use were the most prevalent barriers to the adoption of the MDI/spacer. Common strategies used by early-adopting sites included the active participation of all professional groups in the adoption process in addition to a well-planned and executed educational component for staff, patients, and families. Early adopter sites were also more likely to have the MDI/spacer included in a clinical protocol/pathway.</p> <p>Conclusion</p> <p>Potential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study.</p

Non-specific cough in children: diagnosis and treatment

Cough is a common reason for parents to seek medical attention. When the history, examination, chest X-ray and, if possible, spirometry ore normal, the cough can be classified as non-specific, which is often found. This article focuses on non-specific cough, addresses common questions and gives a simple approach to evaluating the child with a cough