IA-CCF: Individual accountability for permissioned ledgers

Permissioned ledger systems allow a consortium of members that do not trust one another to execute transactions safely on a set of replicas. Such systems typically use Byzantine fault tolerance (BFT) protocols to distribute trust, which only ensures safety when fewer than 1/3 of the replicas misbehave. Providing guarantees beyond this threshold is a challenge: current systems assume that the ledger is corrupt and fail to identify misbehaving replicas or hold the members that operate them accountable—instead all members share the blame. We describe IA-CCF, a new permissioned ledger system that provides individual accountability. It can assign blame to the individual members that operate misbehaving replicas regardless of the number of misbehaving replicas or members. IA-CCF achieves this by signing and logging BFT protocol messages in the ledger, and by using Merkle trees to provide clients with succinct, universally-verifiable receipts as evidence of successful transaction execution. Anyone can audit the ledger against a set of receipts to discover inconsistencies and identify replicas that signed contradictory statements. IACCF also supports changes to consortium membership and replicas by tracking signing keys using a sub-ledger of governance transactions. IA-CCF provides strong disincentives to misbehavior with low overhead: it executes 47,000 tx/s while providing clients with receipts in two network round trips

The cause of urinary symptoms among Human T Lymphotropic Virus Type I (HLTV-I) infected patients: a cross sectional study

BACKGROUND: HTLV-I infected patients often complain of urinary symptomatology. Epidemiological studies have suggested that these individuals have a higher prevalence and incidence of urinary tract infection (UTI) than seronegative controls. However, the diagnosis of UTI in these studies relied only on patient information and did not require confirmation by urine culture. The purpose of this study was to investigate the role of urinary tract infection (UTI) as the cause of urinary symptoms in HTLV-I infected patients. METHODS: In this cross sectional study we interviewed, and cultured urine from, 157 HTLV-I seropositive individuals followed regularly at a specialized clinic. All patients were evaluated by a neurologist and classified according to the Expanded Disability Status Scale (EDSS). Urodynamic studies were performed at the discretion of the treating physician. RESULTS: Sixty-four patients complained of at least one active urinary symptom but UTI was confirmed by a positive urine culture in only 12 of these patients (19%); the majority of symptomatic patients (81%) had negative urine cultures. To investigate the mechanism behind the urinary complaints in symptomatic individuals with negative urine cultures, we reviewed the results of urodynamic studies performed in 21 of these patients. Most of them (90.5%) had abnormal findings. The predominant abnormalities were detrusor sphincter hyperreflexia and dyssynergia, findings consistent with HTLV-I-induced neurogenic bladder. On a multivariate logistic regression, an abnormal EDSS score was the strongest predictor of urinary symptomatology (OR 9.87, 95% CI 3.465 to 28.116, P < 0.0001). CONCLUSION: Urinary symptomatology suggestive of UTI is highly prevalent among HTLV-I seropositive individuals but true UTI is responsible for the minority of cases. We posit that the main cause of urinary symptoms in this population is neurogenic bladder. Our data imply that HLTV-I infected patients with urinary symptomatology should not be empirically treated for UTI but rather undergo urine culture; if a UTI is excluded, further investigation with urodynamic studies should be considered