Digital Investigation of Security Attacks on Cardiac Implantable Medical Devices

A Cardiac Implantable Medical device (IMD) is a device, which is surgically implanted into a patient's body, and wirelessly configured using an external programmer by prescribing physicians and doctors. A set of lethal attacks targeting these devices can be conducted due to the use of vulnerable wireless communication and security protocols, and the lack of security protection mechanisms deployed on IMDs. In this paper, we propose a system for postmortem analysis of lethal attack scenarios targeting cardiac IMDs. Such a system reconciles in the same framework conclusions derived by technical investigators and deductions generated by pathologists. An inference system integrating a library of medical rules is used to automatically infer potential medical scenarios that could have led to the death of a patient. A Model Checking based formal technique allowing the reconstruction of potential technical attack scenarios on the IMD, starting from the collected evidence, is also proposed. A correlation between the results obtained by the two techniques allows to prove whether a potential attack scenario is the source of the patient's death.Comment: In Proceedings AIDP 2014, arXiv:1410.322

An Evaluation of Formant Tracking methods on an Arabic Database

International audienceIn this paper we present a formant database of Arabic used to evaluate our new automatic formant tracking algorithm based on Fourier ridges detection. In this method we have introduced a continuity constraint based on the computation of centres of gravity for a set of formant candidates. This leads to connect a frame of speech to its neighbours and thus improves the robustness of tracking. The formant trajectories obtained by the algorithm proposed are compared to those of the hand edited formant database and those given by Praat with LPC data

Evaluation d'une nouvelle méthode de suivi de formants sur un corpus Arabe

National audienceThis paper develops a formant tracking technique based on Fourier ridges detection. In this method we have introduced a constraint of tracking based on the computation of centre of gravity for a set of frequency formant candidates which leads to connect a frame of speech to its neighbours and thus to improve the robustness of tracking. The formant trajectories obtained by the algorithm proposed are compared to those of a hand edited formant Arabic database, created especially for this work, and those given by Praat with LPC data

Trajectory planing for cooperating unmanned aerial vehicles in the IoT

The use of Unmanned Aerial Vehicles (UAVs) in data transport has attracted a lot of attention and applications, as a modern traffic engineering technique used in data sensing, transport, and delivery to where infrastructure is available for its interpretation. Due to UAVs’ constraints such as limited power lifetime, it has been necessary to assist them with ground sensors to gather local data, which has to be transferred to UAVs upon visiting the sensors. The management of such ground sensor communication together with a team of flying UAVs constitutes an interesting data muling problem, which still deserves to be addressed and investigated. This paper revisits the issue of traffic engineering in Internet-of-Things (IoT) settings, to assess the relevance of using UAVs for the persistent collection of sensor readings from the sensor nodes located in an environment and their delivery to base stations where further processing is performed. We propose a persistent path planning and UAV allocation model, where a team of heterogeneous UAVs coming from various base stations are used to collect data from ground sensors and deliver the collected information to their closest base stations. This problem is mathematically formalised as a real-time constrained optimisation model, and proven to be NP-hard. The paper proposes a heuristic solution to the problem and evaluates its relative efficiency through performing experiments on both artificial and real sensors networks, using various scenarios of UAVs settings

Border surveillance monitoring using Quadcopter UAV-Aided Wireless Sensor Networks

In this paper we propose a novel cooperative bordersurveillance solution, composed of a Wireless Sensor Network (WSN) deployed terrestrially to detect and track trespassers, and a set of lightweight unmanned aircraft vehicles (UAVs) in the form of quadcopters that interact with the deployed WSN to improve the border surveillance, the detection and investigation of network failures, the maintenance of the sensor network, the tracking of trespasser, the capture and transmission of realtime video of the intrusion scene, and the response to hostage situations. A heuristic-based scheduling algorithm is described to optimize the tracking mission by increasing the rate of detected trespassers spotted by the quadcopters. Together with the design of the electrical, mechanical and software architecture of the proposed VTail quadcopter, we develop in this paper powerless techniques to accurately localize terrestrial sensors using RFID technology, compute the optimal positions of the new sensors to drop, relay data between isolated islands of nodes, and wake up sensors to track intruders. The developed VTail prototype is tested to provide valid and accurate parameters’ values to the simulation. The latter is conducted to evaluate the performance of the proposed WSN-based surveillance solution

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Effect of Exogenous Fibrolytic Enzymes Supplementation or Functional Feed Additives on In Vitro Ruminal Fermentation of Chemically Pre-Treated Sunflower Heads

peer reviewedThis study aims to provide possible utilization of sunflower head byproduct (SFH) as a feedstuff by implementing chemical pretreatments (4% sodium hydroxide (SFHNaOH) or 4% urea (SFHurea) and supplementation with either exogenous fibrolytic enzymes (EFE) or functional feed additive (FFA). The experimental EFE was a complex (1:1, v/v) of two enzyme products with high activity of β-1,3-1,4-glucanase and endo-1,4-β-D-xylanase and applied at 0 (SFHout), 1, 2, 5, and 10 µL/ gdry matter, while FFA was a fermentation byproduct rich in cellulase and xylanase activities, applied at 0 (SFHout), 0.5, 1, 2, and 4 mg/g DM. SFHurea had the highest (p < 0.05) crude protein (CP) content compared to other SFH substrates. Linear enhancements (p < 0.05) in kinetics of gas production (GP), metabolizable energy (ME), organic matter digestibility (OMD) and total short-chain fatty acids (SCFAs) concentrations were observed for all SFH substrates supplemented with EFE. The SFHout had the highest (p < 0.05) potential GP, maximum rate (Rmax) of GP, ME, OMD and SCFAs. Supplementation of EFE was more pronounced than FFA in affecting the kinetic parameters of in vitro GP for all SFH substrates. SFHout supplemented with EFE seems to be the most promising substrate to enhance microbial fermentation in vitro

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially