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Introduction Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis. Objective To review these conditions in Gipuzkoa (Spain), 2014−2019. Methods A retrospective review of serology registries and clinical registries, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA ≥1/256). Results Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids. Conclusion Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.

We investigated whether the difference of antigen tube 2 (TB2) minus antigen tube 1 (TB1) (TB22TB1) of the QuantiFERON-TB gold plus test, which has been postulated as a surrogate for the CD81 T-cell response, could be useful in identifying recent tuberculosis (TB) exposure. We looked at the interferon gamma (IFN-g) responses and differences in TB2 and TB1 tubes for 686 adults with QFT-plus positive test results. These results were compared among groups with high (368 TB contacts), low (229 patients with immune-mediated inflammatory diseases [IMID]), and indeterminate (89 asylum seekers or people from abroad [ASPFA]) risks of recent TB exposure. A TB2-TB1 value.0.6 IU.ml(-1) was deemed to indicate a true difference between tubes. In the whole cohort, 13.6%, 10.9%, and 11.2% of cases had a TB2>TB1 result in the contact, IMID, and ASPFA groups, respectively (P = 0.591). The adjusted odds ratios (aORs) for an association between a TB2-TB1 result of >0.6 IU.ml(-1) and risk of recent exposure versus contacts were 0.71 (95% confidence interval [CI], 0.31 to 1.61) for the IMID group and 0.86 (95% CI, 0.49 to 1.52) for the ASPFA group. In TB contact subgroups, 11.4%, 15.4%, and 17.7% with close, frequent, and sporadic contact had a TB2>TB1 result (P = 0.362). The aORs versus the close subgroup were 1.29 (95% CI, 0.63 to 2.62) for the frequent subgroup and 1.55 (95% CI, 0.67 to 3.60) for the sporadic subgroup. A TB2-TB1 difference of.0.6 IU.ml(-1) was not associated with increased risk of recent TB exposure, which puts into question the clinical potential as a proxy marker for recently acquired TB infection. IMPORTANCE Contact tuberculosis tracing is essential to identify recently infected people, who therefore merit preventive treatment. However, there are no diagnostic tests that can determine whether the infection is a result of a recent exposure or not. It has been suggested that by using the QuantiFERON-TB gold plus, an interferon gamma (IFN-gamma) release assay, a difference in IFN-gamma production between the two antigen tubes (TB2 minus TB1) of.0.6 IU.ml(-1) could serve as a proxy marker for recent infection. In this large multinational study, infected individuals could not be classified according to the risk of recent exposure based on differences in IFN- g in TB1 and TB2 tubes that were higher than 0.6 IU.ml(-1). QuantiFERON-TB gold plus is not able to distinguish between recent and remotely acquired tuberculosis infection, and it should not be used for that purpose in contact tuberculosis tracing. Funding Agencies|Department of Clinical Sciences of the University of Barcelona

The heterogeneity of Internet of Things (IoT) systems has so far prevented the definition of adequate standards, hence making it difficult to compare meaningfully the security degree of diverse architectural choices. This task can be nonetheless achieved with formal methodologies. However, the dedicated IoT literature shows no evidence of a universal model allowing the security evaluation of any arbitrary system. Based on these considerations, we propose a new model that aims at being global and all-encompassing. Our model can be used to fairly analyse the security level of different IoT systems and compare them in a significant way. It is designed to be adaptive with realistic definitions of the adversary’s (1) actions of interacting with IoT systems; (2) capabilities of accessing the data generated by and exchanged in IoT systems with established rules; and (3) objectives of attacking IoT systems according to the four recognised security properties of confidentiality, integrity, availability and soundness. Such a design enables the straightforward characterization of new adversaries. It further helps in providing a fine-grained security evaluation of IoT systems by either accurately describing attacks against the analysed systems or formally proving their guaranteed level of security.

A nosocomial case of Legionella pneumophila pneumonia likely caused by a serogroup 3 strain was detected by a urinary antigen test in Spain in 2018. Although Legionella bacteria could not be isolated from respiratory samples, molecular methods implicated the sink faucet of the patient's room as the probable infection source.

BackgroundClinical trials are conducted during pregnancy to evaluate benefits and risks of medicines for mother and child. The safety of maternal treatments is a key issue for healthcare professionals and parents.ObjectiveTo analyse offspring data reported in clinical trials in pregnant women with diabetes, HIV infection or hypertension (three of the most common diseases in women of childbearing potential) and either treated prior to pregnancy for these chronic diseases or diagnosed and treated during pregnancy.MethodsPubMed and Embase (1 January 1997 to 31 December 2017) were searched for drug trials in pregnant women with diabetes, HIV infection or hypertension. Titles and abstracts were screened, followed by a full-text review of eligible articles. Inclusion criteria were interventional clinical trials in pregnant women treated with medication and full text in English. Trial characteristics, maternal and offspring data were extracted. Data were summarised by disease and study. Twelve key items were considered for the offspring.ResultsOverall, 196 articles reporting 132 clinical trials (diabetes n=55; HIV n=59; hypertension n=18) were included. Key offspring data were frequently not reported, for example, number of births (diabetes: 22/55, 40%; HIV: 14/59, 24%; hypertension: 10/18, 56%). Congenital malformations were often not reported with sufficient detail (diabetes: 40/55, 73%; HIV: 39/59, 66%; hypertension: 17/18, 94%). Similar observations were made for other key items (eg, fetal losses, neonatal deaths).ConclusionUnder-reporting of key data for the offspring was frequent in publications of clinical trials in pregnant women with diabetes, HIV infection or hypertension making the assessment of the benefit-risk ratio of treatment options during pregnancy difficult.Trial registration numberCRD42017057024.

Objectives The aim of the study was to assess the feasibility of living network meta-analysis (NMA) taking into account the pace of evidence generation across different medical areas. Study Design and Setting We performed a systematic review to identify published NMAs. For each NMA, we calculated the cumulative number of new trials. To assess the feasibility of living NMA, we considered different update frequencies (4, 6, and 12 months), then evaluated the number of new trials to be included at each update in the NMA and the workload percentage for an update relative to the initial NMA. Results We identified 77 NMAs covering 17 different medical areas; 60 (78%) had fewer than four new trials included per year, on average, and 5 (7%) had more than seven trials. With an update frequency of 4, 6, and 12 months, the median number of new trials to be included in the NMA was 0 (interquartile range, 0–1), 1 (0–2), and 2 (1–4), respectively, with mean of 4%, 5%, and 11% workload per update, respectively. Conclusion The workload associated with updating a living NMA represents about one-tenth of the initial workload; therefore, living NMA is manageable.

After several years of research on cryptographic models for privacy in RFID systems, it appears that no universally model exists yet. Experience shows that security experts usually prefer using their own ad-hoc model than the existing ones. In particular, the impossibility of the models to refine the privacy assessment of different protocols has been highlighted in several studies. The paper emphasizes the necessity to define a new model capable of comparing protocols meaningfully. It introduces an untraceability model that is operational where the previous models are not. The model aims to be easily usable to design proofs or describe attacks. This spirit led to a modular model where adversary actions (oracles), capabilities (selectors and restrictions), and goals (experiment) follow an intuitive and practical approach. This design enhances the ability to formalize new adversarial assumptions and future evolutions of the technology, and provide a finest privacy evaluation of protocols.

Australia has worked towards uniform food legislation since 1908. The development of an effective national food safety regulatory system for Australia was driven by a number of imperatives including: to reduce inconsistencies and inefficiencies with State and Territory legislation; to reduce the cost of food regulation on the food industry; an increase in foodborne illness; a concern that existing requirements were ineffective in reducing the growing burden of foodborne illness; and international developments linking food safety with trade. However, it was not until the end of 2000 that States and Territories formally agreed to a national food safety regulatory system. The recently introduced national food safety regulatory system consists of: nationally consistent Food Acts; mandatory standards for food safety practices and food premises and equipment; a ‘model’ standard for ‘food safety programs’ and supporting infrastructure projects to assist with its implementation. The primary objective of this new system is to reduce the incidence of foodborne illness in Australia by requiring food businesses to take responsibility for the safety of the food they handle and sell by moving towards a preventative approach to managing the food safety risks within their business. The States and Territories are now implementing this system and will be formally evaluating whether it is effective in improving the safety of food within Australia.

The rise of wireless applications based on RFID has brought up major concerns on privacy. Indeed nowadays, when such an application is deployed, informed customers yearn for guarantees that their privacy will not be threatened. One formal way to perform this task is to assess the privacy level of the RFID application with a model. However, if the chosen model does not reflect the assumptions and requirements of the analyzed application, it may misevaluate its privacy level. Therefore, selecting the most appropriate model among all the existing ones is not an easy task. This paper investigates the eight most well-known RFID privacy models and thoroughly examines their advantages and drawbacks in three steps. Firstly, five RFID authentication protocols are analyzed with these models. This discloses a main worry: although these protocols intuitively ensure different privacy levels, no model is able to accurately distinguish them. Secondly, these models are grouped according to their features (e.g., tag corruption ability). This classification reveals the most appropriate candidate model(s) to be used for a privacy analysis when one of these features is especially required. Furthermore, it points out that none of the models are comprehensive. Hence, some combinations of features may not match any model. Finally, the privacy properties of the eight models are compared in order to provide an overall view of their relations. This part highlights that no model globally outclasses the other ones. Considering the required properties of an application, the thorough study provided in this paper aims to assist system designers to choose the best suited model.

Authentication protocols are usually designed to face an adversary who is able to tamper with the channel, possibly with the prover, but rarely with the verifier. When considering large-scale RFID applications, e.g., mass transportation or ticketing, the last threat is no longer a fiction. A typical case is the loss or theft of a handheld reader. If the protocol is expected to be privacy-friendly, and run by offline readers, there is no solution currently to restore the privacy once the readers are compromised except renewing all the tags, which is definitely impractical. We introduce a privacy-friendly authentication protocol that is able to maintain the security level in case of compromised readers, but also gradually restores the privacy thanks to the mobility of the customers in the system. We provide a thorough security analysis and a precise performance evaluation of our proposal. The efficiency of our solution is also demonstrated on a real-life case: we analyze the logs of 55 offline readers used during a 3-day sport event in 2010 that involved more than 100,000 tags.

Privacy is one of the most important security concerns in radio frequency identification. The publication of hundred RFID-based authentication protocols during the last decade raised the need of designing a dedicated privacy model. An important step has been done with the model of Vaudenay that combines early models into a unified and powerful one. In particular, this model addresses the case where an adversary is able to know whether or not the protocol execution succeeded. This modelizes the fact that the adversary may get information from a side channel about the termination of the protocol, e.g., she notices that the access is granted to the RFID-tag holder. We go one step forward in this paper and stress that the adversary may also have access to a side channel that leaks the computational time of the reader. This modelizes an adversary who measures how long it takes to grant the access. Although this channel could be seen as an implementation flaw, we consider that it is always risky to require the implementation to solve what the design should deal with. This new channel enables to demonstrate that many key-reference protocols are not as privacy-friendly as they claim to be, e.g., WSRE, OSK, C2, O-FRAP, O-FRAKE,... We then introduce the TIMEFUL oracle in the model of Vaudenay, which allows to analyze the resistance of the protocols to time-based attacks as soon as the design phase. Finally, we suggest some methods that make RFID-based authentication protocols immune to such attacks.

RFID-based access control solutions for mobile environments, e.g. ticketing systems for sport events, commonly rely on readers that are not continuously connected to the back-end system. The readers must so be able to perform their tasks even in offline mode, what commonly requires the management by the readers of sensitive data. We stress in this paper the problem of compromised readers and its impact in practice. We provide a thorough review of the existing authentication protocols faced to this constraint, and extend our analysis with the privacy property. We show that none of the reviewed protocols fits the required properties in case of compromised readers. We then design a sporadically-online solution that meets our expectations in terms of both security and privacy.