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Sample records for phlegm wheeze attacks

  1. Prevalence of chronic cough, chronic phlegm & associated factors in Mysore, Karnataka, India.

    Science.gov (United States)

    Mahesh, P A; Jayaraj, B S; Prabhakar, A K; Chaya, S K; Vijayasimha, R

    2011-07-01

    Chronic cough and chronic phlegm are important indicators of respiratory morbidity, accelerated lung function decline, increased hospitalization and mortality. This study was planned to estimate the prevalence of chronic cough and phlegm in the absence of dyspneoa and wheezing and to study its associated factors in a representative population of Mysore district. A cross-sectional survey was planned in a representative population of Mysore taluk. Eight villages were randomly selected based on the list of villages from census 2001. Trained field workers using the Burden of Obstructive Diseases questionnaire carried out a house-to-house survey. A total of 4333 adult subjects were enrolled in the study with 2333 males and 2000 females. The prevalence of chronic cough in the community was 2.5 per cent and that of chronic phlegm was 1.2 per cent. A significant association was observed between chronic cough and age, gender, occupation and smoking and chronic phlegm with age, gender, occupation, indoor animals and smoking. A multivariate analysis confirmed independent association of age, occupation and smoking for chronic cough and age and smoking for chronic phlegm. On sub-group analysis of males, heavy smokers had higher prevalence of chronic cough and chronic phlegm as compared to light smokers and non smokers. The prevalence of chronic cough was 2.5 per cent and chronic phlegm was 1.2 per cent in the general population in Mysore which is lower than that observed in other studies. Heavy smoking was an important preventable risk factor identified in this study and efforts towards smoking cessation are crucial to achieve good respiratory health in the community.

  2. Primary mucoepidermoid carcinoma at the carina of trachea presenting with wheezing in an asthmatic child mimicking an attack of asthma: A case report.

    Science.gov (United States)

    Lin, Chien-Heng; Chao, Yu-Hua; Wu, Kang-Hsi; Lin, Wei-Ching

    2016-11-01

    Asthma is a very common disease, but primary tracheal tumors are extremely rare in children. Wheezing is not pathognomonic, but is the typical presentation of asthma and could also be found in patients with tracheal tumors. This report describes a 12-year-old boy with a previous history of frequent asthma attacks and experienced responses to antiasthma treatment. He was admitted to the hospital due to persistent wheezing and progressive dyspnea. Hyperinflation in the bilateral lungs was detected on chest x-ray, but without other significant findings. Chest computed tomography revealed a mass at the carina. Tracheal mucoepidermoid carcinoma was diagnosed by histopathological assessment. Despite the rarity of tracheal tumors, chest computed tomography scans should be performed in the first place for children presenting persistent wheezing and having poor response to antiasthma treatment to rule out the other alternative diagnosis. Coexistence of other diseases such as tracheal tumor in asthmatic patients should be considered.

  3. Limit Asthma Attacks Caused by Colds or Flu

    Science.gov (United States)

    Asthma: Limit asthma attacks caused by colds or flu A cold or the flu can trigger an asthma attack. Here's why — and how to keep your sneeze ... plan. If you notice warning signs of an asthma attack — such as coughing, wheezing, chest tightness or shortness ...

  4. Lack of effect of zinc sulfate on wheezing after bronchiolitis in infants less than two years

    Directory of Open Access Journals (Sweden)

    R Abasi

    2014-10-01

    Full Text Available Backgrounds & aim: Wheezing after bronchiolitis is known as a risk factor for asthma. No cure or effective vaccine has been identified for such disease. The purpose of this study was to determine the effects of zinc sulfate on persistent wheezing after bronchiolitis in infants less than two years. Methods: The present randomized clinical trial study was conducted on 90 infants under two years of age suffering from the first attack with a clinical diagnosis of bronchiolitis wheezing hospitalized in Imam Sajjad Hospital, Yasuj. All infants were equally placed in test groups and control group. In addition to bronchiolitis usual treatment, test group received 20 mg of elemental zinc for seven days. Patient information including risk factors associated with wheezing and persistent wheezing were compared 48 hours and two weeks after treatment. Data were analyzed using chi-square and t tests. Results: In all 90 infants diagnosed with bronchiolitis, wheezing was observed. After 48 hours and two weeks wheezing was continued in 67 patients (74.4% and 54 patients (60% respectively Conclusion: The results showed Zinc sulfate had no effect on the improvement of wheezing after bronchiolitis.

  5. Soft Stethoscope for Detecting Asthma Wheeze in Young Children

    Directory of Open Access Journals (Sweden)

    Chun Yu

    2013-06-01

    Full Text Available Asthma is a chronic disease that is commonly suffered by children. Asthmatic children have a lower quality of life than other children. Physicians and pediatricians recommend that parents record the frequency of attacks and their symptoms to help manage their children’s asthma. However, the lack of a convenient device for monitoring the asthmatic condition leads to the difficulties in managing it, especially when it is suffered by young children. This work develops a wheeze detection system for use at home. A small and soft stethoscope was used to collect the respiratory sound. The wheeze detection algorithm was the Adaptive Respiratory Spectrum Correlation Coefficient (RSACC algorithm, which has the advantages of high sensitivity/specificity and a low computational requirement. Fifty-nine sound files from eight young children (one to seven years old were collected in the emergency room and analyzed. The results revealed that the system provided 88% sensitivity and 94% specificity in wheeze detection. In conclusion, this small soft stethoscope can be easily used on young children. A noisy environment does not affect the effectiveness of the system in detecting wheeze. Hence, the system can be used at home by parents who wish to evaluate and manage the asthmatic condition of their children.

  6. Soft stethoscope for detecting asthma wheeze in young children.

    Science.gov (United States)

    Yu, Chun; Tsai, Tzu-Hsiu; Huang, Shi-Ing; Lin, Chii-Wann

    2013-06-06

    Asthma is a chronic disease that is commonly suffered by children. Asthmatic children have a lower quality of life than other children. Physicians and pediatricians recommend that parents record the frequency of attacks and their symptoms to help manage their children's asthma. However, the lack of a convenient device for monitoring the asthmatic condition leads to the difficulties in managing it, especially when it is suffered by young children. This work develops a wheeze detection system for use at home. A small and soft stethoscope was used to collect the respiratory sound. The wheeze detection algorithm was the Adaptive Respiratory Spectrum Correlation Coefficient (RSACC) algorithm, which has the advantages of high sensitivity/specificity and a low computational requirement. Fifty-nine sound files from eight young children (one to seven years old) were collected in the emergency room and analyzed. The results revealed that the system provided 88% sensitivity and 94% specificity in wheeze detection. In conclusion, this small soft stethoscope can be easily used on young children. A noisy environment does not affect the effectiveness of the system in detecting wheeze. Hence, the system can be used at home by parents who wish to evaluate and manage the asthmatic condition of their children.

  7. A deceiving wheeze.

    LENUS (Irish Health Repository)

    Chotirmall, S H

    2009-08-07

    \\'Wheeze\\' is a common symptom in both paediatric and adult populations. Unexplained wheeze is concerning and warrants investigation. We present a case of a young girl with childhood asthma suffering with \\'persistent wheeze\\'. This was explained by the presence of a dual aortic arch which only became apparent during her teenage years. This report serves as a reminder to all clinicians that "not all that wheezes is asthma".

  8. First episode of preschool wheeze requiring hospitalization: a prospective study on the chance of recurrence and associated factors.

    Science.gov (United States)

    Chantawarangul, Karaked; Deerojanawong, Jitladda; Sritippayawan, Suchada

    2017-09-17

    Although wheezing is very common in preschoolers, epidemiologic studies in Thailand are quite limited. The likelihood of having a second wheezing episode following the first attack remains unclearly established. This study aims to investigate the incidence of recurrent wheezing in preschool children presenting with first wheezing episode and identify the associated factors. The study is an observational prospective study conducted at the inpatient pediatric department. Patients admitted with first episode of wheezing were followed up as an outpatient approximately one week after hospital discharge and subsequently followed up by telephone 3-monthly with a structured questionnaire seeking information concerning recurrent wheezing, defined as having a second wheezing episode requiring bronchodilator within a 1-year period. The total of 97 patients, aged 6 months to 5 years, were recruited from June 2014 to November 2015. Thirty-five patients were excluded because of inaccessibility for telephone follow-up. Amongst the remaining 62 patients, twenty-eight (45.2%) had recurrent wheezing within one year. The mean lapse duration was 4.7 ± 3.7 months after the first episode. Having an allergic sensitization to aeroallergen was a risk factor for recurrent wheezing (OR 2.48, 95%CI 1.81-3.4). Although not statistically significant, having an allergic sensitization to food seems to be another related factor (OR 2.36, 95%CI 1.75-3.18). The recurrent rate of wheezing was 45%, which was considerably significant. Allergic sensitization to aeroallergen might increase the risk. These patients should be followed up, especially within the first year after their first wheezing episode.

  9. The association between blood lipid and phlegm turbidity syndrome of angina pectoris: a systematic review and meta-analysis.

    Science.gov (United States)

    Kong, Dezhao; Wang, Yang; Liu, Yue; Zhang, Zhe; Liu, Guanghui; Qi, Wencheng; Xiao, Lei; Yuan, Dongchao; Yang, Guanlin

    2014-08-01

    A series of case-control studies have been conducted to investigate the association between blood lipid and phlegm turbidity syndrome of angina pectoris, but produced inconsistent results. We performed a meta-analysis to determine the association between blood lipid and phlegm turbidity syndrome of angina pectoris more precisely. Manual screening as well as screening of the China National Knowledge Infrastructure (CNKI), Chinese Journal full-text database (VIP), Wanfang database (WF), ScienceDirect, Pubmed, the Cochrane Library, and Embase were carried out for relevant literature. The formula was translated to calculate the pooled mean value and standard deviation value. The "Newcastle-Ottawa Quality Assessment Scale: Case-Control Studies" (NOS) was taken to assess the quality of the included studies. The Revman 5.2.6 software provided by "The Cochrane Collaboration" was used to analyze the collected data. The subgroup analysis was established according to the sample size proportion between the test group and the control group. Sensitivity analysis was constructed by using two different effect models. Besides, a funnel plot was created to analyze potential publication bias. No statistically meaningful difference existed between the test group and control group of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) in non-Qi and yin deficiency syndrome (QYDS) and non-Yang deficiency syndrome (YDS) subgroup, whereas the two biotic indicators in the test group were higher than the non-phlegm syndrome group in other subgroups. Triglyceride (TG) in phlegm syndrome group showed superior to non-phlegm syndrome group in the rest subgroups except for the non-CCS (Cold coagulating syndrome)-non-YDS subgroup. High-density lipoprotein-cholesterol (HDL-C) levels of the phlegm group were lower than that of the non-phlegm group in all subgroups. When comparing with Traditional Chinese Medicine (TCM) syndromes of asthenia nature, such as YDS, QYDS, and heart qi

  10. Focal Stenosis in Right Upper Lobe Bronchus in a Recurrently Wheezing Child Sequentially Studied by Multidetector-row Spiral Computed Tomography and Scintigraphy

    Directory of Open Access Journals (Sweden)

    I-Chen Chen

    2009-12-01

    Full Text Available Lower respiratory tract infections associated with wheezing are not uncommon in infants and young children. Among the wheezing-associated disorders, allergic etiologies are more commonly encountered than anatomic anomalies. We present a 3-year-old girl with a sudden attack of asthmatic symptoms including dyspnea, cyanosis and diffuse wheezing. Based on a history of choking, and atelectasis in the right upper lobe detected by chest films, flexible tracheobronchoscopy was arranged and incidentally detected a stenotic orifice in the right upper lobe bronchus. Multidetector-row spiral computed tomography and pulmonary scintigraphy subsequently also disclosed the focal stenosis. She suffered from recurrent wheezing, pneumonia and lung atelectasis during 1 year of follow-up. We emphasize the diagnosis, clinical course and management of focal stenosis in the right upper lobe bronchus.

  11. Preschool wheeze: pathogenetic factors

    African Journals Online (AJOL)

    Ehab

    trigger wheeze are more likely to have asthma compared to those with ... The role of airway infections in preschool wheeze ... and immunocompromised patients, with children younger than five ... expiratory flows and volumes were observed in.

  12. Infantile wheeze: rethinking dogma.

    Science.gov (United States)

    de Benedictis, Fernando Maria; Bush, Andrew

    2017-04-01

    Wheeze is a common symptom in young children and is usually associated with viral illnesses. It is a major source of morbidity and is responsible for a high consumption of healthcare and economic resources worldwide. A few children have a condition resembling classical asthma. Rarer specific conditions may have a wheezy component and should be considered in the differential diagnosis. Over the last half century, there have been many circular discussions about the best way of managing preschool wheeze. In general, intermittent wheezing should be treated with intermittent bronchodilator therapy, and a controller therapy should be prescribed for a young child with recurrent wheezing only if positively indicated, and only then if carefully monitored for efficacy. Good multidisciplinary support, attention to environmental exposition and education are essential in managing this common condition. This article analyses the pathophysiological basis of wheezing in infancy and critically discusses the evolution of the scientific progress over time in this unique field of respiratory medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma.

    Science.gov (United States)

    Weinberger, Miles; Abu-Hasan, Mutasim

    2007-10-01

    Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome. The respiratory sounds that occur with the upper airway obstruction caused by the various manifestations of the vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia are often mischaracterized as wheezing and attributed to asthma. The perception of dyspnea is a prominent symptom of hyperventilation attacks. This can occur in those with or without asthma, and patients with asthma may not readily distinguish the perceived dyspnea of a hyperventilation attack from the acute airway obstruction of asthma. Dyspnea on exertion, in the absence of other symptoms of asthma or an unequivocal response to albuterol, is most likely a result of other causes. Most common is the dyspnea associated with normal exercise limitation, but causes of dyspnea on exertion can include other physiologic abnormalities including exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, and exercise-induced supraventricular tachycardia. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations.

  14. Synthetic bedding and wheeze in childhood.

    Science.gov (United States)

    Ponsonby, Anne-Louise; Dwyer, Terence; Kemp, Andrew; Cochrane, Jennifer; Couper, David; Carmichael, Allan

    2003-01-01

    The reasons for the increase in childhood asthma over time are unclear. The indoor environment is of particular concern. An adverse role for synthetic bedding on asthma development in childhood has been suggested by cross-sectional studies that have found an association between synthetic pillow use and childhood wheeze. Prospective data on infant bedding have not been available. Bedding data at 1 month of age were available from an infant survey for children who were participating in a 1995 follow-up study (N = 863; 78% traced). The 1995 follow-up was embedded in a larger cross-sectional survey involving 6,378 seven year olds in Tasmania (N = 92% of eligible). Outcome measures included respiratory symptoms as defined in the International Study of Asthma and Allergies in Childhood protocol. Frequent wheeze was defined as more than 12 wheeze episodes over the past year compared with no wheeze. Synthetic pillow use at 1 month of age was associated with frequent wheeze at age 7 (adjusted relative risk [aRR] = 2.5; 95% confidence interval [CI] = 1.2-5.5) independent of childhood exposure. Current synthetic pillow and quilt use was strongly associated with frequent wheeze (aRR = 5.2; CI = 1.3-20.6). Substantial trends were evident for an association of increasing number of synthetic bedding items with frequent wheeze and with increasing wheeze frequency. Among children with asthma, the age of onset of asthma occurred earlier if synthetic bedding was used in infancy. In this cohort, synthetic bedding was strongly and consistently associated with frequent childhood wheeze. The association did not appear to be attributable to bedding choice as part of an asthma management strategy.

  15. Definition, assessment and treatment of wheezing disorders in preschool children

    DEFF Research Database (Denmark)

    Brand, P L P; Baraldi, E; Bisgaard, H

    2008-01-01

    There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze...

  16. Treatment of Phlegm- and Heat-induced Insomnia by Acupuncture in 120 Cases

    Institute of Scientific and Technical Information of China (English)

    崔芮; 周德安

    2003-01-01

    @@ Clinical Data The 120 cases in this series were outpatients suffering from insomnia due to interior-stirring by phlegm-heat, ranging in age from 28 to 67 years. They were randomly divided into a treatment group and a control group.

  17. Intermittent inhaled corticosteroids in infants with episodic wheezing

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Hermansen, Mette Northman; Loland, Lotte

    2006-01-01

    BACKGROUND: We hypothesized that asthma is preceded by a stage of recurrent episodes of wheezing during the first years of life and that inhaled corticosteroid therapy during symptomatic episodes in this early phase may delay progression to persistent wheezing. METHODS: We assigned one-month-old ......BACKGROUND: We hypothesized that asthma is preceded by a stage of recurrent episodes of wheezing during the first years of life and that inhaled corticosteroid therapy during symptomatic episodes in this early phase may delay progression to persistent wheezing. METHODS: We assigned one......-month-old infants to treatment with two-week courses of inhaled budesonide (400 mug per day) or placebo, initiated after a three-day episode of wheezing, in this single-center, randomized, double-blind, prospective study of three years' duration. The primary outcome was the number of symptom-free days; key...... secondary outcomes were the time to discontinuation due to persistent wheezing and safety, as evaluated by height and bone mineral density at the end of the study. RESULTS: We enrolled 411 infants and randomly assigned 294 to receive budesonide at a first episode of wheezing. The proportion of symptom...

  18. Pneumonia and Wheezing in the First Year : An International Perspective

    NARCIS (Netherlands)

    Garcia-Marcos, Luis; Mallol, Javier; Sole, Dirceu; Brand, Paul L. P.; Martinez-Torres, Antonela; Sanchez-Solis, Manuel

    2015-01-01

    Background: The relationship between pneumonia and recurrent wheezing (RW) and the factors associated to pneumonia in wheezing and non-wheezing infants have not been compared between affluent and non-affluent populations. Methods: The International Study of Wheezing in Infants (EISL) is a large

  19. Effects of oral methylprednisolone and inhaled salbutamol in the decrease of wheezing in patients with asthma after tracheal intubation

    Directory of Open Access Journals (Sweden)

    2008-08-01

    Full Text Available Background: Airway instrumentation in patients with bronchial hyperreactivity, may evoke life-threatening asthma attack and a good strategy for the prevention of bronchospasm"nhas not been defined. In a randomized, prospective, placebo-controlled study, it was determined whether prophylaxis with either inhaled salbutamol-or combined inhaled salbutamol and oral methylprednisolone improves lung functions and prevents wheezing after intubation. Methods: Thirty one patients with partially reversible airway obstruction (airway resistance> 180%, forced expiratory volume in 1 second [FEV1] < 70% of predicted value, and FEV1 increase> 12% after two puffs of salbutamol were randomized to receive daily either 3-2 puffs (0.2 mg of salbutamol (n =16 or 3-2 puffs (0.2 mg of salbutamol and 40 mg of methylprednisolone (n = 15 orally for 5 days. In all patients lung function was evaluated daily and wheezing changes was assessed before and 5 minutes after tracheal intubation. Results: Both salbutamol and combined inhaled salbutamol and oral methylprednisolone treatment significantly improved airway resistance and FEV1 to a steady state, with no difference between groups. When a single-dose of salbutamol pre-induction or prolonged salbutamol treatment was employed, most patients (8 of 10 and 7 of 9 experienced wheezing after intubation. In contrast, only one patient of those who received both salbutamol and methylprednisolone experienced wheezing (P = 0.0058. Conclusions: Pretreatment with either salbutamol or combined inhaled salbutamol and oral methylprednisolone significantly improves lung function and decreases the incidence of wheezing after tracheal intubation. Methylprednisolone decreases incidence of wheezing more than salbutamol. Therefore, in patients with bronchial hyper reactivity, preoperative treatment with both methylprednisolone and salbutamol minimizes intubation-evoked broncho-constriction.

  20. A new model of wheezing severity in young children using the validated ISAAC wheezing module: A latent variable approach with validation in independent cohorts.

    Science.gov (United States)

    Brunwasser, Steven M; Gebretsadik, Tebeb; Gold, Diane R; Turi, Kedir N; Stone, Cosby A; Datta, Soma; Gern, James E; Hartert, Tina V

    2018-01-01

    The International Study of Asthma and Allergies in Children (ISAAC) Wheezing Module is commonly used to characterize pediatric asthma in epidemiological studies, including nearly all airway cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) consortium. However, there is no consensus model for operationalizing wheezing severity with this instrument in explanatory research studies. Severity is typically measured using coarsely-defined categorical variables, reducing power and potentially underestimating etiological associations. More precise measurement approaches could improve testing of etiological theories of wheezing illness. We evaluated a continuous latent variable model of pediatric wheezing severity based on four ISAAC Wheezing Module items. Analyses included subgroups of children from three independent cohorts whose parents reported past wheezing: infants ages 0-2 in the INSPIRE birth cohort study (Cohort 1; n = 657), 6-7-year-old North American children from Phase One of the ISAAC study (Cohort 2; n = 2,765), and 5-6-year-old children in the EHAAS birth cohort study (Cohort 3; n = 102). Models were estimated using structural equation modeling. In all cohorts, covariance patterns implied by the latent variable model were consistent with the observed data, as indicated by non-significant χ2 goodness of fit tests (no evidence of model misspecification). Cohort 1 analyses showed that the latent factor structure was stable across time points and child sexes. In both cohorts 1 and 3, the latent wheezing severity variable was prospectively associated with wheeze-related clinical outcomes, including physician asthma diagnosis, acute corticosteroid use, and wheeze-related outpatient medical visits when adjusting for confounders. We developed an easily applicable continuous latent variable model of pediatric wheezing severity based on items from the well-validated ISAAC Wheezing Module. This model prospectively associates with

  1. Prevalence of chronic cough and phlegm among male cigar and pipe smokers: results of the Scottish Heart Health Study.

    OpenAIRE

    Brown, C. A.; Woodward, M.; Tunstall-Pedoe, H.

    1993-01-01

    BACKGROUND--Previous studies investigating the effect of cigar or pipe smoking on the occurrence of chronic cough and chronic phlegm have reported prevalences among cigar and pipe smokers lying between those of non-smokers and current cigarette smokers. This study uses data on previous cigarette consumption, current cigar or pipe consumption, and biochemical markers of smoking to provide a detailed analysis of chronic cough and chronic phlegm among cigar and pipe smokers. METHODS--A total of ...

  2. Prenatal Paracetamol Exposure and Wheezing in Childhood: Causation or Confounding?

    Directory of Open Access Journals (Sweden)

    Enrica Migliore

    Full Text Available Several studies have reported an increased risk of wheezing in the children of mothers who used paracetamol during pregnancy. We evaluated to what extent this association is explained by confounding.We investigated the association between maternal paracetamol use in the first and third trimester of pregnancy and ever wheezing or recurrent wheezing/asthma in infants in the NINFEA cohort study. Risks ratios (RR and 95% confidence intervals (CI were estimated after adjustment for confounders, including maternal infections and antibiotic use during pregnancy.The prevalence of maternal paracetamol use was 30.6% during the first and 36.7% during the third trimester of pregnancy. The prevalence of ever wheezing and recurrent wheezing/asthma was 16.9% and 5.6%, respectively. After full adjustment, the RR for ever wheezing decreased from 1.25 [1.07-1.47] to 1.10 [0.94-1.30] in the first, and from 1.26 [1.08-1.47] to 1.10 [0.93-1.29] in the third trimester. A similar pattern was observed for recurrent wheezing/asthma. Duration of maternal paracetamol use was not associated with either outcome. Further analyses on paracetamol use for three non-infectious disorders (sciatica, migraine, and headache revealed no increased risk of wheezing in children.The association between maternal paracetamol use during pregnancy and infant wheezing is mainly, if not completely explained by confounding.

  3. Pulmonary Tuberculosis Wheezing In Early Childhood

    Directory of Open Access Journals (Sweden)

    Dumitra G

    2013-06-01

    Full Text Available Background: Primary pulmonary tuberculosis in children and infants can be suggested by the presence of a wheezing, often interpreted as acute bronchiolitis or asthma. The objective of this study is to assess the frequency and mechanism of wheezing in infants and toddlers with tuberculosis and to assess its value as an alarm symptom in children from areas where tuberculosis incidence is high.

  4. Incidence and characteristics of early childhood wheezing, Dhaka, Bangladesh, 2004-2010.

    Science.gov (United States)

    Dawood, Fatimah S; Fry, Alicia M; Goswami, Doli; Sharmeen, Amina; Nahar, Kamrun; Anjali, Bilkis Ara; Rahman, Mustafizur; Brooks, W Abdullah

    2016-06-01

    Early childhood wheezing substantially impacts quality of life in high-income countries, but data are sparse on early childhood wheezing in low-income countries. We estimate wheezing incidence, describe wheezing phenotypes, and explore the contribution of respiratory viral illnesses among children aged accounting for 8,901 episodes (733 [8%] associated with hospitalization); 25% wheezed at work of breathing (OR 1.6, 95%CI 1.4-1.8), and hospitalization (OR 2.0, 95%CI 1.6-2.4). Respiratory viruses were detected in 66% (578/873) of episodes with testing. In urban Bangladesh, early childhood wheezing is common and largely associated with respiratory virus infections. Recurrent wheezing is associated with more severe illness and may predict children who would benefit most from closer follow-up and targeted interventions. Pediatr Pulmonol. 2016;51:588-595. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  5. Analysis of wheezes using wavelet higher order spectral features.

    Science.gov (United States)

    Taplidou, Styliani A; Hadjileontiadis, Leontios J

    2010-07-01

    Wheezes are musical breath sounds, which usually imply an existing pulmonary obstruction, such as asthma and chronic obstructive pulmonary disease (COPD). Although many studies have addressed the problem of wheeze detection, a limited number of scientific works has focused in the analysis of wheeze characteristics, and in particular, their time-varying nonlinear characteristics. In this study, an effort is made to reveal and statistically analyze the nonlinear characteristics of wheezes and their evolution over time, as they are reflected in the quadratic phase coupling of their harmonics. To this end, the continuous wavelet transform (CWT) is used in combination with third-order spectra to define the analysis domain, where the nonlinear interactions of the harmonics of wheezes and their time variations are revealed by incorporating instantaneous wavelet bispectrum and bicoherence, which provide with the instantaneous biamplitude and biphase curves. Based on this nonlinear information pool, a set of 23 features is proposed for the nonlinear analysis of wheezes. Two complementary perspectives, i.e., general and detailed, related to average performance and to localities, respectively, were used in the construction of the feature set, in order to embed trends and local behaviors, respectively, seen in the nonlinear interaction of the harmonic elements of wheezes over time. The proposed feature set was evaluated on a dataset of wheezes, acquired from adult patients with diagnosed asthma and COPD from a lung sound database. The statistical evaluation of the feature set revealed discrimination ability between the two pathologies for all data subgroupings. In particular, when the total breathing cycle was examined, all 23 features, but one, showed statistically significant difference between the COPD and asthma pathologies, whereas for the subgroupings of inspiratory and expiratory phases, 18 out of 23 and 22 out of 23 features exhibited discrimination power, respectively

  6. Diesel Exhaust Exposure, Wheezing and Sneezing

    Science.gov (United States)

    2012-01-01

    The rising incidence of allergic disorders in developed countries is unexplained. Exposure to traffic related air pollutants may be an important cause of wheezing and asthma in childhood. Experimental evidence from human studies suggests that diesel exhaust particles, constituents of fine particulate matter less than 2.5 microns (PM2.5), may act to enhance IgE mediated aeroallergen sensitization and Th2 directed cytokine responses. To date, epidemiologic investigations indicate that children living in close proximity to heavily travelled roads are more likely to be atopic and wheeze. The Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) birth cohort study was initiated to test the hypothesis that early high exposure to traffic related air pollutants is associated with early aeroallergen sensitization and allergic respiratory phenotypes. Using an exposure cohort design, more than 700 infants born to atopic parents were recruited at age 1 living either less than 400 meters (high traffic pollutant exposure) or greater than 1,500 meters (low exposure) from a major road. Children were medically evaluated and underwent skin prick testing with aeroallergen at screening, and re-evaluated sequentially at ages 1, 2, 3, 4, and 7. In this study, both proximity and land use regression (LUR) models of traffic air pollutant exposure have been assessed. Proximity to stop and go traffic with large concentrations of bus and truck traffic predicted persistent wheezing during infancy. The LUR model estimated elemental carbon attributable to traffic (ECAT) as a proxy for diesel exhaust particulate exposure. High ECAT was significantly associated with wheezing at age 1 as well as persistent wheezing at age 3. High mold exposure predicted a well defined asthma phenotype at age 7. PMID:22754710

  7. The bedding environment, sleep position, and frequent wheeze in childhood.

    Science.gov (United States)

    Ponsonby, Anne-Louise; Dwyer, Terence; Trevillian, Leigh; Kemp, Andrew; Cochrane, Jennifer; Couper, David; Carmichael, Allan

    2004-05-01

    Synthetic quilt use has been associated with increased childhood wheeze in previous studies. Our aim was to examine whether the adverse effect of synthetic quilt use on frequent wheeze differed by usual sleep position. A population-based cross-sectional study of 6378 (92% of those eligible) 7-year-olds in Tasmania, Australia, was conducted in 1995. Exercise-challenge lung function was obtained on a subset of 414 children from randomly selected schools. Child bedding including pillow and overbedding composition and usual sleep position by parental questionnaire. Frequent wheeze (>12 wheeze episodes over the past year), using the International Study of Asthma and Allergies in Childhood parental questionnaire, and baseline and postexercise forced expiratory volume in 1 second lung-function measures. Frequent wheeze (n = 117) was positively associated with synthetic quilts, synthetic pillows, electric blankets, and sleeping in a bottom bunk bed but did not vary by sleep position. In a nested case-control analysis, the association between synthetic quilt use and frequent wheeze differed by sleep position. Among children who slept supine, synthetic (versus feather) quilt use was associated with frequent wheeze (adjusted odds ratio: 2.37 [1.08, 5.23]). However, among nonsupine sleepers, overlying synthetic quilt use was not associated with frequent wheeze (adjusted odds ratio: 1.06 [0.60, 1.88]). This difference in quilt effect by sleep position was highly significant. Similarly, synthetic quilt use was associated with lower postexercise forced expiratory volume in 1 second measures among supine but not nonsupine sleeping children. An increasing focus on the bedding environment immediately adjacent to the nose and mouth is required for respiratory disorders provoked by bedding, such as child asthma characterized by frequent wheeze.

  8. Infant wheeze, comorbidities and school age asthma.

    Science.gov (United States)

    Neuman, Asa; Bergström, Anna; Gustafsson, Per; Thunqvist, Per; Andersson, Niklas; Nordvall, Lennart; Kull, Inger; Wickman, Magnus

    2014-06-01

    Factors associated with early onset of wheeze have been described, but there is limited knowledge on which of these infant wheezers who will have developed asthma in school age. The aim was to identify clinical risk factors for asthma in the 8-yr-old children that wheezed during infancy in a population-based setting. Three thousand two hundred and fifty-one children from a population-based birth cohort followed prospectively from infancy until age 8 yr were included in the study. Data were analyzed using multivariate logistic regression analysis. Parents reported any wheeze episode before age 2 yr in 823 subjects (25%). Infant wheezers had an almost fourfold risk of asthma at age 8 [adjusted odds ratio (aOR) 3.68, 95% CI 2.74-4.96], equivalent to an asthma prevalence of 14% compared with 4% among non-wheezers (p < 0.001). After adjustments for sex, exposure to tobacco smoke and indoor dampness/mould, allergic heredity (aOR 1.53, 95% CI 1.02-2.30), increased frequency of wheeze (aOR 3.41, 95% CI 2.09-5.56 for children with ≥3 episodes compared with ≤2 episodes during the first 2 yr of life), infant eczema (aOR 2.31, 95% CI 1.52-3.49), and recurrent abdominal pain (aOR 2.33, 95% CI 1.30-4.16) remained risk factors for school age asthma in the infant wheezing group. Among infant wheezers, allergic heredity, increased severity of wheeze, infant eczema, and recurrent abdominal pain were independent risk factors for asthma at age 8 yr. Among children with three or four of these risk factors, 38% had asthma at school age. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Impact of innate and environmental factors on wheezing persistence during childhood.

    Science.gov (United States)

    Just, Jocelyne; Belfar, Samira; Wanin, Stéphanie; Pribil, Céline; Grimfeld, Alain; Duru, Gérard

    2010-05-01

    Persistent asthma in adults starts often early in childhood and is associated with alterations in respiratory function that occur early in life. The aim of this study was to evaluate the importance of innate and environmental factors associated with occurrence of asthma during childhood in a population of recurrent wheezing infants followed prospectively. A cohort of infants less than 30 months old with recurrent wheezing was established in order to assess severity of respiratory symptoms and to look for the presence of atopy and environmental risk factors. At the age of 6 years, they were reevaluated with respect to remission or persistence of wheezing over the previous 12-month period. Data were available for 219 subjects aged 15 +/- 5 months. In 27% of the infants with recurrent wheeze, wheezing persisted until the age of 6 years. In multivariate analysis, stepwise logit analysis showed that the risk factors for persistent wheezing are eosinophilia >or=470/mm(3), allergenic sensitization, and a father with asthma. Environmental factors present during the first year of life that protect from persistence of wheezing are ( 1 ) breastfeeding for longer than 3 months, ( 2 ) pets at home, and ( 3 ) >or=3 siblings. The detection rate for persistent wheezing in this model is 72%. The persistence score showed good specificity 91% but low sensitivity 35%. This study confirms the role of atopic host factors on wheezing persistence during childhood and detected protective environmental factors.

  10. Maternal Smoking during Pregnancy, Prematurity and Recurrent Wheezing in Early Childhood

    Science.gov (United States)

    Robison, Rachel G; Kumar, Rajesh; Arguelles, Lester M; Hong, Xiumei; Wang, Guoying; Apollon, Stephanie; Bonzagni, Anthony; Ortiz, Kathryn; Pearson, Colleen; Pongracic, Jacqueline A; Wang, Xiaobin

    2013-01-01

    Summary Background Prenatal maternal smoking and prematurity independently affect wheezing and asthma in childhood. Objective We sought to evaluate the interactive effects of maternal smoking and prematurity upon the development of early childhood wheezing. Methods We evaluated 1448 children with smoke exposure data from a prospective urban birth cohort in Boston. Maternal antenatal and postnatal exposure was determined from standardized questionnaires. Gestational age was assessed by the first day of the last menstrual period and early prenatal ultrasound (pretermprematurity and maternal antenatal smoking on recurrent wheeze, controlling for relevant covariates. Results In the cohort, 90 (6%) children had recurrent wheezing, 147 (10%) were exposed to in utero maternal smoke and 419 (29%) were premature. Prematurity (odds ratio [OR] 2.0; 95% CI, 1.3-3.1) was associated with an increased risk of recurrent wheezing, but in utero maternal smoking was not (OR 1.1, 95% CI 0.5-2.4). Jointly, maternal smoke exposure and prematurity caused an increased risk of recurrent wheezing (OR 3.8, 95% CI 1.8-8.0). There was an interaction between prematurity and maternal smoking upon episodes of wheezing (p=0.049). Conclusions We demonstrated an interaction between maternal smoking during pregnancy and prematurity on childhood wheezing in this urban, multiethnic birth cohort. PMID:22290763

  11. Risk factors for wheezing during infancy. A study of 5,953 infants

    DEFF Research Database (Denmark)

    Bisgaard, H; Dalgaard, P; Nyboe, J

    1987-01-01

    --particularly environmental. Poor social environment increases the risk of wheezing, as does the mother's smoking, and placement of the baby in day-care. Boys experienced wheezing more often than girls. Premature infants are more liable to develop wheezing than mature children. Remarkably, children born in the period April......Risk factors for the development of wheezing during infancy were studied in 5,953 children. The data for the study were collected from a large prospective investigation of children born in 1959-61, who had attended a one-year follow-up examination. Wheezing was diagnosed when the symptom had been...... through September develop wheezing, but not bronchitis, more often than children born in October through March....

  12. Rhinovirus Wheezing Illness and Genetic Risk of Childhood-Onset Asthma

    DEFF Research Database (Denmark)

    Calışkan, Minal; Bochkov, Yury A; Kreiner-Møller, Eskil

    2013-01-01

    Background Both genetic variation at the 17q21 locus and virus-induced respiratory wheezing illnesses are associated with the development of asthma. Our aim was to determine the effects of these two factors on the risk of asthma in the Childhood Origins of Asthma (COAST) and the Copenhagen...... Prospective Study on Asthma in Childhood (COPSAC) birth cohorts. Methods We tested genotypes at the 17q21 locus for associations with asthma and with human rhinovirus (HRV) and respiratory syncytial virus (RSV) wheezing illnesses and tested for interactions between 17q21 genotypes and HRV and RSV wheezing...... illnesses with respect to the risk of asthma. Finally, we examined genotype-specific expression of 17q21 genes in unstimulated and HRV-stimulated peripheral-blood mononuclear cells (PBMCs). Results The 17q21 variants were associated with HRV wheezing illnesses in early life, but not with RSV wheezing...

  13. Ambient air pollution triggers wheezing symptoms in infants

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Loft, S; Ketzel, Matthias

    2008-01-01

    There is limited evidence for the role of air pollution in the development and triggering of wheezing symptoms in young children. A study was undertaken to examine the effect of exposure to air pollution on wheezing symptoms in children under the age of 3 years with genetic susceptibility to asthma....

  14. Occupation and three-year incidence of respiratory symptoms and lung function decline: the ARIC Study

    Directory of Open Access Journals (Sweden)

    Mirabelli Maria C

    2012-03-01

    Full Text Available Abstract Background Specific occupations are associated with adverse respiratory health. Inhalation exposures encountered in these jobs may place workers at risk of new-onset respiratory disease. Methods We analyzed data from 8,967 participants from the Atherosclerosis Risk in Communities (ARIC study, a longitudinal cohort study. Participants included in this analysis were free of chronic cough and phlegm, wheezing, asthma, chronic bronchitis, emphysema, and other chronic lung conditions at the baseline examination, when they were aged 45-64 years. Using data collected in the baseline and first follow-up examination, we evaluated associations between occupation and the three-year incidence of cough, phlegm, wheezing, and airway obstruction and changes in forced expiratory volume in one second (FEV1 and forced vital capacity (FVC measured by spirometry. All associations were adjusted for age, cigarettes per day, race, smoking status, and study center. Results During the approximately three-year follow-up, the percentage of participants developing chronic cough was 3%; chronic phlegm, 3%; wheezing, 3%; and airway obstruction, defined as FEV1 1/FVC 1 and FVC were 56 mL and 66 mL, respectively, among men and 40 mL and 52 mL, respectively, among women. Relative to a referent category of managerial and administrative support occupations, elevated risks of new-onset chronic cough and chronic phlegm were observed for mechanics and repairers (chronic cough: RR: 1.81, 95% CI: 1.02, 3.21; chronic phlegm: RR: 2.10, 95% CI: 1.23, 3.57 and cleaning and building service workers (chronic cough: RR: 1.85, 95% CI: 1.01, 3.37; chronic phlegm: RR: 2.28, 95% CI: 1.27, 4.08. Despite the elevated risk of new-onset symptoms, employment in cleaning and building services was associated with attenuated lung function decline, particularly among men, who averaged annual declines in FEV1 and FVC of 14 mL and 23 mL, respectively, less than the declines observed in the

  15. Design of Wearable Breathing Sound Monitoring System for Real-Time Wheeze Detection

    Directory of Open Access Journals (Sweden)

    Shih-Hong Li

    2017-01-01

    Full Text Available In the clinic, the wheezing sound is usually considered as an indicator symptom to reflect the degree of airway obstruction. The auscultation approach is the most common way to diagnose wheezing sounds, but it subjectively depends on the experience of the physician. Several previous studies attempted to extract the features of breathing sounds to detect wheezing sounds automatically. However, there is still a lack of suitable monitoring systems for real-time wheeze detection in daily life. In this study, a wearable and wireless breathing sound monitoring system for real-time wheeze detection was proposed. Moreover, a breathing sounds analysis algorithm was designed to continuously extract and analyze the features of breathing sounds to provide the objectively quantitative information of breathing sounds to professional physicians. Here, normalized spectral integration (NSI was also designed and applied in wheeze detection. The proposed algorithm required only short-term data of breathing sounds and lower computational complexity to perform real-time wheeze detection, and is suitable to be implemented in a commercial portable device, which contains relatively low computing power and memory. From the experimental results, the proposed system could provide good performance on wheeze detection exactly and might be a useful assisting tool for analysis of breathing sounds in clinical diagnosis.

  16. Air pollution involving nitrogen dioxide exposure and wheezing bronchitis in children.

    Science.gov (United States)

    Pershagen, G; Rylander, E; Norberg, S; Eriksson, M; Nordvall, S L

    1995-12-01

    A population-based case-control study was performed in Stockholm to assess the influence of air pollution on the occurrence of severe wheezing bronchitis in children. The study included 197 children aged 4 months to 4 years, who were hospitalized because of breathing difficulties with wheezing, and 350 population controls. Information on potential risk factors for childhood wheezing and a residential history was obtained at home interview with parents. Outdoor nitrogen dioxide (NO2) concentrations at home addresses and day care centres from birth on were estimated from validated models, mainly using data on traffic intensity from municipal registers. The risk of wheezing bronchitis was related to time-weighted mean outdoor NO2 exposure in girls (P = 0.02), but not in boys. A gas stove in the home appeared to be a risk factor primarily for girls. All analyses controlled for parental asthma and maternal smoking, which were independent risk factors for wheezing bronchitis. The results suggest that exposure to combustion products containing NO2 may be of particular importance for the development of wheezing bronchitis in girls.

  17. Disrupted Prenatal Maternal Cortisol, Maternal Obesity, and Childhood Wheeze. Insights into Prenatal Programming

    Science.gov (United States)

    Fisher, Kate; Chiu, Yueh-Hsiu Mathilda; Wright, Robert O.; Fein, Rebecca; Cohen, Sheldon; Coull, Brent A.

    2013-01-01

    Rationale: Exploring prenatal factors influencing childhood wheeze may inform programming mechanisms. Objectives: We examined associations among prenatal maternal cortisol profiles, maternal obesity, and repeated wheeze up to age 2 years (n = 261). Methods: Salivary cortisol was collected five times per day over 3 days at 29.0 ± 4.9 weeks gestation. Mothers were categorized as obese (body mass index ≥ 30 kg/m2) versus nonobese (body mass index cortisol metrics (level at each time point, morning rise, diurnal and afternoon slopes) and obesity on wheeze adjusting for covariates. Linear mixed models were implemented to examine associations between cortisol trajectories and wheezing. Interactions between maternal cortisol and obesity were considered. Measurements and Main Results: Mothers were primarily minority (56.5% Hispanic, 24.1% African American), 61% had less than or equal to 12 years of education, 34% were obese, and 8.4% of children had repeated wheeze. An interquartile range increase in mean log cortisol at bedtime (odds ratio, 2.2; 95% confidence interval, 1.09–4.09) and maternal obesity (odds ratio, 3.43; 95% confidence interval, 1.26–9.35) were independently associated with wheeze. Linear mixed models revealed an association between a flatter afternoon slope (slower decline in log cortisol per hour) and repeated wheeze in children of obese mothers (children with [−0.017 change] and without [−0.061 change] wheeze [P = 0.009 for time × wheeze interaction]), but not in children of nonobese mothers (with [−0.050 change] and without [−0.061 change] wheeze [P = 0.51]). Conclusions: Maternal prenatal cortisol disruption and obesity were independently associated with children’s wheeze. Obese women with adverse cortisol profiles were most likely to have children with repeated wheeze. PMID:23590260

  18. Polymorphisms in inflammation genes, tobacco smoke and furred pets and wheeze in children

    DEFF Research Database (Denmark)

    Sorensen, M.; Allermann, L.; Vogel, Ulla Birgitte

    2009-01-01

    Persistent wheeze in childhood is associated with airway inflammation. The present study investigated relationships between polymorphisms in inflammatory genes, exposure to tobacco smoke and furred pets and risk of recurrent wheeze in children. Within a birth cohort of 101,042 children we...... identified 1111 eighteen month old cases with recurrent wheeze and 735 wheeze-free controls among 11942 children recruited in the Copenhagen area. Polymorphisms in IL-4R, IL-8, IL-13, SPINK5, and CD14 were genotyped. Interviews at gestational wks 12 and 30, and at age 6 and 18 months included questions...... on number of episodes with wheeze (18 months), exposure to tobacco smoke and pet-keeping. Recurrent wheeze was defined as at least four episodes of wheeze before the child was 18 months old. There was a statistically significant association between the IL-13 Arg144Gln polymorphism and risk of recurrent...

  19. Obese individuals experience wheezing without asthma but not asthma without wheezing

    DEFF Research Database (Denmark)

    Çolak, Yunus; Shoaib, Afzal; Lange, Peter

    2016-01-01

    and asthma, and that the association between high BMI and asthma is explained by wheezing. METHODS: We genotyped 85 437 individuals aged 20-100 years from the Copenhagen General Population Study for FTO (rs9939609), MC4R (rs17782313), TMEM18 (rs6548238) GNPDA2 (rs10938397) and BDNF (rs10767664); 14 500...

  20. Risk factors for wheeze in the last 12 months in preschool children.

    Science.gov (United States)

    Quah, B S; Mazidah, A R; Simpson, H

    2000-06-01

    Most children with asthma develop their symptoms before the age of 5 years and many preschool wheezers continue to wheeze in the early school years. It is thus important to investigate the factors that predispose young children to wheeze. The objective of this study was to investigate the relevant environmental and family influences on recent wheeze (wheeze within the last 12 months) in preschool children. A cross-sectional study was conducted in five primary health clinics in the district of Kota Bharu from April to October 1998. Nurses from these clinics distributed Bahasa Malaysia questionnaires containing questions on asthma symptoms, environmental risk factors, family's social status and family history of atopy and wheeze to preschool children aged 1-5 years during their home visits. The respondents were parent(s) or carer(s) of the children. A total of 2,524 (87.7%) complete questionnaires were available for analysis of risk factors. One hundred and fifty six (6.2%) children had current wheeze. Significant risk factors associated with current wheeze were a family history of asthma (O.R. = 6.36, 95% C.I. = 4.45-9.09), neonatal hospital admission (O.R. = 2.38, 95% C.I. = 1.51 - 3.75), and a maternal (O.R. = 2.12, 95% C.I. = 1.31-3.41) or paternal (O.R. = 1.52, 95% C.I. = 0.95-2.43) history of allergic rhinitis. Among environmental factors examined, namely, household pets, carpeting in bedroom, use of fumigation mats, mosquito coils and aerosol insect repellents, maternal and paternal smoking, and air conditioning, none were associated with an increased risk of wheeze. In conclusion, the strongest association with current wheeze was a family history of asthma. Also significant were neonatal hospital admission and a history of allergic rhinitis in either the mother or father. None of the environmental factors studied were related to current wheeze in preschool children.

  1. Risk factors for wheezing in infants born in Cuba.

    Science.gov (United States)

    Venero-Fernández, S J; Suárez-Medina, R; Mora-Faife, E C; García-García, G; Valle-Infante, I; Gómez-Marrero, L; Abreu-Suárez, G; González-Valdez, J; Fabró-Ortiz, D Dania; Fundora-Hernández, H; Venn, A; Britton, J; Fogarty, A W

    2013-11-01

    Cuba is a unique country, and despite limited economic development, has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high. As early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheezing in Cuban infants. Cross-sectional study. A random sample of 2032 children aged 12-15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers. Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of emergency services was 30% and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema [odds ratio (OR) 2.09; 95% confidence interval (CI) 1.48-2.94], family history of asthma (OR 2.05; 95% CI 1.60-2.62), poor ventilation in the house (OR 1.99; 95% CI 1.48-2.67), attendance at nursery (OR 1.78; 95% CI 1.24-2.57), male sex (OR1.52; 95% CI 1.19-1.96) and the number of smokers in the house (P Cuba. As the prevalence of smoking in the house is high (51%), intervention studies are required to determine effective strategies to improve infant health.

  2. Rhinovirus Wheezing Illness and Genetic Risk of Childhood-Onset Asthma

    Science.gov (United States)

    Çalışkan, Minal; Bochkov, Yury A.; Kreiner-Møller, Eskil; Bønnelykke, Klaus; Stein, Michelle M.; Du, Gaixin; Bisgaard, Hans; Jackson, Daniel J.; Gern, James E.; Lemanske, Robert F.; Nicolae, Dan L.; Ober, Carole

    2013-01-01

    BACKGROUND Both genetic variation at the 17q21 locus and virus-induced respiratory wheezing illnesses are associated with the development of asthma. Our aim was to determine the effects of these two factors on the risk of asthma in the Childhood Origins of Asthma (COAST) and the Copenhagen Prospective Study on Asthma in Childhood (COPSAC) birth cohorts. METHODS We tested genotypes at the 17q21 locus for associations with asthma and with human rhinovirus (HRV) and respiratory syncytial virus (RSV) wheezing illnesses and tested for interactions between 17q21 genotypes and HRV and RSV wheezing illnesses with respect to the risk of asthma. Finally, we examined genotype-specific expression of 17q21 genes in unstimulated and HRV-stimulated peripheral-blood mononuclear cells (PBMCs). RESULTS The 17q21 variants were associated with HRV wheezing illnesses in early life, but not with RSV wheezing illnesses. The associations of 17q21 variants with asthma were restricted to children who had had HRV wheezing illnesses, resulting in a significant interaction effect with respect to the risk of asthma. Moreover, the expression levels of ORMDL3 and of GSDMB were significantly increased in HRV-stimulated PBMCs, as compared with unstimulated PBMCs. The expression of these genes was associated with 17q21 variants in both conditions, although the increase with exposure to HRV was not genotype-specific. CONCLUSIONS Variants at the 17q21 locus were associated with asthma in children who had had HRV wheezing illnesses and with expression of two genes at this locus. The expression levels of both genes increased in response to HRV stimulation, although the relative increase was not associated with the 17q21 genotypes. (Funded by the National Institutes of Health.) PMID:23534543

  3. Pneumonia and wheezing in the first year: An international perspective.

    Science.gov (United States)

    Garcia-Marcos, Luis; Mallol, Javier; Solé, Dirceu; Brand, Paul L P; Martinez-Torres, Antonela; Sanchez-Solis, Manuel

    2015-12-01

    The relationship between pneumonia and recurrent wheezing (RW) and the factors associated to pneumonia in wheezing and non-wheezing infants have not been compared between affluent and non-affluent populations. The International Study of Wheezing in Infants (EISL) is a large population-based cross-sectional study carried out in Latin America (LA) and Europe (EU). We used a validated questionnaire for identifying wheeze in the first year of life. The questionnaire also inquired about pneumonia diagnosis, together with other potentially related factors. Associations between both conditions and between potential risk/protective factors for pneumonia were tested by random-effects logit model and adjusting for all factors found previously associated to RW in this cohort. Pneumonia and RW were strongly associated to each other in LA and EU (aOR 5.42; 95%CI: 4.87-6.04 and aOR 13.99; 95%CI: 9.61-20.36, respectively). Infant eczema was the most consistent risk factor of pneumonia in both continents, in the whole population and also among wheezers and non-wheezers (aOR ranging from 1.30; 95%CI: 1.11-1.52 to 2.65; 95%CI: 1.68-4.18); while breast feeding for at least 3 months was the most consistent protective factor (aOR ranging from 0.60; 95%CI: 0.51-0.71 to 0.76; 95%CI: 0.69-0.84). Factors associated to pneumonia were similar between continents among wheezers, but differed considerably among non-wheezers. Pneumonia and RW are associated conditions sharing many risk/protective factors in EU and LA among wheezing infants, but not among non-wheezing infants. The association between pneumonia and RW could be due to shared pathophysiology or by diagnostic confusion between the two conditions. © 2015 Wiley Periodicals, Inc.

  4. Pesticides are Associated with Allergic and Non-Allergic Wheeze among Male Farmers

    Science.gov (United States)

    Hoppin, Jane A.; Umbach, David M.; Long, Stuart; London, Stephanie J.; Henneberger, Paul K.; Blair, Aaron; Alavanja, Michael; Freeman, Laura E. Beane; Sandler, Dale P.

    2016-01-01

    Background: Growing evidence suggests that pesticide use may contribute to respiratory symptoms. Objective: We evaluated the association of currently used pesticides with allergic and non-allergic wheeze among male farmers. Methods: Using the 2005–2010 interview data of the Agricultural Health Study, a prospective study of farmers in North Carolina and Iowa, we evaluated the association between allergic and non-allergic wheeze and self-reported use of 78 specific pesticides, reported by ≥ 1% of the 22,134 men interviewed. We used polytomous regression models adjusted for age, BMI, state, smoking, and current asthma, as well as for days applying pesticides and days driving diesel tractors. We defined allergic wheeze as reporting both wheeze and doctor-diagnosed hay fever (n = 1,310, 6%) and non-allergic wheeze as reporting wheeze but not hay fever (n = 3,939, 18%); men without wheeze were the referent. Results: In models evaluating current use of specific pesticides, 19 pesticides were significantly associated (p pyraclostrobin) had significantly different associations for allergic and non-allergic wheeze. In exposure–response models with up to five exposure categories, we saw evidence of an exposure–response relationship for several pesticides including the commonly used herbicides 2,4-D and glyphosate, the insecticides permethrin and carbaryl, and the rodenticide warfarin. Conclusions: These results for farmers implicate several pesticides that are commonly used in agricultural and residential settings with adverse respiratory effects. Citation: Hoppin JA, Umbach DM, Long S, London SJ, Henneberger PK, Blair A, Alavanja M, Beane Freeman LE, Sandler DP. 2017. Pesticides are associated with allergic and non-allergic wheeze among male farmers. Environ Health Perspect 125:535–543; http://dx.doi.org/10.1289/EHP315 PMID:27384423

  5. Sensitization predicts asthma development among wheezing toddlers in secondary healthcare

    NARCIS (Netherlands)

    Boersma, Nienke A.; Meijneke, Ruud W.H.; Kelder, Johannes C.; van der Ent, Cornelis K.; Balemans, Walter A.F.

    2017-01-01

    Introduction: Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. Aim: This study examines the predictive value of sensitization to inhalant allergens among wheezing

  6. Chronic effects of ambient air pollution on respiratory morbidities among Chinese children: a cross-sectional study in Hong Kong.

    Science.gov (United States)

    Gao, Yang; Chan, Emily Yy; Li, Liping; Lau, Patrick Wc; Wong, Tze Wai

    2014-02-03

    The chronic health effects from exposure to ambient air pollution are still unclear. This study primarily aims to examine the relationship between long-term exposure to ambient air pollution and respiratory morbidities in Chinese children. A cross-sectional study was conducted among 2,203 school children aged 8-10 in three districts with different air pollution levels in Hong Kong. Annual means for ambient PM10, SO2, NO2 and O3 in each district were used to estimate participants' individual exposure. Two questionnaires were used to collect children's respiratory morbidities and other potential risk factors. Multivariable logistic regression was fitted to estimate the risks of air pollution for respiratory morbidities. Compared to those in the low-pollution district (LPD), girls in the high-pollution district (HPD) were at significantly higher risk for cough at night (ORadj. = 1.81, 95% CI: 1.71-2.78) and phlegm without colds (ORadj. = 3.84, 95% CI: 1.74-8.47). In addition, marginal significance was reached for elevated risks for asthma, wheezing symptoms, and phlegm without colds among boys in HPD (adjusted ORs: 1.71-2.82), as well as chronic cough among girls in HPD (ORadj. = 2.03, 95% CI: 0.88-4.70). Results have confirmed certain adverse effects on children's respiratory health from long-term exposure to ambient air pollution. PM10 may be the most relevant pollutant with adverse effects on wheezing and phlegm in boys. Both PM10 and NO2 may be contributing to cough and phlegm in girls.

  7. Duration of exclusive breastfeeding and wheezing in the first year of life: A longitudinal study.

    Science.gov (United States)

    Verduci, Elvira; Banderali, Giuseppe; Peroni, Diego; Lassandro, Carlotta; Radaelli, Giovanni

    Wheezing is the most common symptom associated with asthma in young children. There is a lack of well-designed prospective studies on the relationship of exclusive breastfeeding with wheezing in infants. This prospective cohort study investigated whether a relationship exists of exclusive breastfeeding with wheezing at 12 months of age. A series of 1632 mother-infant pairs were sequentially recruited. Mothers were trained at hospital on breastfeeding practices and how to recognise wheezing. At hospital discharge they received a calendar-diary to record the date at stopping breastfeeding and at onset of wheezing. Data were collected by telephone interviews through 12 months post-delivery. Breastfeeding was in accordance with the World Health Organisation and wheezing with the International Classification of Diseases (ICD-10-CM code R06.2). At 12 months 1522 mother-infant pairs were participating. Breastfeeding started in 95.9% of them and was exclusive in 86.1%. The incidence of wheezing ever and recurrent wheezing at 12 months of age was 33.7% and 10.0%, respectively. Duration of exclusive breastfeeding was shorter in wheezing than non-wheezing infants (median 2.6 months vs. 4.1 months, Pever by 11% and of recurrent wheezing by 15%, at 12 months of age. Longer duration of exclusive breastfeeding reduces the risk of wheezing throughout the first 12 months of life. These findings would be relevant to all healthcare operators and mothers, also to improve their awareness about the best feeding practices for the infant's health. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  8. Variations in the prevalence of childhood asthma and wheeze in MeDALL cohorts in Europe

    Directory of Open Access Journals (Sweden)

    Eleonora P. Uphoff

    2017-07-01

    Full Text Available While there is evidence for variations in prevalence rates of childhood wheeze and asthma between countries, longitudinal, individual-level data are needed to understand these differences. The aim of this study was to examine variations in prevalence rates of childhood asthma, wheeze and wheeze with asthma in Europe. We analysed datasets from 10 MeDALL (Mechanisms of the Development of ALLergy cohorts in eight countries, representing 26 663 children, to calculate prevalence rates of wheeze and asthma by child age and wheeze with asthma at age 4 years. Harmonised variables included outcomes parent-reported wheeze and parent-reported doctor-diagnosed asthma, and covariates maternal education, parental smoking, pets, parental asthma, doctor-diagnosed allergic rhinitis, doctor-diagnosed eczema and wheeze severity. At age 4 years, asthma prevalence varied from 1.72% in Germany to 13.48% in England and the prevalence of wheeze varied from 9.82% in Greece to 55.37% in Spain. Adjusted estimates of the proportion of 4-year-old children with wheeze diagnosed with asthma remained highest in England (38.14%, 95% CI 31.38–44.90% and lowest in Spain (15.94%, 95% CI 6.16–25.71%. The large differences in prevalence rates of asthma, wheeze and wheeze with asthma at age 4 years between European cohorts may indicate that childhood asthma is more readily diagnosed in some countries while going unrecognised elsewhere.

  9. Predictors of Onset of Wheezing in Grain Elevator Workers

    Directory of Open Access Journals (Sweden)

    Punam Pahwa

    1998-01-01

    Full Text Available A longitudinal study of Canadian grain elevator workers over a 12-year period was conducted. Data on respiratory symptoms and pulmonary function tests were collected once every three years as part of the Grain Dust Medical Surveillance Program started by Labour Canada in 1978; each three-year interval was called a 'cycle'. Of workers who had two or more observations, 1848 subjects (67.2% were free of respiratory symptoms (wheeze, dyspnea, cough or sputum at the baseline (cycle II. Predictors of first episode of wheezing were examined in these symptoms-free grain workers. Baseline mean age ± SD of the grain workers was 34.0±11.4 years and mean duration of work in the industry was 9.9±8.7 years. Of the 1848 symptoms-free grain workers at cycle II, 203 (11.0% subsequently reported wheezing during the study. Cox's proportional hazards model for analysis of survival data was used to determine significant predictors of first episode of wheezing. Significant predictors for first episode of wheezing were current smoking (relative risk [RR] 2.33; 95% CI 1.63 to 3.33; P<0.0001 and baseline forced expiratory volume in 1 s to forced vital capacity ratio [RR 0.02; 95% CI 0.003 to 0.20; P<0.0001. Baseline pulmonary function measurements and smoking habits appear to be important predictors of future development of asthma-like symptoms in grain elevator workers.

  10. Non-invasive ventilation in severe asthma attack, its possibilities and problems.

    Science.gov (United States)

    Murase, K; Tomii, K; Chin, K; Niimi, A; Ishihara, K; Mishima, M

    2011-06-01

    Asthma attack is characterized by episodic attacks of cough, dyspnea and wheeze occurring due to bronchoconstriction, airway hyperresponsiveness and mucous hypersecretion. Although nationwide clinical guidelines have been published to establish the standard care of asthma, choices in the treatment of fatal asthma attacks remain of clinical significance. Especially, in a severe asthma attack, despite the application of conventional medical treatment, respiratory management is critical. Even though non-invasive ventilation (NIV) has been shown to be effective in a wide variety of clinical settings, reports of NIV in asthmatic patients are scarce. According to a few prospective clinical trials reporting promising results in favour of the use of NIV in a severe asthma attack, a trial of NIV prior to invasive mechanical ventilation seems acceptable and may benefit patients by decreasing the need for intubation and by supporting pharmaceutical treatments. Although selecting the appropriate patients for NIV use is a key factor in successful NIV application, how to distinguish such patients is quite controversial. Larger high quality clinical trails are urgently required to confirm the benefits of NIV to patients with severe asthma attack. In this article, we focus on the body of evidence supporting the use of NIV in asthma attacks and discuss its advantages as well its problems.

  11. Factors associated with the time to the first wheezing episode in infants : a cross-sectional study from the International Study of Wheezing in Infants (EISL)

    NARCIS (Netherlands)

    Pacheco-Gonzalez, Rosa M.; Mallol, Javier; Sole, Dirceu; Brand, Paul L. P.; Perez-Fernandez, Virginia; Sanchez-Solis, Manuel; Garcia-Marcos, Luis

    2016-01-01

    Male gender, asthmatic heredity, perinatal tobacco smoke exposure and respiratory infections have been associated with wheeze in the first years of life, among other risk factors. However, information about what factors modify the time to the first episode of wheeze in infants is lacking. The

  12. Factors associated with the time to the first wheezing episode in infants: a cross-sectional study from the International Study of Wheezing in Infants (EISL).

    Science.gov (United States)

    Pacheco-Gonzalez, Rosa M; Mallol, Javier; Solé, Dirceu; Brand, Paul L P; Perez-Fernandez, Virginia; Sanchez-Solis, Manuel; Garcia-Marcos, Luis

    2016-01-21

    Male gender, asthmatic heredity, perinatal tobacco smoke exposure and respiratory infections have been associated with wheeze in the first years of life, among other risk factors. However, information about what factors modify the time to the first episode of wheeze in infants is lacking. The present study analyses which factors are associated with shorter time to the first episode of wheeze in infants. Parents of 11- to 24-month-old children were surveyed when attending their health-care centres for a control visit. They answered a questionnaire including the age in months when a first wheeze episode (if any) had occurred (outcome variable). The study was performed in 14 centres in Latin America (LA) and in 8 centres in Europe (EU) (at least 1,000 infants per centre). Factors known to be associated with wheezing in the cohort were included in a survival analysis (Cox proportional hazards model). Summary hazard ratios adjusted for all risk factors (aHR) were calculated using the meta-analysis approach with random effects. A total of 15,067 infants had experienced wheezing at least once, out of 35,049 surveyed. Male gender in LA (aHR 1.05, 95% confidence interval (CI) 1.00-1.10, P=0.047), parental asthma in LA and EU (aHR 1.05, 95% CI 1.00-1.11, P=0.037), infant eczema in EU (aHR 1.25, 95% CI 1.12-1.39, Passociated with a shorter period of time to the first episode. Breast feeding for at least 3 months was associated with a longer period, only in LA (aHR 0.91, 95% CI 0.86-0.96, Passociation.

  13. Household conditions, eczema symptoms and rhinitis symptoms: relationship with wheeze and severe wheeze in children living in the Polokwane area, South Africa

    DEFF Research Database (Denmark)

    Wichmann, Janine; Wolvaardt, Jacqueline E; Maritz, Chantelle

    2009-01-01

    was conducted during August 2004 and February 2005. Parents/guardians of 6- to 7-year-old children completed the questionnaires in English, Afrikaans or North-Sotho. However, the statistical analyses were restricted to the North-Sotho group (n = 2,437). RESULTS: The 12-month prevalence rates of wheeze......BACKGROUND: This is the fifth study that applied the International Study of Asthma and Allergies in Childhood (ISAAC) methodology in the Southern African Development Community (SADC region). However, it is the first ISAAC study that focused on 6- to 7-year-old children living in South Africa...... and that also investigated the association between potential risk factors and asthma symptoms. Objective To assess the 12-month prevalence of wheeze and severe wheeze along with their potential risk factors. Setting Within a 60-km radius from the Polokwane city centre, Limpopo Province. METHODS: The survey...

  14. A Metabonomics Profiling Study on Phlegm Syndrome and Blood-Stasis Syndrome in Coronary Heart Disease Patients Using Liquid Chromatography/Quadrupole Time-of-Flight Mass Spectrometry

    Directory of Open Access Journals (Sweden)

    Linlin Zhao

    2014-01-01

    Full Text Available A metabonomics approach based on liquid chromatography/quadrupole time-of-flight mass spectrometry (LC-Q-TOF/MS was utilized to obtain potential biomarkers of coronary heart disease (CHD patients and investigate the ZHENG types differentiation in CHD patients. The plasma samples of 20 CHD patients with phlegm syndrome, 20 CHD patients with blood-stasis syndrome, and 16 healthy volunteers were collected in the study. 26 potential biomarkers were identified in the plasma of CHD patients and 19 differential metabolites contributed to the discrimination of phlegm syndrome and blood-stasis syndrome in CHD patients (VIP>1.5; P<0.05 which mainly involved purine metabolism, pyrimidine metabolism, amino acid metabolism, steroid biosynthesis, and arachidonic acid metabolism. This study demonstrated that metabonomics approach based on LC-MS was useful for studying pathologic changes of CHD patients and interpreting the differentiation of ZHENG types (phlegm and blood-stasis syndrome in traditional Chinese medicine (TCM.

  15. Incidence of new-onset wheeze: a prospective study in a large middle-aged general population.

    Science.gov (United States)

    Holm, Mathias; Torén, Kjell; Andersson, Eva

    2015-12-16

    Wheeze is a very common respiratory symptom, which is associated with several factors and diseases. Studies on incidence of new-onset wheeze in general adult populations are rare. The present prospective study aimed to investigate the incidence rate of new-onset wheeze, and predictors for wheeze, in a general, middle-aged population. Individuals, born 1943-1973, who had participated in a previous Swedish study in 1993 (n = 15,813), were mailed a new respiratory questionnaire in 2003. The questionnaire, which included items about respiratory symptoms, atopy, and smoking was answered by 11,463 (72%). Incidence rates of new-onset wheeze were calculated. Cox regression analyses were performed with incident wheeze as an event and person-years under observation as dependent variable. Among those free of wheeze at baseline (n = 8885), there were 378 new cases of wheeze during the study period (1993-2003). The incidence rate was 4.3/1000 person-years. The adjusted risk was increased in relation to smoking (HR 2.1;95% CI 1.7-2.7), ex-smoking (HR 1.4;95% CI 1.1-1.9), young age (HR 1.7;95% CI 1.3-2.2), chronic bronchitis (HR 2.3;95% CI 0.96-5.7), and rhinitis (HR 1.8;95% CI 1.4-2.2) at baseline, and body mass index ≥30 (HR 1.9;95% CI 1.5-2.6) at follow-up. This is a unique study that presents an incidence rate for new-onset wheeze in a middle-aged, general population sample previously free of adult wheeze. The results indicate that new-onset wheeze is quite common in this age group. Health care staff should bear this in mind since new-onset wheeze could be one of the earliest symptoms of severe respiratory disease. Special attention should be paid to patients with a smoking history, chronic bronchitis, rhinitis or obesity.

  16. Wheeze sound analysis using computer-based techniques: a systematic review.

    Science.gov (United States)

    Ghulam Nabi, Fizza; Sundaraj, Kenneth; Chee Kiang, Lam; Palaniappan, Rajkumar; Sundaraj, Sebastian

    2017-10-31

    Wheezes are high pitched continuous respiratory acoustic sounds which are produced as a result of airway obstruction. Computer-based analyses of wheeze signals have been extensively used for parametric analysis, spectral analysis, identification of airway obstruction, feature extraction and diseases or pathology classification. While this area is currently an active field of research, the available literature has not yet been reviewed. This systematic review identified articles describing wheeze analyses using computer-based techniques on the SCOPUS, IEEE Xplore, ACM, PubMed and Springer and Elsevier electronic databases. After a set of selection criteria was applied, 41 articles were selected for detailed analysis. The findings reveal that 1) computerized wheeze analysis can be used for the identification of disease severity level or pathology, 2) further research is required to achieve acceptable rates of identification on the degree of airway obstruction with normal breathing, 3) analysis using combinations of features and on subgroups of the respiratory cycle has provided a pathway to classify various diseases or pathology that stem from airway obstruction.

  17. [Efficacy and safety of tulobuterol patch versus oral salbutamol sulfate in children with mild or moderate acute attack of bronchial asthma: a comparative study].

    Science.gov (United States)

    Lin, Qian; Liu, Quan-Hua; Bao, Yi-Xiao

    2013-06-01

    To compare tulobuterol patch and oral salbutamol sulfate in terms of efficacy and safety in children with mild or moderate acute attack of bronchial asthma. A total of 92 children with mild and moderate acute asthmatic attack were randomly divided into salbutamol group (n=46) and tulobuterol group (n=46). Both groups received routine treatment with antihistamine, selective leukotriene receptor antagonist and glucocorticoid. In addition, the salbutamol group was given slow-release capsules of salbutamol sulfate, and the tulobuterol group was treated with tulobuterol patch. The two groups were compared with respect to symptom scores of cough, wheeze, respiratory rate, wheezing sound, three depression sign and peak expiratory flow, as well as adverse events. As the treatment proceeded, symptom scores decreased in both groups; on the third day of treatment, all symptom scores except cough score showed a significant decrease in both groups (Pattack.

  18. Study on correspondence between prescription and syndrome and the essence of phlegm and blood stasis syndrome in coronary heart disease based on metabonomics.

    Science.gov (United States)

    Lu, Xiao-yan; Xu, Hao; Li, Geng; Zhao, Tie

    2014-01-01

    Studying the essence of a syndrome has been a key challenge in the field of Chinese medicine. Until now, due to limitations of the methods available, the progress towards understanding such complicated systems has been slow. Metabonomics encompasses the dynamics, composition and analysis of metabolites, enabling the observation of changes in the metabolic network of the human body associated with disease. Being from the point of view of the whole organism, metabonomics provides an opportunity to study the essence of a syndrome to an unprecedented level. Phlegm and blood stasis syndrome is the main syndrome associated with coronary heart disease (CHD), which bring difficulties in clinical treatment due to difficulties associated with differentiation of symptoms and signs. The fundamental differences of material between the two also need to be interpreted. The authors consider that we can use the method of combining a disease (in this case CHD) with associated syndromes (phlegm and blood stasis syndrome) to select patients with phlegm and blood stasis syndrome of CHD, and utilize metabonomics to explore the essence of the syndrome by difference analysis of metabolite spectra. Meanwhile, we can study the syndrome in CM, observe the change regularity of metabolism spectra after the treatment of corresponding and non-corresponding prescription and syndrome, in order to validate the material fundament in the progress of syndrome formation and their differences. This will not only have great significance in enhancing the ability to identify syndrome of phlegm and blood stasis in CHD and to establish the clinical curative criteria, but will also offer a new approach of studying the essence for a syndrome using metabonomics.

  19. The Effects of Inhaled Steroids on Recurrent Wheeze After Acute Bronchiolitis

    Directory of Open Access Journals (Sweden)

    Patricia Green MD

    2015-07-01

    Full Text Available Background. Acute bronchiolitis infection during infancy is associated with an increased risk of asthma later in life. The objective of this study was to determine if inhaled steroids are effective in preventing the development of recurrent wheeze or asthma following acute bronchiolitis. Methods. Multiple databases and bibliographies of selected references were searched. Inclusion required (a a randomized controlled trial of inhaled steroids and control group, (b at least 2 weeks duration of therapy started during the acute phase of disease, and (c identification of the rate of recurrent wheeze or asthma at least 6 months after therapy. Results. Of 1410 studies reviewed, 8 reports were included in this meta-analysis (748 patients. The overall odds ratio for developing recurrent wheeze or asthma with treatment versus without treatment was 1.02 (95% confidence interval = 0.58-1.81. Conclusions. A course of inhaled steroids after acute bronchiolitis is not effective in preventing recurrent wheeze or asthma.

  20. [Recurrent wheezing: prevalence and associated factors in infants from Buenos Aires City, Argentina].

    Science.gov (United States)

    Szulman, Gabriela Aída; Freilij, Héctor; Behrends, Ilse; Gentile, Ángela; Mallol, Javier

    The episodes of bronchial obstruction at early age constitute a frequent problem in Pediatrics. The aim of this study was to evaluate the prevalence of recurrent wheezing in infants in Buenos Aires City, as well as to identify any associated factors. Cross-sectional study performed from 2011 to 2012 in the Children Hospital Ricardo Gutiérrez, Buenos Aires City, as part of the International Study of Wheezing in Infants. A validated questionnaire was applied to parents of infants aged between 12 and 15 months. The prevalence of wheezing, mostly the recurrent episodes (three or more), and their probable associated factors were evaluated. Data were statistically analyzed with χ 2 , Fisher's test, binary and logistics multiple regression analysis. The significance level was 0.05. Over 1063 infants, 58.9% (confidence interval (CI) 95% 55.9-61.9) presented at least one episode of wheezing and 26.3% (CI95% 23.8-29.9) three or more episodes (recurrent wheezing). Risk factors associated to wheezing were male gender (p=0.001), six or more episodes of cold during the first year of life (p Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  1. Prenatal antibiotic use and risk of childhood wheeze/asthma: A meta-analysis.

    Science.gov (United States)

    Zhao, Desheng; Su, Hong; Cheng, Jian; Wang, Xu; Xie, Mingyu; Li, Kesheng; Wen, Liying; Yang, Huihui

    2015-12-01

    Existing body of knowledge suggests that antibiotic use during pregnancy was inconsistently associated with childhood wheeze/asthma. The aim of this study was to determine whether exposure to antibiotic during pregnancy could increase the risk for childhood wheeze/asthma using a comprehensive meta-analysis. PubMed, MEDLINE, and China National Knowledge Infrastructure (CNKI) were systematically searched for studies up to September 10, 2014, and additional studies were found by searching reference lists of relevant articles. For this meta-analysis, cohort studies and case-control studies assessing the association between antibiotic use during pregnancy and risk of childhood wheeze/asthma were included. Extracted data were mainly pooled using random-effects model. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Ten studies were identified in final analysis. Pooling analysis of these studies showed an OR of 1.20 (95% CI, 1.13-1.27) for wheeze/asthma. After excluding case-control studies and prospective studies without achieving high scores on the NOS, the pooled OR was 1.18 (95% CI, 1.11-1.26). We found the risk of antibiotic use and pooled ORs of wheeze/asthma were 1.09 (95% CI, 0.92-1.29) for the first trimester, 1.14 (95% CI, 1.01-1.29) for the second trimester, and 1.33 (95% CI, 1.11-1.60) for the third trimester, respectively. This meta-analysis suggests that antibiotic exposure during pregnancy may increase the risk of wheeze/asthma in childhood. Besides, the risk of developing wheeze/asthma in childhood was marked during last two trimesters of pregnancy. Future studies of large-size and prospective cohorts which adequately address concerns for confounder bias are needed to examine the relationship between antibiotic use and risk of childhood asthma. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Long-term exposure to indoor air pollution and wheezing symptoms in infants

    DEFF Research Database (Denmark)

    Raaschou-Nielsen, O.; Hermansen, M.N.; Loland, L.

    2010-01-01

    Long-term exposure to air pollution is suspected to cause recurrent wheeze in infants. The few previous studies have had ambiguous results. The objective of this study was to estimate the impact of measured long-term exposure to indoor air pollution on wheezing symptoms in infants. We monitored......-point 'any symptom-day' (yes/no) and by standard linear regression with the end-point 'number of symptom-days'. The results showed no systematic association between risk for wheezing symptoms and the levels of these air pollutants with various indoor and outdoor sources. In conclusion, we found no evidence...... of an association between long-term exposure to indoor air pollution and wheezing symptoms in infants, suggesting that indoor air pollution is not causally related to the underlying disease. Practical Implications Nitrogen oxides, formaldehyde and fine particles were measured in the air in infants' bedrooms...

  3. Indoor exposures and recurrent wheezing in infants: a study in the BAMSE cohort.

    Science.gov (United States)

    Emenius, G; Svartengren, M; Korsgaard, J; Nordvall, L; Pershagen, G; Wickman, M

    2004-07-01

    The aim of this study was to examine the relationship between indoor exposures and the home environment, and the development of recurrent wheezing during infancy. A birth cohort, comprising 4089 children, was followed. Information on exposures was obtained shortly after birth, and episodes of wheezing were recorded when the infants were 1 and 2 y of age. In a nested case-control study, 181 infants were enrolled, who had three or more reported episodes of wheezing after 3 mo of age combined with either use of inhaled steroids or symptoms of bronchial hyper-reactivity, and 359 age-matched controls. Home inspections were performed during the winter following enrolment, and indoor conditions were measured. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated. The OR for recurrent infant wheezing associated with signs of dampness reported prospectively by parents was 1.4 (0.9-2.2), and the OR for observed signs of dampness at home inspections was 1.6 (1.0-2.5). A trend was found in the risk of recurrent wheezing in relation to the number of indicators of dampness: OR 1.3 (0.8-2.2) for one sign of dampness and OR 2.7 (1.3-5.4) for three or more signs of dampness. Newly painted surfaces in the child's bedroom was associated with an increased OR for recurrent wheezing: 1.7 (1.3-2.6). Indicators of dampness, as well as recently repainted interior surfaces, appear to be associated with recurrent infant wheezing, with a strengthened effect of combined indoor exposures.

  4. Poverty, dirt, infections and non-atopic wheezing in children from a Brazilian urban center.

    Science.gov (United States)

    Barreto, Mauricio L; Cunha, Sergio S; Fiaccone, Rosemeire; Esquivel, Renata; Amorim, Leila D; Alvim, Sheila; Prado, Matildes; Cruz, Alvaro A; Cooper, Philip J; Santos, Darci N; Strina, Agostino; Alcantara-Neves, Neuza; Rodrigues, Laura C

    2010-12-01

    The causation of asthma is poorly understood. Risk factors for atopic and non-atopic asthma may be different. This study aimed to analyze the associations between markers of poverty, dirt and infections and wheezing in atopic and non-atopic children. 1445 children were recruited from a population-based cohort in Salvador, Brazil. Wheezing was assessed using the ISAAC questionnaire and atopy defined as allergen-specific IgE ≥ 0.70 kU/L. Relevant social factors, environmental exposures and serological markers for childhood infections were investigated as risk factors using multivariate multinomial logistic regression. Common risk factors for wheezing in atopic and non-atopic children, respectively, were parental asthma and respiratory infection in early childhood. No other factor was associated with wheezing in atopic children. Factors associated with wheezing in non-atopics were low maternal educational level (OR 1.49, 95% CI 0.98-2.38), low frequency of room cleaning (OR 2.49, 95% CI 1.27-4.90), presence of rodents in the house (OR 1.48, 95% CI 1.06-2.09), and day care attendance (OR 1.52, 95% CI 1.01-2.29). Non-atopic wheezing was associated with risk factors indicative of poverty, dirt and infections. Further research is required to more precisely define the mediating exposures and the mechanisms by which they may cause non-atopic wheeze.

  5. Sibilancias recurrentes en el niño Recurrent wheezes in the child

    Directory of Open Access Journals (Sweden)

    Israel Valcárcel Vidal

    2008-12-01

    characteristics and risk factors in children with recurrent wheezes 10 years after the first episode of acute bronchiolitis caused by respiratory syncytial virus. METHODS. A descriptive retrospective longitudinal study was conducted among 34 children that were classified as transient wheezing and persistent wheezing. Risk, socioeconomic and environmental factors were identified. Skin sensitive tests with aeroallergens were performed. RESULTS. Persistent wheezes were observed in 22 patients (64.7 % and transient wheezes in 12 (35.3 %. The most common atopic family history was bronchial asthma with predominance in children with persistent wheezes (68.1 %. Early weaning was the most frequent personal history. Smoking and the attendance to day care centers were the prevailing socioeconomic and environmental risk factors (63.6 % and 59 %, respectively, specially in children with persistent wheezes. Six persistent wheezing children (27.2 % required attention at the Polivalent Intensive Care Unit, whereas only one transient wheezing child (8.3 % had to be admitted in that unit. The aeroallergen skin-prick tests yielded positive in 7 permanent wheezing children (31.8 % and in 1 transient wheezing child (8.3 %. CONCLUSIONS. The recurrent wheezes in the child after a first episode of bronchiolitis due to respiratory syncytial virus are generally associated with risk factors, particularly to the atopic family history and smoking. It is very important to early identify the children at risk for presenting atopic persistent asthma and to take therapeutic measures in order to prevent the deterioration of the pulmonary function.

  6. Prenatal maternal stress and wheeze in children: novel insights into epigenetic regulation.

    Science.gov (United States)

    Trump, Saskia; Bieg, Matthias; Gu, Zuguang; Thürmann, Loreen; Bauer, Tobias; Bauer, Mario; Ishaque, Naveed; Röder, Stefan; Gu, Lei; Herberth, Gunda; Lawerenz, Christian; Borte, Michael; Schlesner, Matthias; Plass, Christoph; Diessl, Nicolle; Eszlinger, Markus; Mücke, Oliver; Elvers, Horst-Dietrich; Wissenbach, Dirk K; von Bergen, Martin; Herrmann, Carl; Weichenhan, Dieter; Wright, Rosalind J; Lehmann, Irina; Eils, Roland

    2016-06-28

    Psychological stress during pregnancy increases the risk of childhood wheeze and asthma. However, the transmitting mechanisms remain largely unknown. Since epigenetic alterations have emerged as a link between perturbations in the prenatal environment and an increased disease risk we used whole genome bisulfite sequencing (WGBS) to analyze changes in DNA methylation in mothers and their children related to prenatal psychosocial stress and assessed its role in the development of wheeze in the child. We evaluated genomic regions altered in their methylation level due to maternal stress based of WGBS data of 10 mother-child-pairs. These data were complemented by longitudinal targeted methylation and transcriptional analyses in children from our prospective mother-child cohort LINA for whom maternal stress and wheezing information was available (n = 443). High maternal stress was associated with an increased risk for persistent wheezing in the child until the age of 5. Both mothers and children showed genome-wide alterations in DNA-methylation specifically in enhancer elements. Deregulated neuroendocrine and neurotransmitter receptor interactions were observed in stressed mothers and their children. In children but not in mothers, calcium- and Wnt-signaling required for lung maturation in the prenatal period were epigenetically deregulated and could be linked with wheezing later in children's life.

  7. [Management of wheezing disorders in infants participating in the PARIS birth cohort].

    Science.gov (United States)

    Herr, M; Nikasinovic, L; Foucault, C; Le Marec, A M; Giordanella, J P; Just, J; Momas, I

    2012-01-01

    While wheezing disorders are common in preschool children, their management is not well defined. The aim of this study was to assess the use of medical health care resources due to wheezing disorders in infants aged 18 months followed up in the Pollution and Asthma Risk: an Infant Study (PARIS) birth cohort. Data on wheezing disorders, medical visits and medication on account of respiratory disorders during the previous 12 months were collected with a standardized questionnaire, administered by a paediatrician, during the health check offered to every child aged 18 months included in the PARIS birth cohort. The prevalence of wheezing disorders during the past 12 months amounted to 560/1974 (28.4%). Among wheezers, 493 (89.3%) required a medical visit because of difficult breathing; 61 (11.0%) went to the emergency room, 35 (6.4%) were admitted to the hospital and 375 (67.2%) received an inhaled anti-asthmatic medication. Recourse to chest physiotherapy was reported in 472 of them (85.1%). This study confirms the high use of healthcare resources because of wheezing disorders in infants and suggests a higher use of anti-asthmatic medications in France compared to other European countries. Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  8. Decreased lung function after preschool wheezing rhinovirus illnesses in children at risk to develop asthma.

    Science.gov (United States)

    Guilbert, Theresa W; Singh, Anne Marie; Danov, Zoran; Evans, Michael D; Jackson, Daniel J; Burton, Ryan; Roberg, Kathy A; Anderson, Elizabeth L; Pappas, Tressa E; Gangnon, Ronald; Gern, James E; Lemanske, Robert F

    2011-09-01

    Preschool rhinovirus (RV) wheezing illnesses predict an increased risk of childhood asthma; however, it is not clear how specific viral illnesses in early life relate to lung function later on in childhood. To determine the relationship of virus-specific wheezing illnesses and lung function in a longitudinal cohort of children at risk for asthma. Two hundred thirty-eight children were followed prospectively from birth to 8 years of age. Early life viral wheezing respiratory illnesses were assessed by using standard techniques, and lung function was assessed annually by using spirometry and impulse oscillometry. The relationships of these virus-specific wheezing illnesses and lung function were assessed by using mixed-effect linear regression. Children with RV wheezing illness demonstrated significantly decreased spirometry values, FEV(1) (P = .001), FEV(0.5) (P Children who wheezed with respiratory syncytial virus or other viral illnesses did not have any significant differences in spirometric or impulse oscillometry indices when compared with children who did not. Children diagnosed with asthma at ages 6 or 8 years had significantly decreased FEF(25-75) (P = .05) compared with children without asthma. Among outpatient viral wheezing illnesses in early childhood, those caused by RV infections are the most significant predictors of decreased lung function up to age 8 years in a high-risk birth cohort. Whether low lung function is a cause and/or effect of RV wheezing illnesses is yet to be determined. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  9. Usefulness of chest radiographs in first asthma attacks

    International Nuclear Information System (INIS)

    Gershel, J.C.; Goldman, H.S.; Stein, R.E.K.; Shelov, S.P.; Ziprkowski, M.

    1983-01-01

    To assess the value of routine chest radiography during acute first attacks of asthma, we studied 371 consecutive children over one year of age who presented with an initial episode of wheezing. Three hundred fifty children (94.3%) had radiographic findings that were compatible with uncomplicated asthma and were considered negative. Twenty-one (5.7%) had positive findings: atelectasis and pneumonia were noted in seven, segmental atelectasis in six, pneumonia in five, multiple areas of subsegmental atelectasis in two, and pneumomediastinum in one. The patients with positive films were more likely to have a respiratory rate above 60 or a pulse rate above 160 (P < 0.001), localized rales or localized decreased breath sounds before treatment (P < 0.01), and localized rales (P < 0.005) and localized wheezing (P < 0.02) after treatment; also, these patients were admitted to the hospital more often (P < 0.001). Ninety-five percent (20 of 21) of the children with positive films could be identified before treatment on the basis of a combination of tachypnea, tachycardia, fever, and localized rales or localized decreased breath sounds. Most first-time wheezers will not have positive radiographs; careful clinical evaluation should reveal which patients will have abnormal radiographs and will therefore benefit from the procedure. 20 references, 3 tables

  10. An unusual case of refractory wheeze

    Science.gov (United States)

    Ramesh, Venkat; Acharya, Vishak; Pai, Narasimha; Krishnan, Ananda

    2015-01-01

    A 37-year-old man presented with a history of episodic wheeze and breathlessness of 3 years’ duration refractory to treatment. Physical examination revealed diffuse expiratory polyphonic rhonchi while the remainder of the examination including the cardiac examination was reported as normal. Pulmonary function testing revealed mild obstruction with bronchodilator reversibility. The patient was discharged on a 6-month course of antitubercular treatment (ATT) as bronchial brush cytology (obtained via bronchoscopy) was positive for acid-fast bacilli. The patient presented after completing 6 months of ATT with persistent symptoms, a loud S1 and a mid-diastolic murmur at the apex. High-resolution CT of the chest showed bilateral dependent ground glass opacities. An echocardiogram revealed a left atrial myxoma, and normal RV size and pressures. The patient underwent successful surgical removal of the same, and made a complete recovery. Refractory wheeze is a very unusual presentation of a left atrial myxoma. PMID:25733086

  11. Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

    NARCIS (Netherlands)

    Bont, L.; Steijn, M.; van Aalderen, W. M. C.; Brus, F.; Th Draaisma, J. M.; van Diemen-Steenvoorde, R. A. A. M.; Pekelharing-Berghuis, M.; Kimpen, J. L. L.

    2004-01-01

    Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of

  12. Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

    NARCIS (Netherlands)

    Bont, L; Steijn, M; van Aalderen, WMC; Brus, F; Draaisma, JMT; Van Diemen-Steenvoorde, RAAM; Pekelharing-Berghuis, M; Kimpen, JLL

    Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of

  13. Poverty-associated risk factors for wheezing in the first year of life in Honduras and El Salvador.

    Science.gov (United States)

    Bueso, A; Figueroa, M; Cousin, L; Hoyos, W; Martínez-Torres, A E; Mallol, J; Garcia-Marcos, L

    2010-01-01

    Risk factors for wheezing specifically during the first year of life have been studied in well-developed countries, but the information from developing countries is very scarce. There are no such studies focusing on factors derived from poverty. The aim of the present study was to determine if risk factors related to poverty are associated to wheezing during the first year of life in infants from Honduras and El Salvador. A survey, using a validated questionnaire, was carried out in the metropolitan area of San Pedro Sula (Honduras) and in La Libertad (El Salvador) in centres where infants attended for a scheduled vaccination shot or a healthy child visit at 12 months of age. Fieldworkers offered questionnaires to parents and helped the illiterate when necessary. The main outcome variable was wheezing during the first year of life, as reported by parents. A total of 1047 infants in El Salvador and 780 in Honduras were included in the analysis. The prevalence of wheeze in the first year was higher in El Salvador (41.2%) than in Honduras (27.7%), as was recurrent wheezing defined as three or more episodes (18.4% vs. 11.7%). Wheezing and recurrent wheezing was associated to unpaved floor in the household (summary odds ratios for both countries 1.55, p=0.036 and 1.72, p=0.054 for any wheeze and recurrent wheezing, respectively); dust entering from streets (1.30, p=0.052 and 1.67, p=0.008); living in a heavily polluted area (1.33, p=0.037 and 1.52, p=0.033); and having mould stains on the household walls (1.36, p=0.072 and 1.76, p=0.007). Furthermore, marginal associations were found for additional person at home and use of kerosene as cooking fuel. University studies in the mother (0.34, p=0.046 and 0.32, p=0.022) and a professional occupation in the father (0.34, p=0.046 and 0.26, p=0.047) were associated to a lower risk. The prevalence of wheezing and recurrent wheezing is notoriously high in El Salvador and Honduras. In those populations factors related to poverty

  14. Risk factors for non-atopic asthma/wheeze in children and adolescents: a systematic review

    OpenAIRE

    Strina, Agostino; Barreto, Mauricio L; Cooper, Philip J; Rodrigues, Laura C

    2014-01-01

    BACKGROUND: The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings.\\ud \\ud OBJECTIVE: To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents.\\ud \\ud METHODS: A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE.\\u...

  15. Is it traffic type, volume, or distance? Wheezing in infants living near truck and bus traffic.

    Science.gov (United States)

    Ryan, Patrick H; LeMasters, Grace; Biagini, Jocelyn; Bernstein, David; Grinshpun, Sergey A; Shukla, Rakesh; Wilson, Kimberly; Villareal, Manuel; Burkle, Jeff; Lockey, James

    2005-08-01

    Previous studies of air pollution have not examined the association between exposure to varying types, distance, and amounts of traffic and wheezing in very young infants. We sought to determine the relationship between types of traffic, traffic volume, and distance and wheezing among infants less than 1 year of age. A geographic information system and a classification scheme were developed to categorize infants enrolled in the study as living near moving truck and bus traffic (highway >50 miles per hour, >1000 trucks daily, bus traffic (bus and truck traffic had a significantly increased prevalence of wheezing (adjusted odds ratio, 2.50; 95% CI, 1.15-5.42) when compared with unexposed infants. The prevalence of wheezing among nonwhite infants was at least twice that of white infants, regardless of exposure. Infants living less than 400 m from a high volume of moving traffic, however, did not have an increased prevalence of wheezing. These results suggest that the distance from and type of traffic exposures are more significant risk factors than traffic volume for wheezing in early infancy.

  16. A survey on automated wheeze detection systems for asthmatic patients

    Directory of Open Access Journals (Sweden)

    Syamimi Mardiah Shaharum

    2012-11-01

    Full Text Available The purpose of this paper is to present an evidence of automated wheeze detection system by a survey that can be very beneficial for asthmatic patients. Generally, for detecting asthma in a patient, stethoscope is used for ascertaining wheezes present. This causes a major problem nowadays because a number of patients tend to delay the interpretation time, which can lead to misinterpretations and in some worst cases to death. Therefore, the development of automated system would ease the burden of medical personnel. A further discussion on automated wheezes detection system will be presented later in the paper. As for the methodology, a systematic search of articles published as early as 1985 to 2012 was conducted. Important details including the hardware used, placement of hardware, and signal processing methods have been presented clearly thus hope to help and encourage future researchers to develop commercial system that will improve the diagnosing and monitoring of asthmatic patients.

  17. Classification and pharmacological treatment of preschool wheezing: changes since 2008

    DEFF Research Database (Denmark)

    Brand, P. L. P.; Caudri, D.; Eber, E.

    2014-01-01

    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some......, with scheduled close follow-up to monitor treatment effect. The group recommends discontinuing treatment if there is no benefit and taking favourable natural history into account when making decisions about long-term therapy. Oral corticosteroids are not indicated in mild-to-moderate acute wheeze episodes...

  18. Clinical score and arterial oxygen saturation in children with wheezing associated respiratory illness (WARI).

    Science.gov (United States)

    Sritippayawan, S; Deerojanawong, J; Prapphal, N

    2000-10-01

    To determine the correlation between clinical score (based on respiratory rate, chest wall retractions, air entry, wheezing, consciousness and audible wheezing) and arterial oxygen saturation (SaO2: measured by pulse oximetry) as well as the most appropriate total score for predicting hypoxemia (SaO2 WARI). 70 children (1 month-5 years old) hospitalized in the Department of Pediatrics, Chulalongkorn Hospital with the diagnosis of WARI from January 1, 1996 to December 31, 1996 were studied. Half of them were diagnosed to have acute lower respiratory tract infection (LRI) with wheezing while the remainder had reactive airway disease (RAD). Cross sectional, analytical study. In each group of patients, the clinical score and SaO2 were assessed by the same pediatrician throughout the study. The correlation between the clinical signs and SaO2 as well as the cut off point of total score for predicting hypoxemia were analyzed. The sensitivity, specificity and accuracy of that total score in predicting hypoxemia were also calculated. In both groups of patients (acute LRI with wheezing and RAD group), the clinical signs correlated with SaO2 were wheezing (rs = -0.67 and -0.47 respectively) and chest wall retractions (rs = -0.57 and -0.59 respectively). Total score was also correlated with SaO2 (rs = -0.68 and -0.5 respectively). The cut off point of total score in predicting hypoxemia was 4 providing 80 per cent sensitivity in both groups with accuracy 74.3 per cent and 80 per cent respectively. This clinical score may be used to assess the severity of hypoxemia in WARI patients. Wheezing, chest wall retractions and total score correlated well with SaO2. The total score > 4 was most appropriate in predicting hypoxemia in both children with RAD and wheezing associated with LRI.

  19. Association between Chlamydia pneumoniae antibodies and wheezing in young children and the influence of sex.

    Science.gov (United States)

    Normann, E; Gnarpe, J; Wettergren, B; Janson, C; Wickman, M; Nordvall, L

    2006-12-01

    The proposed association between Chlamydia pneumoniae (Cpn) infection and wheezing needs further clarification. Serum samples obtained from 1581 children aged 4 years in a population based cohort were tested for antibodies to Cpn and IgE antibodies to common allergens. Data on environmental factors and disease were collected prospectively from birth. The occurrence of IgG antibodies to Cpn at 4 years of age was associated with reported wheezing at different ages; however, these findings were most often not significant. In girls, the occurrence of anti-Cpn IgG was associated with wheezing at the ages of 1, 2, and 4 years (odds ratios (ORs) 3.41 (95% confidence interval (CI) 1.46 to 7.96), 2.13 (95% CI 1.02 to 4.44), and 2.01 (95% CI 1.14 to 3.54), respectively), and even higher ORs were observed for each age category when only high level antibody responses to Cpn were analysed. At the time of blood sampling the association between anti-Cpn IgG and wheezing was restricted to girls without atopic sensitisation (OR 2.39 (95% CI 1.25 to 4.57). No associations with wheezing were detected in boys, in whom IgE sensitisation was inversely associated with the presence of anti-Cpn IgG (OR 0.49 (95% CI 0.26 to 0.90)). This study suggests an association between evidence of earlier Cpn infection and a history of wheezing in young girls. Infection with Cpn may be an important risk factor for wheezing and possibly for non-atopic asthma, predominantly in girls.

  20. Is parent-child bed-sharing a risk for wheezing and asthma in early childhood?

    Science.gov (United States)

    Luijk, Maartje P C M; Sonnenschein-van der Voort, Agnes M M; Mileva-Seitz, Viara R; Jansen, Pauline W; Verhulst, Frank C; Hofman, Albert; Jaddoe, Vincent W V; de Jongste, Johan C; van IJzendoorn, Marinus H; Duijts, Liesbeth; Tiemeier, Henning

    2015-03-01

    Household crowding can place young children at risk for respiratory infections which subsequently provoke asthma symptoms. However, crowding might also protect against asthma, in accordance with the hygiene hypothesis. We tested if parent-infant bed-sharing, an important dimension of household crowding, increases or decreases the risk for asthma. In a population-based prospective cohort (N = 6160) we assessed bed-sharing at 2 and 24 months; wheezing between 1 and 6 years of age; and asthma at 6 years of age. Generalised estimating equation models were used to assess repeated measures of wheezing and asthma. We found no association between bed-sharing in early infancy and wheezing or diagnosis of asthma. By contrast, we found a positive association between bed-sharing in toddlerhood and both wheezing (OR 1.42, 95% CI 1.15-1.74) and asthma (OR 1.57, 95% CI 1.03-2.38). Wheezing was not associated with bed-sharing when using cross-lagged modelling. This study suggests that bed-sharing in toddlerhood is associated with an increased risk of asthma at later ages, and not vice versa. Further studies are needed to explore the underlying causal mechanisms. Copyright ©ERS 2015.

  1. Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm

    NARCIS (Netherlands)

    de Marco, Roberto; Accordini, Simone; Cerveri, Isa; Corsico, Angelo; Anto, Josep M.; Kunzli, Nino; Janson, Christer; Sunyer, Jordi; Jarvis, Deborah; Chinn, Susan; Vermeire, Paul; Svanes, Cecilie; Ackermann-Liebrich, Ursula; Gislason, Thorarinn; Heinrich, Joachim; Leynaert, Benedicte; Neukirch, Francoise; Schouten, Jan P.; Wjst, Matthias; Burney, Peter

    2007-01-01

    Rationale: The few prospective studies aimed at assessing the incidence of chronic obstructive pulmonary disease (COPD) in relation to the presence of chronic cough/phlegm have produced contrasting results. Objectives: To assess the incidence of COPD in a cohort of young adults and to test whether

  2. Timing and Duration of Traffic-related Air Pollution Exposure and the Risk for Childhood Wheeze and Asthma.

    Science.gov (United States)

    Brunst, Kelly J; Ryan, Patrick H; Brokamp, Cole; Bernstein, David; Reponen, Tiina; Lockey, James; Khurana Hershey, Gurjit K; Levin, Linda; Grinshpun, Sergey A; LeMasters, Grace

    2015-08-15

    The timing and duration of traffic-related air pollution (TRAP) exposure may be important for childhood wheezing and asthma development. We examined the relationship between TRAP exposure and longitudinal wheezing phenotypes and asthma at age 7 years. Children completed clinical examinations annually from age 1 year through age 4 years and age 7 years. Parental-reported wheezing was assessed at each age, and longitudinal wheezing phenotypes (early-transient, late-onset, persistent) and asthma were defined at age 7 years. Participants' time-weighted exposure to TRAP, from birth through age 7 years, was estimated using a land-use regression model. The relationship between TRAP exposure and wheezing phenotypes and asthma was examined. High TRAP exposure at birth was significantly associated with both transient and persistent wheezing phenotypes (adjusted odds ratio [aOR] = 1.64; 95% confidence interval [CI], 1.04-2.57 and aOR = 2.31; 95% CI, 1.28-4.15, respectively); exposure from birth to age 1 year and age 1 to 2 years was also associated with persistent wheeze. Only children with high average TRAP exposure from birth through age 7 years were at significantly increased risk for asthma (aOR = 1.71; 95% CI, 1.01-2.88). Early-life exposure to TRAP is associated with increased risk for persistent wheezing, but only long-term exposure to high levels of TRAP throughout childhood was associated with asthma development.

  3. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults.

    Science.gov (United States)

    Potts, James F; Rona, Roberto J; Oyarzun, Manuel J; Amigo, Hugo; Bustos, Patricia

    2008-04-01

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semirural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  4. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults

    Energy Technology Data Exchange (ETDEWEB)

    Potts, J.F.; Rona, R.J.; Oyarzun, M.J.; Amigo, H.; Bustos, P. [Kings College London, London (United Kingdom). Dept. for Public Health Science

    2008-04-15

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semi-rural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  5. Indoor Risk Factors for Cough and Their Relation to Wheeze and Sensitization in Chilean Young Adults

    Science.gov (United States)

    Potts, James F.; Rona, Roberto J.; Oyarzun, Manuel J.; Amigo, Hugo; Bustos, Patricia

    2008-01-01

    Objectives. We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Methods. Our sample was composed of 1232 men and women residing in a semirural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Results. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Conclusions. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity. PMID:17666696

  6. Cross sectional analysis of respiratory symptoms in an injection drug user cohort: the impact of obstructive lung disease and HIV

    Directory of Open Access Journals (Sweden)

    Mehta Shruti H

    2010-05-01

    Full Text Available Abstract Background Injection drug use is associated with an increased risk of human immunodeficiency virus (HIV infection and with obstructive lung diseases (OLD. Understanding how HIV and OLD may impact respiratory symptoms among injection drug users (IDUs is important to adequately care for this high-risk population. We characterized the independent and joint effects of HIV and OLD on respiratory symptoms of a cohort of inner-city IDUs. Methods Demographics, risk behavior and spirometric measurements were collected from a cross-sectional analysis of the Acquired Immunodeficiency Syndrome Link to the IntraVenous Experience study, an observational cohort of IDUs followed in Baltimore, MD since 1988. Participants completed a modified American Thoracic Society respiratory questionnaire and the Medical Research Council (MRC dyspnea score to assess respiratory symptoms of cough, phlegm, wheezing and dyspnea. Results Of 974 participants, 835 (86% were current smokers and 288 (29.6% were HIV-infected. The prevalence of OLD (FEV1/FVC ≤ 0.70 was 15.5%, and did not differ by HIV status. OLD, but not HIV, was associated with increased frequency of reported respiratory symptoms. There was a combined effect of OLD and HIV on worsening of MRC scores. OLD and HIV were independently associated with an increased odds of reporting an MRC ≥ 2 (OR 1.83 [95%CI 1.23-2.73] and 1.50 [95%CI 1.08-2.09], respectively. COPD, but not HIV, was independently associated with reporting an MRC ≥ 3 (OR 2.25 [95%CI 1.43-3.54] and 1.29 [95%CI 0.87-1.91], respectively. Conclusions While HIV does not worsen cough, phlegm or wheezing, HIV significantly increases moderate but not severe dyspnea in individuals of similar OLD status. Incorporating the MRC score into routine evaluation of IDUs at risk for OLD and HIV provides better assessment than cough, phlegm and wheezing alone.

  7. The effect of early child care attendance on childhood asthma and wheezing: A meta-analysis.

    Science.gov (United States)

    Swartz, Alicia; Collier, Tina; Young, Chelsea Anne; Cruz, Eddie; Bekmezian, Arpi; Coffman, Janet; Celedon, Juan; Alkon, Abbey; Cabana, Michael D

    2018-04-09

    Research evidence offers mixed results regarding the relationship between early child care attendance and childhood asthma and wheezing. A meta-analysis was conducted to synthesize the current research evidence of the association between early child care attendance and the risk of childhood asthma and wheezing. Peer reviewed studies published from 1964-January 2017 were identified in MEDLINE, CINAL, and EMBASE using MeSH headings relevant to child care and asthma. Two investigators independently reviewed the selected articles from this search. All relevant articles that met our inclusion criteria were selected for further analysis. Data were extracted from studies that had sufficient data to analyze the odds of asthma or wheezing among children who attended child care. The meta-analysis of 32 studies found that (1) early child care attendance is protective against asthma in children 3-5 years of age but not for children with asthma 6 years of age or older. (2) Early child care attendance increases the risk of wheezing among children 2 years of age or younger, but not the risk of wheezing for children over 2 years of age. This meta-analysis shows that early child care attendance is not significantly associated with the risk of asthma or wheeze in children 6 years of age or older.

  8. Influence of the Mediterranean diet during pregnancy in the development of wheezing and eczema in infants in Pamplona, Spain.

    Science.gov (United States)

    Alvarez Zallo, N; Aguinaga-Ontoso, I; Alvarez-Alvarez, I; Marin-Fernandez, B; Guillén-Grima, F; Azcona-San Julián, C

    This study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. The study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). No association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p=0.372), recurrent wheezing (p=0.118) and eczema (p=0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. The present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  9. Wheezing exacerbations in early childhood: evaluation, treatment, and recent advances relevant to the genesis of asthma

    Science.gov (United States)

    Miller, E. Kathryn; Avila, Pedro C.; Khan, Yasmin W.; Word, Carolyn R.; Pelz, Barry J.; Papadopoulos, Nikolaos G.; Peebles, R. Stokes; Heymann, Peter W.

    2014-01-01

    Children who begin wheezing during early childhood are seen frequently by health care providers in primary care, in hospitals and emergency departments, and by allergists and pulmonologists. When young children, like the 2 year-old case presented here, are evaluated for wheezing, a frequent challenge for clinicians is to determine whether the symptoms represent transient, viral-induced wheezing, or whether sufficient risk factors are present to suspect that the child may experience recurrent wheezing and develop asthma. Most factors influencing prognosis are not mutually exclusive, are interrelated (i.e., cofactors), and often represent gene-environment interactions. Many of these risk factors have been, and continue to be, investigated in prospective studies in order to decipher their relative importance with the goal of developing new therapies and interventions in the future. The etiologies of wheezing in young children, diagnostic methods, treatment, prognostic factors, and potential targets for prevention of the development of asthma are discussed. PMID:25213046

  10. Associations of Pet Ownership with Wheezing and Lung Function in Childhood: Findings from a UK Birth Cohort.

    Science.gov (United States)

    Collin, Simon M; Granell, Raquel; Westgarth, Carri; Murray, Jane; Paul, Elizabeth S; Sterne, Jonathan A C; Henderson, A John

    2015-01-01

    Asthma is a heterogeneous condition and differential effects of pet ownership on non-atopic versus atopic asthma have been reported. The aim of this study was to investigate whether pet ownership during pregnancy and early childhood was associated with wheezing from birth to age 7 years and with lung function at age 8 years in a UK population-based birth cohort. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were used to investigate associations of pet ownership at six time-points from pregnancy to age 7 years with concurrent episodes of wheezing, wheezing trajectories (phenotypes) and lung function at age 8 years using logistic regression models adjusted for child's sex, maternal history of asthma/atopy, maternal smoking during pregnancy, and family adversity. 4,706 children had complete data on pet ownership and wheezing. From birth to age 7 years, cat ownership was associated with an overall 6% lower odds of wheezing (OR=0.94 (0.89-0.99)). Rabbit and rodent ownership was associated with 21% (OR=1.21 (1.12-1.31)) and 11% (OR=1.11 (1.02-1.21)) higher odds of wheezing, respectively, with strongest effects evident during infancy. Rabbit and rodent ownership was positively associated with a 'persistent wheeze' phenotype. Pet ownership was not associated with lung function at age 8 years, with the exception of positive associations of rodent and bird ownership with better lung function. Cat ownership was associated with reduced risk, and rabbit and rodent ownership with increased risk, of wheezing during childhood. The mechanisms behind these differential effects warrant further investigation.

  11. Genome-Wide DNA Methylation Profiles of Phlegm-Dampness Constitution

    Directory of Open Access Journals (Sweden)

    Haiqiang Yao

    2018-03-01

    Full Text Available Background/Aims: Metabolic diseases are leading health concerns in today’s global society. In traditional Chinese medicine (TCM, one body type studied is the phlegm-dampness constitution (PC, which predisposes individuals to complex metabolic disorders. Genomic studies have revealed the potential metabolic disorders and the molecular features of PC. The role of epigenetics in the regulation of PC, however, is unknown. Methods: We analyzed a genome-wide DNA methylation in 12 volunteers using Illumina Infinium Human Methylation450 BeadChip on peripheral blood mononuclear cells (PBMCs. Eight volunteers had PC and 4 had balanced constitutions. Results: Methylation data indicated a genome-scale hyper-methylation pattern in PC. We located 288 differentially methylated probes (DMPs. A total of 256 genes were mapped, and some of these were metabolic-related. SQSTM1, DLGAP2 and DAB1 indicated diabetes mellitus; HOXC4 and SMPD3, obesity; and GRWD1 and ATP10A, insulin resistance. According to Ingenuity Pathway Analysis (IPA, differentially methylated genes were abundant in multiple metabolic pathways. Conclusion: Our results suggest the potential risk for metabolic disorders in individuals with PC. We also explain the clinical characteristics of PC with DNA methylation features.

  12. Impact of air pollution on respiratory diseases in children with recurrent wheezing or asthma.

    Science.gov (United States)

    Esposito, Susanna; Galeone, Carlotta; Lelii, Mara; Longhi, Benedetta; Ascolese, Beatrice; Senatore, Laura; Prada, Elisabetta; Montinaro, Valentina; Malerba, Stefano; Patria, Maria Francesca; Principi, Nicola

    2014-08-07

    Air pollution has many negative health effects on the general population, especially children, subjects with underlying chronic disease and the elderly. The aims of this study were to evaluate the effects of traffic-related pollution on the exacerbation of asthma and development of respiratory infections in Italian children suffering from asthma or wheezing compared with healthy subjects and to estimate the association between incremental increases in principal pollutants and the incidence of respiratory symptoms. This prospective study enrolled 777 children aged 2 to 18 years (375 with recurrent wheezing or asthma and 402 healthy subjects). Over 12 months, parents filled out a daily clinical diary to report information about respiratory symptoms, type of medication used and healthcare utilization. Clinical data were combined with the results obtained using an air pollution monitoring system of the five most common pollutants. Among the 329 children with recurrent wheezing or asthma and 364 healthy subjects who completed follow-up, children with recurrent wheezing or asthma reported significantly more days of fever (p=0.005) and cough (ppollution and the development of asthma exacerbations and respiratory infections in children born to atopic parents and in those suffering from recurrent wheezing or asthma. These findings suggest that environmental control may be crucial for respiratory health in children with underlying respiratory disease.

  13. DNA hypomethylation at ALOX12 is associated with persistent wheezing in childhood.

    Science.gov (United States)

    Morales, Eva; Bustamante, Mariona; Vilahur, Nadia; Escaramis, Georgia; Montfort, Magda; de Cid, Rafael; Garcia-Esteban, Raquel; Torrent, Maties; Estivill, Xavier; Grimalt, Joan O; Sunyer, Jordi

    2012-05-01

    Epigenetic changes may play a role in the occurrence of asthma-related phenotypes. To identify epigenetic marks in terms of DNA methylation of asthma-related phenotypes in childhood, and to assess the effect of prenatal exposures and genetic variation on these epigenetic marks. Data came from two cohorts embedded in the Infancia y Medio Ambiente (INMA) PROJECT: Menorca (n = 122) and Sabadell (n = 236). Wheezing phenotypes were defined at age 4-6 years. Cytosine-guanine (CpG) dinucleotide site DNA methylation differences associated with wheezing phenotypes were screened in children of the Menorca study using the Illumina GoldenGate Panel I. Findings were validated and replicated using pyrosequencing. Information on maternal smoking and folate supplement use was obtained through questionnaires. Dichlorodiphenyldichloroethylene was measured in cord blood or maternal serum. Genotypes were extracted from genome-wide data. Screening identified lower DNA methylation at a CpG site in the arachidonate 12-lipoxygenase (ALOX12) gene in children having persistent wheezing compared with those never wheezed (P = 0.003). DNA hypomethylation at ALOX12 loci was associated with higher risk of persistent wheezing in the Menorca study (odds ratio per 1% methylation decrease, 1.13; 95% confidence interval, 0.99-1.29; P = 0.077) and in the Sabadell study (odds ratio, 1.16; 95% confidence interval, 1.03-1.37; P = 0.017). Higher levels of prenatal dichlorodiphenyldichloroethylene were associated with DNA hypomethylation of ALOX12 in the Menorca study (P = 0.033), but not in the Sabadell study (P = 0.377). ALOX12 DNA methylation was strongly determined by underlying genetic polymorphisms. DNA methylation of ALOX12 may be an epigenetic biomarker for the risk of asthma-related phenotypes.

  14. Infant Respiratory Tract Infections or Wheeze and Maternal Vitamin D in Pregnancy

    DEFF Research Database (Denmark)

    Christensen, Nikolas; Søndergaard, Jens; Fisker, Niels

    2017-01-01

    Respiratory tract infections (RTIs) are a common cause of morbidity and mortality in young children and can be associated with wheeze. Vitamin D can have a protective role against RTI. MATERIALS AND METHODS: A systematic search of Pubmed, Embase and the Cochrane library was performed. Titles...... and abstracts were evaluated and selected articles were reviewed by two authors. We included randomized controlled trials (RCTs) investigating the effect of vitamin D supplementation during pregnancy on RTIs or wheeze in children of 5 years of age or younger. Observational studies on the association between...... serum 25-hydroxyvitamin D (25OHD) during pregnancy, or at birth, and RTIs and/or wheeze were included. The protocol was registered on PROSPERO (Registration No. CRD42015019183). RESULTS: Of four RCTs, one showed a protective effect of a high daily dose (2,000IU) of vitamin D during pregnancy...

  15. Hygiene, atopy and wheeze-eczema-rhinitis symptoms in schoolchildren from urban and rural Ecuador.

    Science.gov (United States)

    Cooper, Philip J; Vaca, Maritza; Rodriguez, Alejandro; Chico, Martha E; Santos, Darci N; Rodrigues, Laura C; Barreto, Mauricio L

    2014-03-01

    Rural residence is protective against atopy and wheeze-rhinitis-eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze-rhinitis-eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9-10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms.

  16. Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Ravn, Henrik; Kristensen, Kim

    2008-01-01

    BACKGROUND: Respiratory syncytial virus (RSV) hospitalization is associated with wheeze. OBJECTIVE: To examine the influence of maternally derived RSV neutralizing antibodies in cord blood on RSV hospitalization and recurrent wheeze in infancy. METHODS: Among children from the Danish National Birth...

  17. Maternal prepregnancy obesity is an independent risk factor for frequent wheezing in infants by age 14 months.

    Science.gov (United States)

    Guerra, Stefano; Sartini, Claudio; Mendez, Michelle; Morales, Eva; Guxens, Mònica; Basterrechea, Mikel; Arranz, Leonor; Sunyer, Jordi

    2013-01-01

    Maternal prepregnancy obesity has been linked to the offspring's risk for subsequent asthma. We determined whether maternal obesity is associated with increased risk of wheezing phenotypes early in life. We used data on 1107 mother-child pairs from two birth cohorts from the INMA-INfancia y Medio Ambiente project. Maternal height was measured and prepregnancy weight self-reported at enrolment (on average at 13.7 ± 2 weeks of gestation). Maternal prepregnancy body mass index was categorised as underweight, normal, overweight and obese according to WHO recommendations. Information on child's wheezing was obtained through questionnaires up to the age of 14 (± 1) months. Wheezing was classified as infrequent (<4 reported wheezing episodes) or frequent (≥ 4 episodes). Weight and length of infants were measured by trained study staff at 14.6 (± 1) months of age and weight-for-length z-scores computed. Although maternal obesity did not increase the risk of the child to have any or infrequent wheezing, children of obese mothers were more likely to have frequent wheezing than children of normal-weight mothers (11.8% vs. 3.8%; P = 0.002). In fully adjusted multinomial logistic regression models, including infants' weight-for-length z-scores and other covariates, maternal prepregnancy obesity was associated with increased risk of frequent [adjusted relative risk (RR) 4.18, 95% confidence interval (CI) 1.55, 11.3] but not infrequent (RR 1.05 [95% CI 0.55, 2.01]) wheezing in their children. Maternal prepregnancy obesity is independently associated with an increased risk of frequent wheezing in the infant by the age of 14 months. These findings add evidence on the potential effects of in utero exposures on asthma-related phenotypes. © 2012 Blackwell Publishing Ltd.

  18. Building characteristics, indoor air quality and recurrent wheezing in very young children (BAMSE).

    Science.gov (United States)

    Emenius, G; Svartengren, M; Korsgaard, J; Nordvall, L; Pershagen, G; Wickman, M

    2004-02-01

    This study was conducted to examine the impact of building characteristics and indoor air quality on recurrent wheezing in infants. We followed a birth cohort (BAMSE) comprising 4089 children, born in predefined areas of Stockholm, during their first 2 years of life. Information on exposures was obtained from parental questionnaires when the children were 2 months and on symptoms and diseases when the children were 1 and 2 years old. Children with recurrent wheezing, and two age-matched controls per case, were identified and enrolled in a nested case-control study. The homes were investigated and ventilation rate, humidity, temperature and NO2 measured. We found that living in an apartment erected after 1939, or in a private home with crawl space/concrete slab foundation were associated with an increased risk of recurrent wheezing, odds ratio (OR) 2.5 (1.3-4.8) and 2.5 (1.1-5.4), respectively. The same was true for living in homes with absolute indoor humidity >5.8 g/kg, OR 1.7 (1.0-2.9) and in homes where windowpane condensation was consistently reported over several years, OR 2.2 (1.1-4.5). However, air change rate and type of ventilation system did not seem to affect the risk. In conclusion, relatively new apartment buildings, single-family homes with crawl space/concrete slab foundation, elevated indoor humidity, and reported wintertime windowpane condensation were associated with recurrent wheezing in infants. Thus, improvements of the building quality may have potential to prevent infant wheezing.

  19. An unusual case of refractory wheeze

    OpenAIRE

    Ramesh, Venkat; Acharya, Vishak; Pai, Narasimha; Krishnan, Ananda

    2015-01-01

    A 37-year-old man presented with a history of episodic wheeze and breathlessness of 3?years? duration refractory to treatment. Physical examination revealed diffuse expiratory polyphonic rhonchi while the remainder of the examination including the cardiac examination was reported as normal. Pulmonary function testing revealed mild obstruction with bronchodilator reversibility. The patient was discharged on a 6-month course of antitubercular treatment (ATT) as bronchial brush cytology (obtaine...

  20. Human rhinovirus infection in young African children with acute wheezing

    Directory of Open Access Journals (Sweden)

    Zar Heather J

    2011-03-01

    Full Text Available Abstract Background Infections caused by human rhinoviruses (HRVs are important triggers of wheezing in young children. Wheezy illness has increasingly been recognised as an important cause of morbidity in African children, but there is little information on the contribution of HRV to this. The aim of this study was to determine the role of HRV as a cause of acute wheezing in South African children. Methods Two hundred and twenty children presenting consecutively at a tertiary children's hospital with a wheezing illness from May 2004 to November 2005 were prospectively enrolled. A nasal swab was taken and reverse transcription PCR used to screen the samples for HRV. The presence of human metapneumovirus, human bocavirus and human coronavirus-NL63 was assessed in all samples using PCR-based assays. A general shell vial culture using a pool of monoclonal antibodies was used to detect other common respiratory viruses on 26% of samples. Phylogenetic analysis to determine circulating HRV species was performed on a portion of HRV-positive samples. Categorical characteristics were analysed using Fisher's Exact test. Results HRV was detected in 128 (58.2% of children, most (72% of whom were under 2 years of age. Presenting symptoms between the HRV-positive and negative groups were similar. Most illness was managed with ambulatory therapy, but 45 (35% were hospitalized for treatment and 3 (2% were admitted to intensive care. There were no in-hospital deaths. All 3 species of HRV were detected with HRV-C being the most common (52% followed by HRV-A (37% and HRV-B (11%. Infection with other respiratory viruses occurred in 20/128 (16% of HRV-positive children and in 26/92 (28% of HRV-negative samples. Conclusion HRV may be the commonest viral infection in young South African children with acute wheezing. Infection is associated with mild or moderate clinical disease.

  1. Controlling Asthma New Guidelines. New Medications. New Action Plans.

    Science.gov (United States)

    ... I began to have symptoms of asthma and asthma attacks at about age 8, prior to my mom ... led to wheezing, and the wheezing turned into asthma attacks. I had been hospitalized on several occasions during ...

  2. The Impact of Tobacco Smoke Exposure on Wheezing and Overweight in 4–6-Year-Old Children

    Directory of Open Access Journals (Sweden)

    Regina Grazuleviciene

    2014-01-01

    Full Text Available Aim. To investigate the association between maternal smoking during pregnancy, second-hand tobacco smoke (STS exposure, education level, and preschool children’s wheezing and overweight. Methods. This cohort study used data of the KANC cohort—1,489 4–6-year-old children from Kaunas city, Lithuania. Multivariate logistic regression was employed to study the influence of prenatal and postnatal STS exposure on the prevalence of wheezing and overweight, controlling for potential confounders. Results. Children exposed to maternal smoking during pregnancy had a slightly increased prevalence of wheezing and overweight. Postnatal exposure to STS was associated with a statistically significantly increased risk of wheezing and overweight in children born to mothers with lower education levels (OR 2.12; 95% CI 1.04–4.35 and 3.57; 95% CI 1.76–7.21, accordingly. Conclusions. The present study findings suggest that both maternal smoking during pregnancy and STS increase the risk of childhood wheezing and overweight, whereas lower maternal education might have a synergetic effect. Targeted interventions must to take this into account and address household smoking.

  3. Prevalence and Risk Factors of Wheeze in Dutch Infants in Their First Year of Life

    NARCIS (Netherlands)

    Visser, Chantal A. N.; Garcia-Marcos, Luis; Eggink, Jenny; Brand, Paul L. P.

    Factors operating in the first year of life are critical in determining the onset and persistence of wheezing in preschool children. This study was designed to examine the prevalence and risk factors of wheeze in the first year of life in Dutch infants. This was a population-based survey of

  4. Maternal Plasma Phosphatidylcholine Fatty Acids and Atopy and Wheeze in the Offspring at Age of 6 Years

    Directory of Open Access Journals (Sweden)

    Katharine C. Pike

    2012-01-01

    Full Text Available Variation in exposure to polyunsaturated fatty acids (PUFAs might influence the development of atopy, asthma, and wheeze. This study aimed to determine whether differences in PUFA concentrations in maternal plasma phosphatidylcholine are associated with the risk of childhood wheeze or atopy. For 865 term-born children, we measured phosphatidylcholine fatty acid composition in maternal plasma collected at 34 weeks’ gestation. Wheezing was classified using questionnaires at 6, 12, 24, and 36 months and 6 years. At age of 6 years, the children underwent skin prick testing, fractional exhaled nitric oxide (FENO measurement, and spirometry. Maternal n-6 fatty acids and the ratio of n-3 to n-6 fatty acids were not associated with childhood wheeze. However, higher maternal eicosapentaenoic acid, docosahexaenoic acid, and total n-3 fatty acids were associated with reduced risk of non-atopic persistent/late wheeze (RR 0.57, 0.67 and 0.69, resp. P=0.01, 0.015, and 0.021, resp.. Maternal arachidonic acid was positively associated with FENO (P=0.024. A higher ratio of linoleic acid to its unsaturated metabolic products was associated with reduced risk of skin sensitisation (RR 0.82, P=0.013. These associations provide some support for the hypothesis that variation in exposure to n-6 and n-3 fatty acids during pregnancy influences the risk of childhood wheeze and atopy.

  5. Rural to urban migration is associated with increased prevalence of childhood wheeze in a Latin-American city.

    Science.gov (United States)

    Rodriguez, Alejandro; Vaca, Maritza G; Chico, Martha E; Rodrigues, Laura C; Barreto, Mauricio L; Cooper, Philip J

    2017-01-01

    The urbanisation process has been associated with increases in asthma prevalence in urban and rural areas of low-income and middle-income countries (LMICs). However, although rural to urban migration and migration between cities are considered important determinants of this process, few studies have evaluated the effects of internal migration on asthma in urban populations of LMICs. The present study evaluated the effects of internal migration on the prevalence of wheeze in an urban area of Latin America. We did a cross-sectional analysis of 2510 schoolchildren living in the city of Esmeraldas, Ecuador. Logistic regression was used to analyse associations between childhood wheeze and different aspects of migration among schoolchildren. 31% of schoolchildren were migrants. Rural to urban migrants had a higher prevalence of wheeze, (adj.OR=2.01,95% CI1.30 to 3.01, p=0.001) compared with non-migrants. Age of migration and time since migration were associated with wheeze only for rural to urban migrants but not for urban to urban migrants. Children who had migrated after 3 years of age had a greater risk of wheeze (OR 2.51, 95% CI 1.56 to 3.97, p=0.001) than non-migrants while migrants with less than 5 years living in the new residence had a higher prevalence of wheeze than non-migrants (Latin-American city. Age of migration and time since migration were important determinants of wheeze only among migrants from rural areas. A better understanding of the social and environmental effects of internal migration could improve our understanding of the causes of the increase in asthma and differences in prevalence between urban and rural populations.

  6. [Asthma at acute attack stage treated with "Shao's five needling therapy": a multi-central randomized controlled study].

    Science.gov (United States)

    Shao, Su-Ju; Quan, Chun-Fen; Shao, Su-Xia; Zhou, Miao; Jing, Xin-Jian; Zhao, Yu-Xiao; Ren, Zhi-Xin; Wang, Pei-Yu; Gao, Xi-Yan; Yang, Jie; Ren, Zhong; Kong, Li

    2013-09-01

    To evaluate the clinical efficacy of asthma at acute attack stage treated with "Shao's five needling therapy". The randomized controlled method was applied to divide 210 cases into an observation group and a control group, 105 cases in each one. In the observation group, "Shao's five needling therapy" [Feishu (BL 13), Dazhui (GV 14), Fengmen (BL 12)] and the combined therapy were adopted, including oxygen uptake, aerosol inhalation and oral administration of prednisone. In the control group, the oral administration of theophylline sustained release tablet and the combined therapy were applied. The treatment was continued for 7 days. The clinical symptoms and physical signs such as wheezing, cough, expectoration, chest stuffiness, wheezing rale and shortness of breath, as well as lung function indices such as forced expiratory volume one second (FEV1) and peak expiratory flow (PEF) were observed before and after treatment in the two groups. In the observation group, 69 cases were cured clinically, 20 cases effective remarkably, 7 cases effective and 0 case failed. In the control group, 49 cases were cured clinically, 31 cases effective remarkably, 15 cases effective and 0 case failed. The difference in the efficacy was significant in comparison of the two groups (P asthma at acute attack stage. It significantly relieves the symptoms and physical signs of the patients and improves lung functions. The effect is better than that of theophylline sustained release tablet.

  7. Associations of ultra-processed food and drink products with asthma and wheezing among Brazilian adolescents.

    Science.gov (United States)

    Melo, B; Rezende, L; Machado, P; Gouveia, N; Levy, R

    2018-04-21

    Although both consumption of ultra-processed products and asthma are common during adolescence, the epidemiological evidence in regarding their association is unclear. We investigated the associations of ultra-processed products consumption with asthma and wheezing in a representative sample of Brazilian adolescents. We used data from a representative sample of 109,104 Brazilian adolescents enrolled in the National Survey of School Health, 2012. The consumption of ultra-processed products was based on the weekly consumption (0-2, 3-4, ≥5 days/week) of sweet biscuits, salty biscuits, ultra-processed meats, sweets/candies, soft drinks, and packaged snacks over the previous seven days. We also calculated an ultra-processed consumption score by adding partial scores corresponding to weekly frequency intake of each ultra-processed product. The ultra-processed consumption score ranged from 0 to 42, the higher score, the higher the intake of these products. Presence of wheezing in the previous 12 months and asthma at any time in the past were self-reported. The adjusted odds ratios of asthma comparing the extreme categories ranged from 1.08 (95% CI 1.03-1.13) for sweets/candies to 1.30 (1.21-1.40) for ultra-processed meats. Similar magnitude of associations was found for wheezing outcome. The ultra-processed consumption score was positively associated with presence of asthma and wheezing in a dose-response manner. The adjusted OR of asthma and wheezing comparing highest to lowest quintile of ultra-processed consumption score were 1.27 (95% CI 1.15-1.41) and 1.42 (1.35-1.50), respectively. The consumption of ultra-processed products was positively associated with the presence of asthma and wheezing in adolescents. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood

    DEFF Research Database (Denmark)

    Wolsk, Helene M; Chawes, Bo L; Litonjua, Augusto A

    2017-01-01

    BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance. OBJECTIVE: To perform......) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses...... of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry. RESULTS: The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR) = 0.74 (95% CI, 0.57-0.96), p = 0.02. The effect was strongest among women...

  9. Patterns of immune development in urban preschoolers with recurrent wheeze and/or atopy.

    Science.gov (United States)

    Gern, James E; Calatroni, Agustin; Jaffee, Katy F; Lynn, Henry; Dresen, Amy; Cruikshank, William W; Lederman, Howard M; Sampson, Hugh A; Shreffler, Wayne; Bacharier, Leonard B; Gergen, Peter J; Gold, Diane R; Kattan, Meyer; O'Connor, George T; Sandel, Megan T; Wood, Robert A; Bloomberg, Gordon R

    2017-09-01

    Disadvantaged urban children have high rates of allergic diseases and wheezing, which are diseases associated with type 2-biased immunity. We sought to determine whether environmental exposures in early life influence cytokine responses that affect the development of recurrent wheezing illnesses and allergic sensitization. A birth cohort of 560 urban families was recruited from neighborhoods with high rates of poverty, and 467 (83%) children were followed until 3 years of age. Cytokine responses were measured in blood cell samples obtained at birth (cord blood) and ages 1 and 3 years. Cytokine responses were examined in relation to personal characteristics and environmental exposures to allergens and endotoxin and to the development of allergic sensitization and recurrent wheeze assessed at age 3 years. Cytokine responses generally increased with age, but responses at birth were poorly predictive for those at ages 1 and 3 years. Exposure to certain allergens (cockroach, mouse, dust mite) was significantly associated with enhanced cytokine responses at age 3 years, including IFN-α and IL-10 responses to certain stimulants and responses to phytohemagglutinin. Regarding the clinical outcomes, reduced LPS-induced IL-10 responses at birth were associated with recurrent wheeze. In contrast, reduced respiratory syncytial virus-induced IL-8 responses and increased 5'-cytosine-phosphate-guanine-3' (CpG)-induced IL-12p40 and allergen-induced IL-4 responses were associated with atopy. These findings suggest that diverse biologic exposures, including allergens and endotoxin, in urban homes stimulate the development of cytokine responses in early life, and that cytokine responses to specific microbial and viral stimuli are associated with the development of allergic sensitization and recurrent wheeze. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  10. Prevention and treatment of respiratory syncytial virus bronchiolitis and postbronchiolitic wheezing

    Directory of Open Access Journals (Sweden)

    Kimpen Jan LL

    2002-06-01

    Full Text Available Abstract Respiratory syncytial virus (RSV is the primary cause of hospitalization for acute respiratory tract illness in general and specifically for bronchiolitis in young children. The link between RSV bronchiolitis and reactive airway disease is not completely understood, even though RSV bronchiolitis is frequently followed by recurrent episodes of wheezing. Therapy with ribavirin does not appear to significantly reduce long-term respiratory outcome of RSV lower respiratory tract infection, and corticosteroid or bronchodilator therapy may possibly improve outcomes only on a short-term basis. No vaccine against RSV is yet available. It is not known whether prophylaxis with RSV intravenous immune globulin or palivizumab can reduce postbronchiolitic wheezing.

  11. Maternal complications in pregnancy and wheezing in early childhood

    DEFF Research Database (Denmark)

    Zugna, Daniela; Galassi, Claudia; Annesi-Maesano, Isabella

    2015-01-01

    BACKGROUND: Evidence on the effect of maternal complications in pregnancy on wheezing in offspring is still insufficient. METHODS: A pooled analysis was performed on individual participant data from fourteen European birth cohorts to assess the relationship between several maternal pregnancy comp...

  12. [Prevalence of wheezing and associated factors in Guarani indigenous children hospitalized for acute respiratory infections in Southern and Southeastern Brazil].

    Science.gov (United States)

    Souza, Patrícia Gomes de; Cardoso, Andrey Moreira; Sant Anna, Clemax Couto

    2014-07-01

    Prevalence of wheezing was studied in Guarani indigenous children hospitalized for acute lower respiratory tract infections in Southern and Southeastern Brazil, recruited by a surveillance routine established in villages from May 2007 to June 2008. Data were obtained from hospital records. Crude and adjusted prevalence ratios for wheezing were estimated according to categories of target variables, using Poisson regression with robust variance. Prevalence of wheezing was 58.1% (136/234). Risk factors that remained significantly associated with wheezing in the final model were: age bracket, inversely associated (0-11 months: reference; 24-35 months: 0.63, 95%CI: 0.40-0.99); hospitalization in the autumn (summer: reference; autumn: 1.58, 95%CI: 1.05-2.40); dyspnea (1.41, 95%CI: 1.09-1.83); chest indrawing (1.42, 95%CI: 1.16-1.73); crackles (1.43, 95%CI: 1.09-1.87). The results show a high disease burden related to wheezing and suggest the phenotype of early-onset persistent wheezing related to recurrence of viral respiratory infections.

  13. A rare cause of wheezing in infancy.

    Science.gov (United States)

    Indinnimeo, Luciana; Pulicati, Patrizio; Della Rocca, Carlo; Barbato, Angelo

    2006-06-01

    We describe an infant with recurrent wheezing and cough caused by an oropharyngeal cyst. Mucosal oropharyngeal cysts arise from obstruction or traumatic severance of a duct in a minor salivary gland, which leads to retention of mucous secretion . The mucosal cyst of the oropharynx is a rare cause of respiratory distress in the infants. The clinical symptoms depend on the size, shape, and location of the cyst.

  14. Indoor visible mold and mold odor are associated with new-onset childhood wheeze in a dose-dependent manner.

    Science.gov (United States)

    Shorter, Caroline; Crane, Julian; Pierse, Nevil; Barnes, Phillipa; Kang, Janice; Wickens, Kristin; Douwes, Jeroen; Stanley, Thorsten; Täubel, Martin; Hyvärinen, Anne; Howden-Chapman, Philippa

    2018-01-01

    Evidence is accumulating that indoor dampness and mold are associated with the development of asthma. The underlying mechanisms remain unknown. New Zealand has high rates of both asthma and indoor mold and is ideally placed to investigate this. We conducted an incident case-control study involving 150 children with new-onset wheeze, aged between 1 and 7 years, each matched to two control children with no history of wheezing. Each participant's home was assessed for moisture damage, condensation, and mold growth by researchers, an independent building assessor and parents. Repeated measures of temperature and humidity were made, and electrostatic dust cloths were used to collect airborne microbes. Cloths were analyzed using qPCR. Children were skin prick tested for aeroallergens to establish atopy. Strong positive associations were found between observations of visible mold and new-onset wheezing in children (adjusted odds ratios ranged between 1.30 and 3.56; P ≤ .05). Visible mold and mold odor were consistently associated with new-onset wheezing in a dose-dependent manner. Measurements of qPCR microbial levels, temperature, and humidity were not associated with new-onset wheezing. The association between mold and new-onset wheeze was not modified by atopic status, suggesting a non-allergic association. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Heightened bronchial hyperresponsiveness in the absence of heightened atopy in children with current wheezing and low income status.

    Science.gov (United States)

    Mallol, J; Castro-Rodriguez, J A; Cortez, E; Aguirre, V; Aguilar, P; Barrueto, L

    2008-02-01

    Although global studies such as the International Study of Asthma and Allergies in Childhood (ISAAC) have provided valuable data on the prevalence of asthma in children in Latin America, there is little information on the relationship between asthma symptoms, pulmonary function, bronchial hyperresponsiveness (BHR) and atopy in the region. This study examined the relationship between self-reported wheezing in the past 12 months, pulmonary function, airway responsiveness and atopy in children from a low income population in a neighbourhood of Santiago, Chile. Two random samples (100 each) of children aged 13-14 years who participated in ISAAC phase I were selected according to whether or not they reported wheezing in the past 12 months. Spirometry, the methacholine bronchial challenge test and the prick test were performed in all individuals. Children who reported current wheezing had significantly higher BHR to methacholine compared with those without wheezing (71.6% vs 52.6%; p = 0.007) and no significant difference was found in forced expiratory volume in 1 s (116.7 (12.3)% vs 120.3 (14.5%); p = 0.11). The prevalence of atopy was not significantly different between those children who reported wheezing compared with those who did not (44.2% vs 42.3%; p = 0.89). Multiple regression analysis showed that only BHR to methacholine (OR 2.72, 95% CI 1.25 to 4.13; p = 0.01) and maternal asthma (OR 3.1, 95% CI 1.2 to 8.3, p = 0.03) were significant risk factors for current wheezing. Our results support previous findings suggesting that in adolescents from underprivileged populations, self-reported current wheezing is related to BHR but not to atopy.

  16. Secondhand tobacco smoke and severity in wheezing children: Nasal oxidant stress and inflammation.

    Science.gov (United States)

    Yilmaz, Ozge; Turkeli, Ahmet; Onur, Ece; Bilge, Sema; Yuksel, Hasan

    2018-05-01

    Prenatal and postnatal smoke exposures are associated with many lung diseases in children due to impaired lung function, increased inflammation, and oxidative stress. We aimed to determine the influence of secondhand tobacco smoke exposure on the levels of nasal glutathione, IL-8, IL-17, MMP-9, and TIMP-1, as well as serum surfactant protein-D (SP-D) in wheezy children. We enrolled 150 children with recurrent wheezing and recorded wheezing characteristics at enrollment. We measured the levels of serum cotinine, SP-D, nasal glutathione, IL-8, IL-17, MMP-9, and TIMP-1. Serum cotinine levels between 3 and 12 ng/mL, and above 12 ng/mL were defined as lower and higher level secondhand tobacco smoke exposure, respectively. The ANOVA test, Pearson's correlation analysis and multivariate analysis with a linear regression test were used for the statistical analysis. Ninety-one children had been exposed to lower level secondhand tobacco smoke, while 24 children were exposed to higher level secondhand tobacco smoke. Thirty-five children were not exposed to cigarette smoke. Wheezing symptom scores were higher in exposed children (p = 0.03). Levels of other biomarkers showed no significant difference. Secondhand tobacco smoke exposure is associated with more severe respiratory symptoms in wheezing children. However, levels of nasal or serum inflammatory markers fail to explain this association, either because of different mechanical factors in the process or due to low levels of the biomarkers especially in nasal secretions.

  17. A young child with a history of wheeze

    DEFF Research Database (Denmark)

    Paton, James; Bindels, Patrick; McMurray, Ann

    2017-01-01

    The parents of a 3-year old boy are anxious about their son who has recurring episodes of wheezing. They are frustrated that no one seems to be able to give them answers to their questions and would like a referral to a specialist. Does their son have asthma and what is the prognosis; how can the...

  18. The effect of montelukast on early-life wheezing: A randomized, double-blinded placebo-controlled study.

    Science.gov (United States)

    Keskin, Ozlem; Arik Yilmaz, Ebru; Motzkus, Christine; Sackesen, Cansin; Lilly, Craig M; Kalayci, Omer

    2018-02-01

    Cysteinyl-leukotrienes are increased in the airways of infants with virus-associated wheezing. We aimed to determine the effects of a cysteinyl-leukotriene-1 receptor antagonist on symptoms during an early-life wheezing illness and to investigate the factors that affect the response to this drug. This placebo-controlled double-blinded randomized controlled trial recruited children aged 3-36 months with wheezing illness and randomized to active drug or placebo for 56 days. A symptom score diary (SSD) was kept by the children's caregivers. One-hundred patients completed the study, and 62 (30 montelukast and 32 placebo) were analyzed. There were no significant differences in the percent of symptom-free days, symptom scores, and the need for rescue salbutamol between the two groups. However, the percent of symptom-free days within the first week was significantly higher for the montelukast than for the placebo group (13.8 ± 4.1% vs. 5.4 ± 3.4%; P = 0.028); wheezing score at 7th day was significantly lower for the montelukast than for the placebo group (0.5 ± 0.1 vs. 1.4 ± 0.2; P = 0.002). In addition, the number of inhaled ß 2 -agonist rescue episodes per day during the first week was significantly lower for the montelukast compared with the placebo group (12.7 ± 1.8 vs. 19.2 ± 1.6; P = 0.013). Conclusions Our results indicate that montelukast may be effective for reducing caregiver-observed wheezing and the need for salbutamol during the first week of treatment for early-life wheezing. The impact for caregivers and the optimal duration of treatment will need to be explored in studies of larger size. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  19. A Comparison of Risk Factors for Wheeze and Recurrent Cough in Preschool Children

    DEFF Research Database (Denmark)

    Hermann, Christian; Westergaard, T.; Pedersen, B. V.

    2005-01-01

    the same etiology. Data were obtained 1) by a mailed parental questionnaire (International Study of Asthma and Allergies in Childhood questions and supplementary questions on cough, sociodemography, perinatal factors, and environmental exposure); 2) through general practitioners (familial allergic disease......In a study of 2,978 Danish children aged 5 years from two suburban counties of Copenhagen, carried out in 1998, the authors compared risk factor profiles for wheeze and recurrent cough without wheeze by using polytomous logistic regression to clarify whether the two conditions are likely to have...

  20. Relationships among Maternal Stress and Depression, Type 2 Responses, and Recurrent Wheezing at Age 3 Years in Low-Income Urban Families.

    Science.gov (United States)

    Ramratnam, Sima K; Visness, Cynthia M; Jaffee, Katy F; Bloomberg, Gordon R; Kattan, Meyer; Sandel, Megan T; Wood, Robert A; Gern, James E; Wright, Rosalind J

    2017-03-01

    Maternal depression and prenatal and early life stress may influence childhood wheezing illnesses, potentially through effects on immune development. To test the hypothesis that maternal stress and/or depression during pregnancy and early life are associated with recurrent wheezing and aeroallergen sensitivity and altered cytokine responses (enhanced type 2 or reduced virus-induced cytokine responses) from stimulated peripheral blood mononuclear cells at age 3 years. URECA (Urban Environment and Childhood Asthma) is a birth cohort at high risk for asthma (n = 560) in four inner cities. Maternal stress, depression, and childhood wheezing episodes were assessed by quarterly questionnaires beginning at birth. Logistic and linear regression techniques were used to examine the relation of maternal stress/depression to recurrent wheezing and peripheral blood mononuclear cell cytokine responses at age 3 years. Overall, 166 (36%) children had recurrent wheeze at age 3 years. Measures of maternal perceived stress at Years 2 and 3 were positively associated with recurrent wheeze (P Maternal depression (any year) was significantly associated with recurrent wheezing (P ≤ 0.01). These associations were also significant when considered in a longitudinal analysis of cumulative stress and depression (P ≤ 0.02). Neither stress nor depression was significantly related to aeroallergen sensitization or antiviral responses. Contrary to our original hypothesis, prenatal and Year 1 stress and depression had significant inverse associations with several type 2 cytokine responses. In urban children at high risk for asthma, maternal perceived stress and depression were significantly associated with recurrent wheezing but not increased atopy or reduced antiviral responses.

  1. Asthmatic/wheezing phenotypes in preschool children: Influential factors, health care and urban-rural differences.

    Science.gov (United States)

    Kutzora, Susanne; Weber, Alisa; Heinze, Stefanie; Hendrowarsito, Lana; Nennstiel-Ratzel, Uta; von Mutius, Erika; Fuchs, Nina; Herr, Caroline

    2018-03-01

    Different wheezing and asthmatic phenotypes turned out to indicate differences in etiology, risk factors and health care. We examined influential factors and urban-rural differences for different phenotypes. Parents of 4732 children filled out a questionnaire concerning children's health and environmental factors administered within the Health Monitoring Units (GME) in a cross-sectional study in Bavaria, Germany (2014/2015). To classify respiratory symptoms, five phenotype groups were built: episodic, unremitting and frequent wheeze, ISAAC (International Study of Asthma and Allergies in Children) - asthma and physician-diagnosed asthma (neither of the groups are mutually exclusive). For each phenotype, health care variables were presented and stratified for residence. Urban-rural differences were tested by Pearson's chi-squared tests. Multivariable logistic regression was performed to analyze associations between influential factors and belonging to a phenotype group, and to compare groups with regard to health care variables as outcome. Risk factors for wheezing phenotypes were male gender (OR = 2.02, 95%-CI = [1.65-2.48]), having older siblings (OR = 1.24, 95%-CI = [1.02-1.51]), and preterm delivery (OR = 1.61, 95%-CI = [1.13-2.29]) (ORs for unremitting wheeze). 57% of children with ISAAC asthma and 74% with physician-diagnosed asthma had performed allergy tests. Medication intake among all groups was more frequent in rural areas, and physician's asthma diagnoses were more frequent in urban areas. In accordance with previous research this study confirms that male gender, older siblings and preterm delivery are associated with several wheezing phenotypes. Overall, low numbers of allergy tests among children with physician's diagnoses highlight a discrepancy between common practice and current knowledge and guidelines. Residential differences in health care might encourage further research and interventions strategies. Copyright © 2017

  2. Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial.

    Science.gov (United States)

    Wai, Katherine C; Hibbs, Anna M; Steurer, Martina A; Black, Dennis M; Asselin, Jeanette M; Eichenwald, Eric C; Ballard, Philip L; Ballard, Roberta A; Keller, Roberta L

    2018-04-04

    To evaluate the relationship between maternal self-reported race/ethnicity and persistent wheezing illness in former high-risk, extremely low gestational age newborns, and to quantify the contribution of socioeconomic, environmental, and biological factors on this relationship. We assessed persistent wheezing illness determined at 18-24 months corrected (for prematurity) age in survivors of a randomized trial. Parents/caregivers were surveyed for wheeze and inhaled asthma medication use quarterly to 12 months, and at 18 and 24 months. We used multivariable analysis to evaluate the relationship of maternal race to persistent wheezing illness, and identified mediators for this relationship via formal mediation analysis. Of 420 infants (25.2 ± 1.2 weeks of gestation and 714 ± 166 g at birth, 57% male, 34% maternal black race), 189 (45%) had persistent wheezing illness. After adjustment for gestational age, birth weight, and sex, infants of black mothers had increased odds of persistent wheeze compared with infants of nonblack mothers (OR = 2.9, 95% CI 1.9, 4.5). Only bronchopulmonary dysplasia, breast milk diet, and public insurance status were identified as mediators. In this model, the direct effect of race accounted for 69% of the relationship between maternal race and persistent wheeze, whereas breast milk diet, public insurance status, and bronchopulmonary dysplasia accounted for 8%, 12%, and 10%, respectively. Among former high-risk extremely low gestational age newborns, infants of black mothers have increased odds of developing persistent wheeze. A substantial proportion of this effect is directly accounted for by race, which may reflect unmeasured environmental influences, and acquired and innate biological differences. ClinicalTrials.gov: NCT01022580. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

    DEFF Research Database (Denmark)

    Brand, P.L.; Baraldi, E.; Bisgaard, H.

    2008-01-01

    causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast...... preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit. Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes Udgivelsesdato: 2008/10...

  4. Wheezing recognition algorithm using recordings of respiratory sounds at the mouth in a pediatric population.

    Science.gov (United States)

    Bokov, Plamen; Mahut, Bruno; Flaud, Patrice; Delclaux, Christophe

    2016-03-01

    Respiratory diseases in children are a common reason for physician visits. A diagnostic difficulty arises when parents hear wheezing that is no longer present during the medical consultation. Thus, an outpatient objective tool for recognition of wheezing is of clinical value. We developed a wheezing recognition algorithm from recorded respiratory sounds with a Smartphone placed near the mouth. A total of 186 recordings were obtained in a pediatric emergency department, mostly in toddlers (mean age 20 months). After exclusion of recordings with artefacts and those with a single clinical operator auscultation, 95 recordings with the agreement of two operators on auscultation diagnosis (27 with wheezing and 68 without) were subjected to a two phase algorithm (signal analysis and pattern classifier using machine learning algorithms) to classify records. The best performance (71.4% sensitivity and 88.9% specificity) was observed with a Support Vector Machine-based algorithm. We further tested the algorithm over a set of 39 recordings having a single operator and found a fair agreement (kappa=0.28, CI95% [0.12, 0.45]) between the algorithm and the operator. The main advantage of such an algorithm is its use in contact-free sound recording, thus valuable in the pediatric population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. An ADAM33 polymorphism associates with progression of preschool wheeze into childhood asthma: a prospective case-control study with replication in a birth cohort study.

    Science.gov (United States)

    Klaassen, Ester M M; Penders, John; Jöbsis, Quirijn; van de Kant, Kim D G; Thijs, Carel; Mommers, Monique; van Schayck, Constant P; van Eys, Guillaume; Koppelman, Gerard H; Dompeling, Edward

    2015-01-01

    The influence of asthma candidate genes on the development from wheeze to asthma in young children still needs to be defined. To link genetic variants in asthma candidate genes to progression of wheeze to persistent wheeze into childhood asthma. In a prospective study, children with recurrent wheeze from the ADEM (Asthma DEtection and Monitoring) study were followed until the age of six. At that age a classification (transient wheeze or asthma) was based on symptoms, lung function and medication use. In 198 children the relationship between this classification and 30 polymorphisms in 16 asthma candidate genes was assessed by logistic regression. In case of an association based on a pchildhood asthma. When replicated in the KOALA study, ADAM33 rs528557 showed a negative association of the CG/GG-genotype with progression of recurrent wheeze into childhood asthma (0.50 (0.26-0.97) p = 0.04) and no association with preschool wheeze. Polymorphisms in ADAM33, ORMDL3/GSDMB and IL4 were associated with childhood asthma in a group of children with recurrent wheeze. The replication of the negative association of the CG/GG-genotype of rs528557 ADAM33 with childhood asthma in an independent birth cohort study confirms that a compromised ADAM33 gene may be implicated in the progression of wheeze into childhood asthma.

  6. Classification and pharmacological treatment of preschool wheezing : changes since 2008

    NARCIS (Netherlands)

    Brand, Paul L. P.; Caudri, Daan; Eber, Ernst; Gaillard, Erol A.; Garcia-Marcos, Luis; Hedlin, Gunilla; Henderson, John; Kuehni, Claudia E.; Merkus, Peter J. F. M.; Pedersen, Soren; Valiuis, Arunas; Wennergren, Goeran; Bush, Andrew

    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some

  7. Severe angina pectoris in asthma attack: a case report.

    Science.gov (United States)

    Nabavizadeh, Seyed Hesamedin; Farahbakhsh, Nazanin; Fazel, Ali; Mosavat, Fereshteh; Anushiravani, Amir

    2016-06-01

    Asthma is a chronic inflammatory disorder of the airways related to the obstruction of reversible airflow. Asthma presents as recurrent attacks of cough and dyspnea. Poor control causes recurrent admissions to the ICU, and mortality is related to poor drug compliance and follow-up. Angina pectoris is a syndrome of recurrent chest discomfort related to myocardial ischemia. The presence of these two disorders rarely has been reported. We reported a 12-year-old boy who was referred with exacerbation of asthma and developed angina pectoris during hospitalization. He had labored breathing and diffuse wheezing. During treatment of the asthma, the patient developed severe chest pain due to shunt formation and coronary hypoxia, caused by the sole administration of ventolin, since oxygen had been disconnected. After receiving appropriate therapy, both his asthma and angina recovered, and, to date, he has not experienced angina pectoris again.

  8. The effect of single and multiple infections on atopy and wheezing in children.

    Science.gov (United States)

    Alcantara-Neves, Neuza Maria; Veiga, Rafael Valente; Dattoli, Vitor Camilo Cavalcante; Fiaccone, Rosimeire Leovigildo; Esquivel, Renata; Cruz, Álvaro Augusto; Cooper, Philip John; Rodrigues, Laura Cunha; Barreto, Maurício Lima

    2012-02-01

    The current epidemic of asthma and atopy has been explained by alterations in immune responses related to reduction in childhood infections. However, the findings of epidemiologic studies investigating the association between infection with atopy and asthma have been inconsistent. We sought to investigate the effect of single or multiple infections (pathogen burden) on atopy and wheeze in urban children from Latin America. Specific IgE against aeroallergens (sIgE) and skin prick test (SPT) reactivity for the most common local allergens were measured in 1128 children aged 4 to 11 years. Data on wheezing and potential confounders were collected by questionnaire. Infections by 8 pathogens were assessed by using serology and stool examination. Associations of wheeze and atopic outcomes with single and multiple infections were analyzed by means of logistic regression. Negative results for Toxoplasma gondii were associated with a higher prevalence of sIgE (≥0.70 kU/L), whereas negative results for Ascaris lumbricoides, T gondii, herpes simplex virus, and EBV were associated with a higher prevalence of SPT reactivity. Children with 3 or fewer infection markers had a higher prevalence of sIgE and SPT reactivity compared with those with 4 or more infection markers. However, isolated infections or pathogen burden were not associated with the prevalence of atopic or nonatopic wheeze. The findings provide support for the idea that the hygiene hypothesis is operating in an urban Latin American context, but its expression is thus far restricted to the atopic status of patients and not the perceived asthma symptoms. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  9. In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections

    DEFF Research Database (Denmark)

    Feng, Haixia; Xun, Pengcheng; Pike, Katharine C

    2017-01-01

    BACKGROUND: Studies of the associations between in utero 25-hydroxyvitamin D (25[OH]D) exposure and risk of childhood asthma, wheeze, and respiratory tract infections are inconsistent and inconclusive. OBJECTIVES: We sought to assess associations between 25(OH)D levels in cord blood or maternal......)D is inversely associated with the risk of asthma and wheeze during childhood. These findings are in keeping with the results of 2 recently published randomized clinical trials of vitamin D supplementation during pregnancy....... venous blood and risk of offspring's asthma, wheeze, and respiratory tract infections. METHODS: Data were derived from PubMed, Embase, Google Scholar, references from relevant articles, and de novo results from published studies until December 2015. A random-effects meta-analysis was conducted among 16...

  10. Maternal vitamin D status in pregnancy and risk of lower respiratory tract infections, wheezing, and asthma in offspring.

    Science.gov (United States)

    Morales, Eva; Romieu, Isabelle; Guerra, Stefano; Ballester, Ferrán; Rebagliato, Marisa; Vioque, Jesús; Tardón, Adonina; Rodriguez Delhi, Cristina; Arranz, Leonor; Torrent, Maties; Espada, Mercedes; Basterrechea, Mikel; Sunyer, Jordi

    2012-01-01

    Adequate vitamin D status in mothers during pregnancy may influence the health status of the child later in life. We assessed whether maternal circulating 25-hydroxyvitamin D (25[OH]D) concentrations in pregnancy are associated with risk of lower respiratory tract infections, wheezing, and asthma in the offspring. Data were obtained from 1724 children of the INfancia y Medio Ambiente (INMA) Project, a population-based birth cohort study. Maternal circulating 25(OH)D concentrations were measured in pregnancy (mean gestational age = 12.6 [SD = 2.5] weeks). When the child was age 1 year, parents were asked if their child had a physician-confirmed history of lower respiratory tract infections or a history of wheezing. The questions about wheezing were repeated annually thereafter. Asthma was defined as parental report of doctor diagnosis of asthma or receiving treatment at the age of 4-6 years or wheezing since the age of 4 years. The median maternal circulating 25(OH)D concentration in pregnancy was 29.5 ng/mL (interquartile range, 22.5-37.1 ng/mL). After multivariable adjustment, there was a trend for an independent association between higher levels of maternal circulating 25(OH)D levels in pregnancy and decreased odds of lower respiratory tract infections in offspring (for cohort- and season-specific quartile Q4 vs. Q1, odds ratio = 0.67 [95% confidence interval = 0.50-0.90]; test for trend, P = 0.016). We found no association between 25(OH)D levels in pregnancy and risk of wheezing at age 1 year or 4 years, or asthma at age 4-6 years. Higher maternal circulating 25(OH)D concentrations in pregnancy were independently associated with lower risk of lower respiratory tract infections in offspring in the first year of life but not with wheezing or asthma in childhood.

  11. Assessment and management of children aged 1-59 months presenting with wheeze, fast breathing, and/or lower chest indrawing; results of a multicentre descriptive study in Pakistan.

    Science.gov (United States)

    Hazir, T; Qazi, S; Nisar, Y B; Ansari, S; Maqbool, S; Randhawa, S; Kundi, Z; Asghar, R; Aslam, S

    2004-11-01

    Using current WHO guidelines, children with wheezing are being over prescribed antibiotics and bronchodilators are underutilised. To improve the WHO case management guidelines, more data is needed about the clinical outcome in children with wheezing/pneumonia overlap. In a multicentre prospective study, children aged 1-59 months with auscultatory/audible wheeze and fast breathing and/or lower chest indrawing were screened. Response to up to three cycles of inhaled salbutamol was recorded. The responders were enrolled and sent home on inhaled bronchodilators, and followed up on days 3 and 5. A total of 1622 children with wheeze were screened from May 2001 to April 2002, of which 1004 (61.8%) had WHO defined non-severe and 618 (38.2%) severe pneumonia. Wheeze was audible in only 595 (36.7%) of children. Of 1004 non-severe pneumonia children, 621 (61.8%) responded to up to three cycles of bronchodilator. Of 618 severe pneumonia children, only 166 (26.8%) responded. Among responders, 93 (14.9%) in the non-severe and 63 (37.9%) children in the severe pneumonia group showed subsequent deterioration on follow ups. No family history of wheeze, temperature >100 degrees F, and lower chest indrawing were identified as predictors of subsequent deterioration. Two third of children with wheeze are not identified by current WHO ARI (acute respiratory infections) guidelines. Antibiotics are over prescribed and bronchodilators under utilised in children with wheeze. Children with wheeze constitute a special ARI group requiring a separate management algorithm. In countries where wheeze is common it would be worthwhile to train health workers in use of the stethoscope to identify wheeze.

  12. Sensitization predicts asthma development among wheezing toddlers in secondary healthcare.

    Science.gov (United States)

    Boersma, Nienke A; Meijneke, Ruud W H; Kelder, Johannes C; van der Ent, Cornelis K; Balemans, Walter A F

    2017-06-01

    Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. This study examines the predictive value of sensitization to inhalant allergens among wheezing toddlers in secondary healthcare for the development of asthma at school age (≥6 years). Preschool children (1-3 years) who presented with wheezing in secondary healthcare were screened on asthma at school age with the International Study of Asthma and Allergies in Childhood questionnaire. The positive and negative predictive value (PPV and NPV) of specific IgE to inhalant allergens (cut-off concentration 0.35 kU/L) and several non-invasive variables from a child's history (such as hospitalization, eczema, and parental atopy) were calculated. The additional predictive value of sensitization when combined with non-invasive predictors was examined in multivariate analysis and by ROC curves. Of 116 included children, 63% developed asthma at school age. Sensitization to inhalant allergens was a strong asthma predictor. The odds ratio (OR), PPV and NPV were 7.4%, 86%, and 55%, respectively. Eczema (OR 3.4) and hospital admission (OR 2.6) were significant non-invasive determinants. Adding sensitization to these non-invasive predictors in multivariate analysis resulted in a significantly better asthma prediction. The area under the ROC curve increased from 0.70 with only non-invasive predictors to 0.79 after adding sensitization. Sensitization to inhalant allergens is a strong predictor of school age asthma in secondary healthcare and has added predictive value when combined with non-invasive determinants. Pediatr Pulmonol. 2017;52:729-736. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  13. An ADAM33 Polymorphism Associates with Progression of Preschool Wheeze into Childhood Asthma : A Prospective Case-Control Study with Replication in a Birth Cohort Study

    NARCIS (Netherlands)

    Klaassen, Ester M. M.; Penders, John; Jobsis, Quirijn; van de Kant, Kim D. G.; Thijs, Carel; Mommers, Monique; van Schayck, Constant P.; van Eys, Guillaume; Koppelman, Gerard H.; Dompeling, Edward

    2015-01-01

    Background The influence of asthma candidate genes on the development from wheeze to asthma in young children still needs to be defined. Objective To link genetic variants in asthma candidate genes to progression of wheeze to persistent wheeze into childhood asthma. Materials and Methods In a

  14. Viral aetiology of wheezing in children under five

    Directory of Open Access Journals (Sweden)

    Prithi Sureka Mummidi

    2017-01-01

    Interpretation & conclusions: The study reported the presence of respiratory viral agents in 28.57 per cent of children with wheezing; RSV and PIV were most common, accounting to 55 per cent of the total cases. Mixed infection was reported in 30 per cent of cases. Seasonal variation in the occurrence of these viruses was also noted. Further studies need to be done with a large sample and longer follow up period to verify these findings.

  15. The impact of prenatal exposure to air pollution on childhood wheezing and asthma: A systematic review.

    Science.gov (United States)

    Hehua, Zhang; Qing, Chang; Shanyan, Gao; Qijun, Wu; Yuhong, Zhao

    2017-11-01

    There has been no clear consensus about whether prenatal exposure to air pollution contributes to the development of wheezing and asthma in children. We conducted a systematic review to analyze the association between exposure to different pollutants during pregnancy and the development of childhood wheezing and asthma. We systematically reviewed epidemiological studies published through June 6, 2017 available in the MEDLINE and Web of Science databases. We included studies that examined the association between prenatal exposure to any air pollutants except tobacco smoke and the incidence or prevalence of "wheezing" or "asthma" from birth to 14 years of age. We extracted key characteristics of each included study using a template of predefined data items. We used the Critical Appraisal Skills Programme checklists to assess the validity of each included study. We conducted overall and subgroup meta-analyses for each summary exposure-outcome association. Pooled odds ratios (OR) with 95% confidence intervals (CI) were estimated by using a random effects model. Eighteen studies met our eligibility criteria. There was notable variability in exposure assessment methods. The overall random effects risk estimates (95% CI) of different pollutants were 1.04 (0.94-1.15) aromatic hydrocarbons (PAH), 1.04 (1.01-1.07) NO 2 , 1.4 (0.97-2.03) PM 2.5 for childhood wheeze and 1.07 (1.01-1.14) NO 2 , 1 (0.97-1.03) PM 2.5 , 1.02 (0.98-1.07) SO 2 , 1.08 (1.05-1.12) PM 10 for childhood asthma. Minimal heterogeneity was seen for PAH and SO 2 , while some heterogeneity was observed for PM 10 , PM 2.5 and NO 2 . The overall and subgroup risk estimates from the meta-analyses showed statistically significant associations between prenatal exposures to NO 2 , SO 2 , and PM 10 and the risk of wheezing and asthma development in childhood. There is insufficient evidence to show an effect of prenatal exposure to BC, CO, and O 3 on childhood wheezing and asthma. Further studies are needed to

  16. Presence of Eosinophils in Nasal Secretion during Acute Respiratory Tract Infection in Young Children Predicts Subsequent Wheezing within Two Months

    Directory of Open Access Journals (Sweden)

    Miwa Shinohara

    2008-01-01

    Conclusions: Our findings not only suggest that nasal eosinophil testing may serve as a convenient clinical marker for identifying young children at risk for subsequent wheezing, but also shed new light on the role of eosinophils in the onset of wheezing in young children.

  17. The effect of internalization and other psychologic factors on the remission and severity of wheeze in children.

    Science.gov (United States)

    Feitosa, Caroline A; Santos, Darci N; Barreto, Maurício L; Rodrigues, Laura C

    2016-06-01

    Asthma prevalence in Latin America is high and continues to increase. There is evidence that the psychologic characteristics of the child are associated with greater asthma morbidity. This study aimed to investigate the independent effect of internalizing/externalizing problems on two asthma/wheeze outcomes: (i) remission and (ii) progression to severity on Latin American children with mild asthma symptoms at baseline. This was a prospective study in a cohort of 371 asthmatic children living in a poor urban area in Salvador, Brazil. The psychologic characteristics of the child were assessed using the Child Behavior Checklist (CBCL), and wheezing was defined using the ISAAC questionnaire at the start and end of follow-up. A multiple logistic regression model with random effects was used to examine the association between the psychologic components and both outcomes. Remission of symptoms of wheeze was observed among 229 (61.73%) children. Remission was 56% lower among children with internalizing problems (OR = 0.54, 95% CI 0.33-0.87, p = 0.01). In addition, we found that 19 (8.76%) of the children acquired severe symptoms during follow-up and there was strong evidence of the effect of internalizing problems in increasing the risk of progression to severe wheeze symptoms (OR = 4.03, 95% CI 1.39-11.70, p = 0.01). Children with internalizing problems but not externalizing had less remission of wheezing, and a higher risk of acquiring severe symptoms. These results highlight the importance of psychologic care for children with asthma, to improve the prognosis of this condition. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Is childhood wheeze and asthma in Latin America associated with poor hygiene and infection? A systematic review

    Science.gov (United States)

    Garner, Paul; Cooper, Philip J

    2018-01-01

    Introduction High asthma prevalence in Latin-American cities is thought to be caused by poor hygiene and infections. This contradicts the widely accepted ‘hygiene hypothesis’ for asthma aetiology. Methods Systematic review of observational studies evaluating the association between poor hygiene exposures or infections and asthma/wheeze among Latin-American children aged 4–16 years. MEDLINE, EMBASE, LILACS and CINAHL electronic databases were searched following a predefined strategy to 18 December 2017. We quantified outcomes measured and reported, assessed risk of bias and tabulated the results. Results Forty-five studies included: 6 cohort, 30 cross-sectional and 9 case–control studies. 26 cross-sectional studies were school-based surveys (14 of over 3000 children), whereas 5 case–control studies were hospital/health centre-based. Exposures measured and reported varied substantially between studies, and current wheeze was the most common outcome reported. Data showed selective reporting based on statistical significance (P value <0.05): 17/45 studies did not clearly describe the number of exposures measured and 15/45 studies reported on less than 50% of the exposures measured. Most exposures studied did not show an association with wheeze or asthma, except for a generally increased risk associated with acute respiratory infections in early life. Contradictory associations were observed frequently between different studies. Conclusion Selective reporting is common in observational studies exploring the association between environmental exposures and risk of wheeze/asthma. This, together with the use of different study outcomes (wheeze/asthma) associated with possibly distinct causal mechanisms, complicates inferences about the role of poor hygiene exposures and childhood infections in explaining asthma prevalence in Latin-American children. PMID:29531744

  19. Systemic corticosteroids and early administration of antiviral agents for pneumonia with acute wheezing due to influenza A(H1N1pdm09 in Japan.

    Directory of Open Access Journals (Sweden)

    Koichiro Kudo

    Full Text Available BACKGROUND: Pneumonia patients with wheezing due to influenza A(H1N1pdm09 were frequently treated with systemic corticosteroids in Japan although systemic corticosteroid for critically ill patients with pneumonia caused by influenza A(H1N1pdm09 has been controversial. Applicability of systemic corticosteroid treatment needs to be evaluated. METHODS/PRINCIPAL FINDINGS: We retrospectively reviewed 89 subjects who were diagnosed with influenza A(H1N1pdm09 and admitted to a national hospital, Tokyo during the pandemic period. The median age of subjects (45 males was 8 years (range, 0-71. All subjects were treated with antiviral agents and the median time from symptom onset to initiation of antiviral agents was 2 days (range, 0-7. Subjects were classified into four groups: upper respiratory tract infection, wheezing illness, pneumonia with wheezing, and pneumonia without wheezing. The characteristics of each group was evaluated. A history of asthma was found more frequently in the wheezing illness (55.6% and pneumonia with wheezing (43.3% groups than in the other two groups (p = 0.017. Corticosteroid treatment was assessed among subjects with pneumonia. Oxygen saturation was lower in subjects receiving corticosteroids (steroid group than in subjects not receiving corticosteroids (no-steroid group (p<0.001. The steroid group required greater oxygen supply than the no-steroid group (p<0.001. No significant difference was found by the Kaplan-Meier method between the steroid and the no-steroid groups in hours to fever alleviation from the initiation of antiviral agents and hospitalization days. In logistic regression analysis, wheezing, pneumonia and oxygen saturation were independent factors associated with using systemic corticosteroids. CONCLUSION: Patients with wheezing and a history of asthma were frequently found in the study subjects. Systemic corticosteroids together with early administration of antiviral agents to pneumonia with wheezing and

  20. Sibilância no lactente: epidemiologia, investigação e tratamento Wheezing in infancy: epidemiology, investigation, and treatment

    Directory of Open Access Journals (Sweden)

    Herberto José Chong Neto

    2010-06-01

    Full Text Available OBJETIVO: Realizar revisão de aspectos epidemiológicos, de investigação e tratamento da sibilância em lactentes. FONTES DOS DADOS: Foram avaliados os estudos disponíveis na base de dados MEDLINE utilizando os descritores "sibilosc, "lactentes", "diagnóstico", "tratamento" e "crianças", e estudos encontrados com a ferramenta Google utilizando o tema "Estudio Internacional de Sibilancias en Lactantes". SÍNTESE DOS DADOS: Foi observada globalmente grande variabilidade na prevalência de sibilância em lactentes. Os fatores associados à sibilância na infância diferem entre os centros. O tratamento de lactentes sibilantes ainda é controverso e depende de diagnóstico preciso. A história clínica e o exame físico são fundamentais para o diagnóstico. CONCLUSÕES: A padronização de método pode demonstrar dados relevantes sobre a epidemiologia e o tratamento da sibilância em nosso país para comparação entre os centros envolvidos.OBJECTIVE: To perform a review of the epidemiological aspects of investigating and treating wheezing in infants. SOURCES: A search was run on MEDLINE using the keywords "wheezing," "infants," "diagnosis," "treatment," and "children," and Google was also used to search for "Estudio Internacional de Sibilancias en Lactantes." SUMMARY OF THE FINDINGS: The prevalence of wheezing in infants varies greatly around the world. The factors associated with wheezing in infants are different at different research centers. Treatment of wheezing infants is still controversial and is dependent on a precise diagnosis. Clinical history and physical examination are fundamental to diagnosis. CONCLUSIONS: A standardized method could reveal data of relevance to the epidemiology and treatment of wheezing in Brazil and allow comparisons between different participating centers.

  1. An ADAM33 polymorphism associates with progression of preschool wheeze into childhood asthma: a prospective case-control study with replication in a birth cohort study.

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    Ester M M Klaassen

    Full Text Available The influence of asthma candidate genes on the development from wheeze to asthma in young children still needs to be defined.To link genetic variants in asthma candidate genes to progression of wheeze to persistent wheeze into childhood asthma.In a prospective study, children with recurrent wheeze from the ADEM (Asthma DEtection and Monitoring study were followed until the age of six. At that age a classification (transient wheeze or asthma was based on symptoms, lung function and medication use. In 198 children the relationship between this classification and 30 polymorphisms in 16 asthma candidate genes was assessed by logistic regression. In case of an association based on a p<0.10, replication analysis was performed in an independent birth cohort study (KOALA study, n = 248 included for the present analysis.In the ADEM study, the minor alleles of ADAM33 rs511898 and rs528557 and the ORMDL3/GSDMB rs7216389 polymorphisms were negatively associated, whereas the minor alleles of IL4 rs2243250 and rs2070874 polymorphisms were positively associated with childhood asthma. When replicated in the KOALA study, ADAM33 rs528557 showed a negative association of the CG/GG-genotype with progression of recurrent wheeze into childhood asthma (0.50 (0.26-0.97 p = 0.04 and no association with preschool wheeze.Polymorphisms in ADAM33, ORMDL3/GSDMB and IL4 were associated with childhood asthma in a group of children with recurrent wheeze. The replication of the negative association of the CG/GG-genotype of rs528557 ADAM33 with childhood asthma in an independent birth cohort study confirms that a compromised ADAM33 gene may be implicated in the progression of wheeze into childhood asthma.

  2. IL13 gene polymorphisms modify the effect of exposure to tobacco smoke on persistent wheeze and asthma in childhood, a longitudinal study

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    Kurukulaaratchy Ramesh

    2008-01-01

    Full Text Available Abstract Background Tobacco smoke and genetic susceptibility are risk factors for asthma and wheezing. The aim of this study was to investigate whether there is a combined effect of interleukin-13 gene (IL13 polymorphisms and tobacco smoke on persistent childhood wheezing and asthma. Methods In the Isle of Wight birth cohort (UK, 1989–1999, five IL13 single nucleotide polymorphisms (SNPs: rs1800925 (-1112C/T, rs2066960, rs1295686, rs20541 (R130Q and rs1295685 were genotyped. Parents were asked whether their children had wheezed in the last 12 months at ages 1, 2, 4 and 10 years. Children who reported wheeze in the first 4 years of life and also had wheezing at age 10 were classified as early-onset persistent wheeze phenotype; non-wheezers never wheezed up to age 10. Persistent asthma was defined as having a diagnosis of asthma both during the first four years of life and at age 10. Logistic regression methods were used to analyze data on 791 children with complete information. Potential confounders were gender, birth weight, duration of breast feeding, and household cat or dog present during pregnancy. Results Maternal smoking during pregnancy was associated with early-onset persistent wheeze (OR 2.93, p IL13 were not (OR 1.15, p = 0.60 for the common haplotype pair. However, the effect of maternal smoking during pregnancy was stronger in children with the common IL13 haplotype pair compared to those without it (OR 5.58 and OR 1.29, respectively; p for interaction = 0.014. Single SNP analysis revealed a similar statistical significance for rs20541 (p for interaction = 0.02. Comparable results were observed for persistent childhood asthma (p for interaction = 0.03. Conclusion This is the first report that shows a combined effect of in utero exposure to smoking and IL13 on asthma phenotypes in childhood. The results emphasize that genetic studies need to take environmental exposures into account, since they may explain contradictory findings.

  3. Recurrent wheezing is associated with intestinal protozoan infections in Warao Amerindian children in Venezuela: a cross-sectional survey.

    Science.gov (United States)

    Overeem, Marcella M A; Verhagen, Lilly M; Hermans, Peter W M; del Nogal, Berenice; Sánchez, Adriana Márquez; Acevedo, Natacha Martinez; Murga, Rosalicia Ramirez; Roelfsema, Jeroen; Pinelli, Elena; de Waard, Jacobus H

    2014-05-29

    While in developed countries the prevalence of allergic diseases is rising, inflammatory diseases are relatively uncommon in rural developing areas. High prevalence rates of helminth and protozoan infections are commonly found in children living in rural settings and several studies suggest an inverse association between helminth infections and allergies. No studies investigating the relationship between parasitic infections and atopic diseases in rural children of developing countries under the age of 2 years have been published so far. We performed a cross-sectional survey to investigate the association of helminth and protozoan infections and malnutrition with recurrent wheezing and atopic eczema in Warao Amerindian children in Venezuela. From August to November 2012, 229 children aged 0 to 2 years residing in the Orinoco Delta in Venezuela were enrolled. Data were collected through standardized questionnaires and physical examination, including inspection of the skin and anthropometric measurements. A stool sample was requested from all participants and detection of different parasites was performed using microscopy and real time polymerase chain reaction (PCR). We observed high prevalence rates of atopic eczema and recurrent wheezing, respectively 19% and 23%. The prevalence of helminth infections was 26% and the prevalence of protozoan infections was 59%. Atopic eczema and recurrent wheezing were more frequently observed in stunted compared with non-stunted children in multivariable analysis (OR 4.3, 95% CI 1.3 - 13.6, p = 0.015 and OR 4.5, 95% CI 0.97 - 21.2, p = 0.055). Furthermore, recurrent wheezing was significantly more often observed in children with protozoan infections than in children without protozoan infections (OR 6.7, 95% CI 1.5 - 30.5). High prevalence rates of atopic eczema and recurrent wheezing in Warao Amerindian children under 2 years of age were related to stunting and intestinal protozoan infections respectively. Helminth

  4. Prevalence and associated factors of wheezing illnesses of children aged three to five years living in under-served settlements of the Colombo Municipal Council in Sri Lanka: a cross-sectional study.

    Science.gov (United States)

    Seneviratne, Ruwanika; Gunawardena, Nalika S

    2018-01-11

    A rising trend in Sri Lanka for asthma and wheezing illness is observed with higher morbidity in younger children and a paucity of related research. 'Under-served settlements' (USS) of Colombo Municipal Council (CMC) have poor living environments conducive to childhood wheezing. The objective was to describe the prevalence and associated factors of wheezing illnesses of three to five year old children living in low-income settlements in CMC. A cross-sectional study was conducted on 460 three to five year old children and their caregivers using cluster sampling among residents of two randomly selected USSs of CMC. An interviewer-administered questionnaire, observation checklist and data extraction form were used in data collection. A physician's diagnosis of wheezing/whistling of the chest in their lifetime and a physician's diagnosis of wheezing/whistling within the past twelve months were considered as 'ever-wheezing illness' and 'current-wheezing illness' respectively. Mean age was 3.98 years (SD = ±0.64 years). A majority were males (51.3%) and Tamils (39.8%). Prevalence of 'ever wheezing illness' and 'current wheezing illness' were 38% (95% confidence interval (CI); 33.6%-42.5%) and 21.3% (95%CI; 17.6%-25.0%), respectively. Maternal (p settlements was found to be high. Children with a history of maternal and/or paternal wheezing should be targeted for early interventions to prevent wheezing illnesses. Interventions to avoid exacerbations should focus on the indoor environmental factors that were found to be associated with wheezing illnesses.

  5. Effect of urban vs. rural residence on the association between atopy and wheeze in Latin America: findings from a case-control analysis.

    Science.gov (United States)

    Endara, P; Vaca, M; Platts-Mills, T A E; Workman, L; Chico, M E; Barreto, M L; Rodrigues, L C; Cooper, P J

    2015-02-01

    The association between atopy and asthma is attenuated in non-affluent populations, an effect that may be explained by childhood infections such as geohelminths. To investigate the association between atopy and wheeze in schoolchildren living in urban and rural areas of Ecuador and examine the effects of geohelminths on this association. We performed nested case-control studies among comparable populations of schoolchildren living in rural communities and urban neighbourhoods in the Province of Esmeraldas, Ecuador. We detected geohelminths in stool samples, measured recent wheeze and environmental exposures by parental questionnaire, and atopy by specific IgE (sIgE) and skin prick test (SPT) reactivity to aeroallergens. Atopy, particularly sIgE to house dust mite (HDM), was more strongly associated with recent wheeze in urban than rural schoolchildren: (urban, adj. OR 5.19, 95% CI 3.37-8.00, P children. The association between atopy and recent wheeze was attenuated by markers of geohelminth infections. Our data suggest that urban residence modifies the association between HDM atopy and recent wheeze, and this effect is explained partly by geohelminth infections. © 2014 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd.

  6. Is childhood wheeze and asthma in Latin America associated with poor hygiene and infection? A systematic review.

    Science.gov (United States)

    Ardura-Garcia, Cristina; Garner, Paul; Cooper, Philip J

    2018-01-01

    High asthma prevalence in Latin-American cities is thought to be caused by poor hygiene and infections. This contradicts the widely accepted 'hygiene hypothesis' for asthma aetiology. Systematic review of observational studies evaluating the association between poor hygiene exposures or infections and asthma/wheeze among Latin-American children aged 4-16 years. MEDLINE, EMBASE, LILACS and CINAHL electronic databases were searched following a predefined strategy to 18 December 2017. We quantified outcomes measured and reported, assessed risk of bias and tabulated the results. Forty-five studies included: 6 cohort, 30 cross-sectional and 9 case-control studies. 26 cross-sectional studies were school-based surveys (14 of over 3000 children), whereas 5 case-control studies were hospital/health centre-based. Exposures measured and reported varied substantially between studies, and current wheeze was the most common outcome reported. Data showed selective reporting based on statistical significance (P value asthma, except for a generally increased risk associated with acute respiratory infections in early life. Contradictory associations were observed frequently between different studies. Selective reporting is common in observational studies exploring the association between environmental exposures and risk of wheeze/asthma. This, together with the use of different study outcomes (wheeze/asthma) associated with possibly distinct causal mechanisms, complicates inferences about the role of poor hygiene exposures and childhood infections in explaining asthma prevalence in Latin-American children.

  7. The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life.

    Science.gov (United States)

    Casas, Lidia; Zock, Jan Paul; Carsin, Anne Elie; Fernandez-Somoano, Ana; Esplugues, Ana; Santa-Marina, Loreto; Tardón, Adonina; Ballester, Ferran; Basterrechea, Mikel; Sunyer, Jordi

    2013-10-01

    To evaluate the effects of household use of cleaning products during pregnancy on infant wheezing and lower respiratory tract infections (LRTI). In four prospective Spanish birth cohorts (n = 2,292), pregnant women reported the use of household cleaning products. When infants were 12-18 months old, current cleaning product use and infant's wheezing and LRTI were reported. Cohort-specific associations between the use of specific products and respiratory outcomes were evaluated using multivariable regression analyses and estimates were combined using random-effects meta-analyses. The period prevalence of LRTI was higher when sprays (combined odds ratio (OR) = 1.29; 95 % confidence interval (CI) 1.04-1.59) or air fresheners (OR = 1.29; CI 1.03-1.63) were used during pregnancy. The odds of wheezing increased with spray (OR = 1.37; CI 1.10-1.69) and solvent (OR = 1.30; CI 1.03-1.62) use. The associations between spray and air freshener use during pregnancy and both outcomes remained apparent when these products were not used after pregnancy. Nevertheless, the estimates were higher when post-natal exposure was included. The use of cleaning sprays, air fresheners and solvents during pregnancy may increase the risk of wheezing and infections in the offspring.

  8. Effects of a 17q21 chromosome gene variant, tobacco smoke and furred pets on infant wheeze

    DEFF Research Database (Denmark)

    Bräuner, E V; Loft, S; Raaschou-Nielsen, O

    2012-01-01

    investigated associations between the rs7216389 polymorphism in the 17q21 locus affecting ORMDL3 expression and the risk for recurrent wheeze and interactions with exposure to tobacco smoke and furred pets during pregnancy and infancy using a birth cohort of 101¿042 infants. Rs7216389 was significantly...... association between pets and wheeze among homozygous wild-type carriers and a negative association among homozygous variant allele carriers. There was no interaction between rs7216389 and tobacco smoke exposure....

  9. The role of maternal anorexia nervosa and bulimia nervosa before and during pregnancy in early childhood wheezing: Findings from the NINFEA birth cohort study.

    Science.gov (United States)

    Popovic, Maja; Pizzi, Costanza; Rusconi, Franca; Gagliardi, Luigi; Galassi, Claudia; Trevisan, Morena; Merletti, Franco; Richiardi, Lorenzo

    2018-05-02

    This study evaluates associations of maternal eating disorders (bulimia nervosa, anorexia nervosa, and purging behaviors) with infant wheezing and examines the effects of eating disorders on several wheezing determinants. We studied 5,150 singletons from the NINFEA birth cohort. Maternal bulimia nervosa and anorexia nervosa diagnoses were ascertained from the questionnaires completed in pregnancy and 6 months after delivery, and were analyzed as: ever diagnosis, only before pregnancy, and during pregnancy. Purging behaviors were assessed for 12 months before or during pregnancy. The associations with wheezing between 6 and 18 months of age were assessed in models adjusted for a priori selected confounders. Children born to mothers with lifetime eating disorders were at an increased risk of developing wheezing (adjusted OR 1.68; [95% CI: 1.08, 2.60]), and this risk further increased when the disorders were active during pregnancy (2.52 [1.23, 5.19]). Increased risk of offspring wheezing was observed also for purging behaviors without history of eating disorder diagnosis (1.50 [1.10, 2.04]). The observed associations were not explained by comorbid depression and/or anxiety. Bulimia nervosa and/or anorexia nervosa during pregnancy were also associated with several risk factors for wheezing, including maternal smoking, adverse pregnancy outcomes, shorter breastfeeding duration, and day-care attendance. The associations of maternal eating disorders with offspring wheezing suggest long-term adverse respiratory outcomes in children of mothers with eating disorders. A better understanding of mechanisms implicated is necessary to help reduce the respiratory disease burden in these children. © 2018 Wiley Periodicals, Inc.

  10. Occupational exposures associated with work-related asthma and work-related wheezing among U.S. workers.

    Science.gov (United States)

    Arif, Ahmed A; Delclos, George L; Whitehead, Lawrence W; Tortolero, Susan R; Lee, Eun S

    2003-10-01

    National estimates of occupational asthma (OA) in the United States are sparse. Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, we analyzed associations between occupation and work-related asthma and work-related wheezing among U.S. workers. This study identified several occupations that were at risk of developing work-related asthma and/or wheezing, with cleaners and equipment cleaners showing the highest risks. Other major occupations identified were farm and agriculture; entertainment; protective services; construction; mechanics and repairers; textile; fabricators and assemblers; other transportation and material moving occupations; freight, stock, and material movers; and motor vehicle operators. The population attributable risks for work-related asthma and work-related wheezing were 26% and 27%, respectively. This study adds evidence to the literature that identifies work-related asthma as an important public health problem. Several occupations are targeted for additional evaluation and study. Of particular interest are cleaners, which are being increasingly reported as a risk group for asthma. Future intervention strategies need to be developed for effective control and prevention of asthma in the workplace. Copyright 2003 Wiley-Liss, Inc.

  11. The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic Wheezing Illness.

    Science.gov (United States)

    Dixon, Dani-Louise

    2015-07-07

    Infants who are breastfed are at an immunological advantage when compared with formula fed infants, evidenced by decreased incidence of infections and diminished propensity for long term conditions, including chronic wheeze and/or asthma. Exclusive breastfeeding reduces the duration of hospital admission, risk of respiratory failure and requirement for supplemental oxygen in infants hospitalised with bronchiolitis suggesting a potentially protective mechanism. This review examines the evidence and potential pathways for protection by immunomodulatory factors in human milk against the most common viral cause of bronchiolitis, respiratory syncytial virus (RSV), and subsequent recurrent wheeze in infants. Further investigations into the interplay between respiratory virus infections such as RSV and how they affect, and are affected by, human milk immunomodulators is necessary if we are to gain a true understanding of how breastfeeding protects many infants but not all against infections, and how this relates to long-term protection against conditions such as chronic wheezing illness or asthma.

  12. Maternal weight, gestational weight gain and preschool wheezing: The Generation R Study

    NARCIS (Netherlands)

    E.T.M. Leermakers (Lisan); A.M.M. van der Sonnenschein-Voort (Agnes); R. Gaillard (Romy); A. Hofman (Albert); J.C. de Jongste (Johan); V.W.V. Jaddoe (Vincent); L. Duijts (Liesbeth)

    2013-01-01

    textabstractWe studied the associations of maternal pre-pregnancy body mass index and gestational weight gain with risks of preschool wheezing in offspring and explored the role of growth, infectious and atopic mechanisms. This substudy of 4656 children was embedded in a population-based birth

  13. NO2, as a marker of air pollution, and recurrent wheezing in children: a nested case-control study within the BAMSE birth cohort.

    Science.gov (United States)

    Emenius, G; Pershagen, G; Berglind, N; Kwon, H-J; Lewné, M; Nordvall, S L; Wickman, M

    2003-11-01

    To investigate the association between air pollution, including with NO2, and recurrent wheezing during the first two years of life. A birth cohort (BAMSE) comprised 4089 children, for whom information on exposures, symptoms, and diseases was available from parental questionnaires at ages 2 months, and 1 and 2 years. NO2 was measured during four weeks in and outside the dwellings of children with recurrent wheezing and two age matched controls, in a nested case-control study (540 children). Conditional logistic regression showed an OR of 1.60 (95% CI 0.78 to 3.26) among children in the highest quartile of outdoor NO2 exposure in relation to those in the lowest quartile, adjusted for potential confounders. The corresponding OR for indoor NO2 was 1.51 (95% CI 0.81 to 2.82). An interaction with environmental tobacco smoke (ETS) was indicated with an OR of 3.10 (95% CI 1.32 to 7.30) among children exposed to the highest quartile of indoor NO2 and ETS. The association between NO2 and recurrent wheezing appeared stronger in children who did not fulfil the criteria for recurrent wheezing until their second year. Although the odds of increased recurrent wheezing are not statistically significantly different from one, results suggest that exposure to air pollution including NO2, particularly in combination with exposure to ETS, increases the risk of recurrent wheezing in children.

  14. Upper airways microbiota in antibiotic-naïve wheezing and healthy infants from the tropics of rural Ecuador.

    Directory of Open Access Journals (Sweden)

    Paul Andres Cardenas

    Full Text Available Observations that the airway microbiome is disturbed in asthma may be confounded by the widespread use of antibiotics and inhaled steroids. We have therefore examined the oropharyngeal microbiome in early onset wheezing infants from a rural area of tropical Ecuador where antibiotic usage is minimal and glucocorticoid usage is absent.We performed pyrosequencing of amplicons of the polymorphic bacterial 16S rRNA gene from oropharyngeal samples from 24 infants with non-infectious early onset wheezing and 24 healthy controls (average age 10.2 months. We analyzed microbial community structure and differences between cases and controls by QIIME software.We obtained 76,627 high quality sequences classified into 182 operational taxonomic units (OTUs. Firmicutes was the most common and diverse phylum (71.22% of sequences with Streptococcus being the most common genus (49.72%. Known pathogens were found significantly more often in cases of infantile wheeze compared to controls, exemplified by Haemophilus spp. (OR=2.12, 95% Confidence Interval (CI 1.82-2.47; P=5.46×10(-23 and Staphylococcus spp. (OR=124.1, 95%CI 59.0-261.2; P=1.87×10(-241. Other OTUs were less common in cases than controls, notably Veillonella spp. (OR=0.59, 95%CI=0.56-0.62; P=8.06×10(-86.The airway microbiota appeared to contain many more Streptococci than found in Western Europe and the USA. Comparisons between healthy and wheezing infants revealed a significant difference in several bacterial phylotypes that were not confounded by antibiotics or use of inhaled steroids. The increased prevalence of pathogens such as Haemophilus and Staphylococcus spp. in cases may contribute to wheezing illnesses in this age group.

  15. A Review of the CD4+ T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population.

    Science.gov (United States)

    Misra, Ravi S

    Childhood asthma and wheezing are very common, especially in those born preterm. Genetic and environmental factors are associated with developing asthma and wheezing. Respiratory syncytial virus and rhinovirus infections have been implicated in playing a causal role in the development of childhood asthma and wheezing, perhaps by altering the development of the immune system. Several subtypes of asthma and wheezing have been described which involve different mechanisms of pathophysiology. Much of the recent work in the field of asthma research has focused on describing unique aspects of these disease subtypes, which could lead to new drug targets. Alterations in CD4+ T cells have been described with alterations in the T helper 1, 2, 17 and regulatory cell balance could provide valuable targets for the development of new treatment strategies for the various subtypes of disease. This review article focuses on factors involved in childhood asthma and wheeze and potential drug targets.

  16. Maternal vitamin D status and childhood asthma, wheeze, and eczema: A systematic review and meta-analysis.

    Science.gov (United States)

    Wei, Zhenzhen; Zhang, Jun; Yu, Xiaodan

    2016-09-01

    Maternal vitamin D status has been reported to be associated with childhood allergic diseases. However, this association remains to be fully elucidated. A systematic review and meta-analysis was conducted using prospective cohort studies that examined the association between maternal vitamin D status and childhood allergic diseases including wheeze, eczema and asthma. We searched electronic databases of PubMed, EMBASE, the Cochrane library, the Wanfang (Chinese) database, the VIP (Chinese) database, and Chinese National Knowledge Infrastructure (CNKI) up to August 2014. Odds ratios and 95% confidence intervals (CIs) from individual studies were synthesized using a fixed effects model. Four studies on the association between maternal vitamin D status and childhood asthma (3666 mother-child pairs), four studies on the association between maternal vitamin D status and childhood wheeze (2225 mother-child pairs) and three papers on the association between maternal vitamin D status and childhood eczema (2172 mother-child pairs) met our inclusion criteria. Maternal vitamin D status during pregnancy was associated with childhood eczema (pooled OR=0.904, 95% CI=0.831-0.983). However, the meta-analysis showed no statistical association between maternal vitamin D status and childhood asthma (pooled OR=0.981, 95% CI=0.944-1.019) or childhood wheeze (pooled OR=0.995, 95% CI=0.982-1.009). Our meta-analysis found that lower maternal vitamin D during pregnancy was associated with an increased risk of childhood eczema but was not associated with childhood asthma or wheeze. The role of maternal vitamin D as an important protective factor for the development of childhood eczema remains to be elucidated. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Sensitization to food and inhalant allergens in relation to age and wheeze among children with atopic dermatitis.

    Science.gov (United States)

    Wisniewski, J A; Agrawal, R; Minnicozzi, S; Xin, W; Patrie, J; Heymann, P W; Workman, L; Platts-Mills, T A; Song, T W; Moloney, M; Woodfolk, J A

    2013-10-01

    Atopic dermatitis (AD) is common in children; however, persistence of AD with or without asthma is less common. Longitudinal studies remain limited in their ability to characterize how IgE antibody responses evolve in AD, and their relationship with asthma. To use a cross-sectional study design of children with active AD to analyse age-related differences in IgE antibodies and relation to wheeze. IgE antibodies to food and inhalant allergens were measured in children with active AD (5 months to 15 years of age, n = 66), with and without history of wheeze. Whereas IgE antibodies to foods persisted at a similar prevalence and titre throughout childhood, IgE antibodies to all aeroallergens rose sharply into adolescence. From birth, the chance of sensitization for any aeroallergen increased for each 12-month increment in age (OR ≥ 1.21, P cat was more strongly associated with wheeze (OR = 4.5, P cat allergic children with AD to those without, revealed higher IgE levels to Fel d 2 and Fel d 4 (P cat and dust mite among young children with AD may aid in identifying those at increased risk for disease progression and development of asthma. Early sensitization to cat and risk for wheeze among children with AD may be linked to an increased risk for sensitization to a broader spectrum of allergen components from early life. Collectively, our findings argue for early intervention strategies designed to mitigate skin inflammation in children with AD. © 2013 John Wiley & Sons Ltd.

  18. [metabonomics research on coronary heart disease patients of phlegm turbidity syndrome and qi deficiency syndrome].

    Science.gov (United States)

    Cheng, Peng; Chen, Ze-qi; Wang, Dong-sheng

    2015-02-01

    To study the correlation between Chinese medical types of coronary heart disease (CHD) [i.e., phlegm turbidity syndrome (PTS) and qi deficiency syndrome (QDS)] and their metabolites. Recruited were 65 CHD patients including 37 cases of PTS and 28 cases of QDS. Serum endogenous metabolites in the two syndrome types were determined by gas chromatograph-mass spectrometer-computer (GC/MS), and their differences between their metabolic profiles analyzed. More than 100 chromatographic peaks were totally scanned. Chromatograms obtained was matched with mass spectrum bank, and finally we got the category contribution value of 46 kinds of substances. Results of MCTree analysis showed patients of PTS and patients of QDS could be effectively distinguished. Compounds contributing to identify the two syndromes were sequenced as serine, valine, 2 hydroxy propionic acid. Comparison of metabolites showed contents of serine and 2 hydroxy propionic acid were higher in patients of PTS than in patients of QDS (Pmetabonomics of CHD TCM syndrome types could provide material bases for TCM syndrome differentiation of CHD, indicating that metabonomics technologies might become a new research method for TCM syndrome typing.

  19. Twelve-month safety and efficacy of inhaled fluticasone propionate in children aged 1 to 3 years with recurrent wheezing

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Allen, David; Milanowski, Janusz

    2004-01-01

    , exacerbations, and requirements for oral steroid treatment and more symptom-free days and days without use of rescue treatment. CONCLUSIONS: Twelve months of treatment with inhaled FP (100 microg twice daily) in preschool children aged 1 to 3 years with recurrent wheeze has no effect on growth and no other......OBJECTIVE: Our aim was to compare the 12-month safety and efficacy of fluticasone propionate (FP) and sodium cromoglycate (SCG) in children aged 1 to 3 years with mild to moderate recurrent wheeze. METHODS: The study was a randomized, parallel-group, open-label multicenter study of 625 children......, aged 1 to 3 years, with recurrent wheeze randomized in a 3:1 ratio to treatment for 52 weeks with FP (100 microg twice daily) via metered-dose inhaler and Babyhaler spacer device or SCG (5 mg 4 times daily) via metered-dose inhaler and Nebuhaler spacer device, respectively. RESULTS...

  20. Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis.

    Science.gov (United States)

    Beckhaus, A A; Garcia-Marcos, L; Forno, E; Pacheco-Gonzalez, R M; Celedón, J C; Castro-Rodriguez, J A

    2015-12-01

    Epidemiologic studies suggest a relationship between maternal nutrition during pregnancy and the occurrence of asthma and atopic conditions during childhood. However, individual study results are conflicting. The objective of this meta-analysis was to critically examine the current evidence for an association between nutrition (dietary patterns, food groups, vitamins, or oligo-elements) ingestion during pregnancy and asthma, wheeze, or atopic conditions in childhood. The inclusion criteria were as follows: (i) systematic recording of diet during the gestational period and (ii) documentation of asthma, wheezing, eczema, or other atopic disease in the offspring. The primary outcomes were prevalence of asthma or wheeze among the offspring during childhood; and secondary outcomes were prevalence of eczema, allergic rhinitis, or other atopic conditions. We found 120 titles, abstracts, and citations, and 32 studies (29 cohorts) were included in this analysis. Data on vitamins, oligo-elements, food groups, and dietary patterns during pregnancy were collected. A meta-analysis revealed that higher maternal intake of vitamin D [odds ratio (OR) = 0.58, 95% confidence interval (CI) = 0.38-0.88], vitamin E (OR = 0.6, 95% CI = 0.46-0.78), and zinc (OR = 0.62, 95% CI = 0.40-0.97) was associated with lower odds of wheeze during childhood. However, none of these or other nutrients was consistently associated with asthma per se or other atopic conditions. Current evidence suggests a protective effect of maternal intake of each of three vitamins or nutrients (vitamin D, vitamin E, and zinc) against childhood wheeze but is inconclusive for an effect on asthma or other atopic conditions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Parental smoking and other risk factors for wheezing bronchitis in children.

    Science.gov (United States)

    Rylander, E; Pershagen, G; Eriksson, M; Nordvall, L

    1993-09-01

    A population-based case-control study was performed to investigate etiologic factors for wheezing bronchitis and asthma in children up to four years of age. A total of 199 children hospitalized for the first time with these diagnoses at a major hospital in Stockholm in 1986-1988 constituted the cases, 351 children from the catchment area of the hospital were used as controls. Information on known and suspected risk factors was obtained through home interviews with a parent. Parental smoking was associated with a relative risk of 1.8 (95% confidence interval 1.3-2.6) corresponding to a population attributable proportion of 27%. The strongest association was seen for maternal smoking and children below 18 months of age. Other major risk factors included atopic heredity, recurrent upper respiratory tract infections and breast-feeding less than 3 months, which appeared to interact multiplicatively with parental smoking. The environmental factors had a stronger influence in the youngest age group, and the overall attributable proportion associated with parental smoking, short breast-feeding period and exposure to pets in the household was 43%. It is clear that successful primary prevention could dramatically reduce the incidence of wheezing bronchitis in children.

  2. Can Economic Deprivation Protect Health? Paradoxical Multilevel Effects of Poverty on Hispanic Children’s Wheezing

    Science.gov (United States)

    Collins, Timothy W.; Kim, Young-an; Grineski, Sara E.; Clark-Reyna, Stephanie

    2014-01-01

    Prior research suggests that economic deprivation has a generally negative influence on residents’ health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children’s current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor’s asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children’s wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health. PMID:25101769

  3. Can Economic Deprivation Protect Health? Paradoxical Multilevel Effects of Poverty on Hispanic Children’s Wheezing

    Directory of Open Access Journals (Sweden)

    Timothy W. Collins

    2014-08-01

    Full Text Available Prior research suggests that economic deprivation has a generally negative influence on residents’ health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children’s current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor’s asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children’s wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health.

  4. Latitude modifies the effect size of factors related to recurrent wheeze in the first year of life.

    Science.gov (United States)

    Garcia-Marcos, Luis; Mallol, Javier; Solé, Dirceu; Brand, Paul L P; Sanchez-Bahillo, Maria; Sanchez-Solis, Manuel

    2013-05-01

    Although the association between latitude and asthma prevalence has been studied to a certain extent, its influence on the magnitude of the association of risk/protective factors with recurrent wheeze in infants has never been reported. The adjusted odd ratios (aOR) of various risk/protective factors for recurrent wheeze from 31,920 infants from 19 centres of the "Estudio Internacional de Sibilacias en Lactantes" (EISL) in very different parts of the world were used to build a meta-regression using the strength of the aOR of each factor as dependent variable and centre latitude as explanatory variable. The meta-regression was further adjusted for continent. There was a positive significant correlation between latitude and the magnitude of the aOR between recurrent wheeze and having cold(s) during the first three months of life (p = 0.004); attending a nursery school (p = 0.011); and having additional siblings (p = 0.003). Furthermore, there was a negative correlation for having been breastfed for at least three months (p = 0.044). Heterogeneity (as measured by I2) of the magnitude of aORs between centres was quite high except for breast feeding: 73.1% for colds; 66.9% for nursery school; 52.6% for additional siblings; and 18.1% for breast feeding. Latitude explained a considerable amount of that heterogeneity: 63.8% for colds; 52.8% for nursery school; 86.6% for additional siblings; and 100% for breast feeding, probably as a consequence of its low heterogeneity. The magnitude in which some risk/protective factors are associated to recurrent wheeze during the first year of life varies significantly with latitude. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Age-Related Effect of Viral-Induced Wheezing in Severe Prematurity

    Directory of Open Access Journals (Sweden)

    Geovanny F. Perez

    2016-10-01

    Full Text Available Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children. Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks, 12% in preterm (32–37 weeks and 21% in severely premature children (<32 weeks. The most common viruses identified were rhinovirus (RV; 60% and respiratory syncytial virus (RSV; 17%. Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to viral infections in children born severely premature is more specific for RV and RSV and persists during the first three years of age. Further studies are needed to elucidate the age-dependent molecular mechanisms that underlie why premature infants develop RV- and RSV-induced wheezing in early life.

  6. In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections: A meta-analysis of birth cohort studies.

    Science.gov (United States)

    Feng, Haixia; Xun, Pengcheng; Pike, Katharine; Wills, Andrew K; Chawes, Bo L; Bisgaard, Hans; Cai, Wei; Wan, Yanping; He, Ka

    2017-05-01

    Studies of the associations between in utero 25-hydroxyvitamin D (25[OH]D) exposure and risk of childhood asthma, wheeze, and respiratory tract infections are inconsistent and inconclusive. We sought to assess associations between 25(OH)D levels in cord blood or maternal venous blood and risk of offspring's asthma, wheeze, and respiratory tract infections. Data were derived from PubMed, Embase, Google Scholar, references from relevant articles, and de novo results from published studies until December 2015. A random-effects meta-analysis was conducted among 16 birth cohort studies. Comparing the highest with the lowest category of 25(OH)D levels, the pooled odds ratios were 0.84 (95% CI, 0.70-1.01; P = .064) for asthma, 0.77 (95% CI, 0.58-1.03; P = .083) for wheeze, and 0.85 (95% CI, 0.66-1.09; P = .187) for respiratory tract infections. The observed inverse association for wheeze was more pronounced and became statistically significant in the studies that measured 25(OH)D levels in cord blood (0.43; 95% CI, 0.29-0.62; P asthma and wheeze during childhood. These findings are in keeping with the results of 2 recently published randomized clinical trials of vitamin D supplementation during pregnancy. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Neonatal BCG vaccination has no effect on recurrent wheeze in the first year of life

    DEFF Research Database (Denmark)

    Thøstesen, Lisbeth Marianne; Stensballe, Lone Graff; Pihl, Gitte Thybo

    2017-01-01

    Background: Recurrent wheeze (RW) is frequent in childhood. Studies have suggested that BCG vaccination can have nonspecific effects, reducing general nontuberculosis morbidity, including respiratory tract infections and atopic diseases. The mechanisms behind these nonspecific effects of BCG...

  8. Differential effects of risk factors on infant wheeze and atopic dermatitis emphasize a different etiology

    DEFF Research Database (Denmark)

    Linneberg, Allan René; Simonsen, Jacob B; Petersen, Janne

    2005-01-01

    regression models. RESULTS: The following variables had significantly differential effects on infant wheezing and AD: parental hay fever, parental asthma, parental AD, sex, maternal age, maternal occupation, smoking during pregnancy, season of birth, birth weight, gestational age, head circumference, breast-feeding...

  9. Effect of Vitamin D3 Supplementation During Pregnancy on Risk of Persistent Wheeze in the Offspring: A Randomized Clinical Trial.

    Science.gov (United States)

    Chawes, Bo L; Bønnelykke, Klaus; Stokholm, Jakob; Vissing, Nadja H; Bjarnadóttir, Elín; Schoos, Ann-Marie M; Wolsk, Helene M; Pedersen, Tine Marie; Vinding, Rebecca K; Thorsteinsdóttir, Sunna; Arianto, Lambang; Hallas, Henrik W; Heickendorff, Lene; Brix, Susanne; Rasmussen, Morten A; Bisgaard, Hans

    2016-01-26

    Observational studies have suggested that increased dietary vitamin D intake during pregnancy may protect against wheezing in the offspring, but the preventive effect of vitamin D supplementation to pregnant women is unknown. To determine whether supplementation of vitamin D3 during the third trimester of pregnancy reduces the risk of persistent wheeze in the offspring. A double-blind, single-center, randomized clinical trial conducted within the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort. Enrollment began March 2009 with a goal of 708 participants, but due to delayed ethical approval, only 623 women were recruited at 24 weeks of pregnancy. Follow-up of the children (N = 581) was completed when the youngest child reached age 3 years in March 2014. Vitamin D3 (2400 IU/d; n = 315) or matching placebo tablets (n = 308) from pregnancy week 24 to 1 week postpartum. All women received 400 IU/d of vitamin D3 as part of usual pregnancy care. Age at onset of persistent wheeze in the first 3 years of life. Secondary outcomes included number of episodes of troublesome lung symptoms, asthma, respiratory tract infections, and neonatal airway immunology. Adverse events were assessed. Of the 581 children, persistent wheeze was diagnosed during the first 3 years of life in 47 children (16%) in the vitamin D3 group and 57 children (20%) in the control group. Vitamin D3 supplementation was not associated with the risk of persistent wheeze, but the number of episodes of troublesome lung symptoms was reduced, and the airway immune profile was up-regulated (principal component analysis, P = .04). There was no effect on additional end points. Intrauterine death was observed in 1 fetus (vitamin D3 group vs 3 fetuses (1%) in the control group and congenital malformations in 17 neonates (5%) in the vitamin D3 group vs 23 neonates (8%) in the control group. [table: see text]. The use of 2800 IU/d of vitamin D3 during the third trimester of pregnancy

  10. Cromolyn Oral Inhalation

    Science.gov (United States)

    ... your doctor.Cromolyn oral inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Your doctor will prescribe ...

  11. Ciclesonide Oral Inhalation

    Science.gov (United States)

    ... use ciclesonide inhalation.Ciclesonide inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use ciclesonide ...

  12. Budesonide Oral Inhalation

    Science.gov (United States)

    ... if they get worse.Budesonide helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Your doctor will prescribe ...

  13. Beclomethasone Oral Inhalation

    Science.gov (United States)

    ... if they get worse.Beclomethasone helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Your doctor will prescribe ...

  14. Fluticasone Oral Inhalation

    Science.gov (United States)

    ... begin to use fluticasone.Fluticasone helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use fluticasone ...

  15. Flunisolide Oral Inhalation

    Science.gov (United States)

    ... use flunisolide inhalation.Flunisolide inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use flunisolide ...

  16. Prevalência de asma em adolescentes na cidade de Fortaleza, CE Prevalence of asthma among adolescents in the city of Fortaleza, Brazil

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Gomes de Luna

    2009-11-01

    Full Text Available OBJETIVO: Avaliar a prevalência de asma em adolescentes (13-14 anos na cidade de Fortaleza, CE. MÉTODOS: Estudo transversal utilizando o questionário do International Study of Asthma and Allergies in Childhood e envolvendo 3.015 adolescentes de escolas públicas e privadas entre 2006 e 2007. RESULTADOS: As prevalências de "sibilos alguma vez na vida", "sibilos nos últimos doze meses" (asma ativa e "asma alguma vez na vida" (asma diagnosticada foram, respectivamente, 44,1%, 22,6% e 11,6%. As prevalências de "sibilos alguma vez na vida" (p = 0,001, "1-3 crises de sibilos nos últimos 12 meses" (p = 0,001; asma ativa (p = 0,002; "sono interrompido por sibilos menos que uma vez por semana" (p OBJECTIVE: To determine the prevalence of asthma among adolescents (13-14 years of age in the city of Fortaleza, Brazil. METHODS: This was a cross-sectional study involving 3,015 adolescents at public and private schools between 2006 and 2007. The participants completed the International Study of Asthma and Allergies in Childhood questionnaire. RESULTS: The prevalences of "wheezing ever", "wheezing within the last 12 months" (active asthma and "asthma ever" (physician-diagnosed asthma were 44.1%, 22.6% and 11.6%, respectively. The prevalences of "wheezing ever" (p = 0.001, "1-3 wheezing attacks within the last 12 months" (p = 0.001, active asthma (p = 0.002, "sleep disturbed due to wheezing less than one night per week" (p < 0.001 and "dry cough at night" (p < 0.001 were higher among girls. Private school students presented higher prevalences of "wheezing ever", active asthma, "1-3 wheezing attacks within the last 12 months", "4-12 wheezing attacks within the last 12 months" and physician-diagnosed asthma (p < 0.001 for all, as well as of "exercise-induced wheezing" (p = 0.032. CONCLUSIONS: The prevalence of asthma and asthma-related symptoms in students aged 13-14 years in the city of Fortaleza, Brazil, was high, predominantly among girls and private

  17. Prevalence and risk factors for wheezing and allergic diseases in preschool children: A perspective from the Mediterranean coast of Turkey.

    Science.gov (United States)

    Bolat, E; Arikoglu, T; Sungur, M A; Batmaz, S B; Kuyucu, S

    The aim of the present study was to determine the prevalence and risk factors of allergic diseases in preschool children from one of the biggest cities in the Mediterranean Region of Turkey. The study population included 396 preschool children attending to urban daycare centres in Mersin. In the first stage, a comprehensive standardised questionnaire modified from the International Study of Asthma and Allergies in Childhood (ISAAC) was employed. In the second stage, serum food and inhalant specific IgE, and skin tests were performed in 45 children with frequent wheezing and 28 children with no wheezing. The prevalence of ever wheezing, current wheezing, physician-diagnosed asthma, allergic rhinitis and eczema were 53% (210), 33.3% (132), 27.3% (108), 13.4% (53) and 8.3% (33), respectively. A family history of atopy (OR=2.5, 95% CI: 1.3-4.7, p=0.004), dampness at home (OR=2.4, 95% CI: 1.2-4.8, p=0.008), a history of intestinal parasites (OR=4.3, 95% CI: 1.7-10.9, p=0.002), previous history of pneumonia (OR=6.9, 95% CI: 1.9-25.9, p=0.004), initiation of complementary foods before the age of three months (OR=6.1, 95%CI: 1.4-26.9, p=0.02) and presence of food allergy (OR=3.1, 95% CI: 1.1-9.2, p=0.03) were found to be significant risk factors for physician-diagnosed asthma. The risk factors for frequent wheezing were maternal smoking during pregnancy (OR=5.2, 95% CI: 0.9-28.7, p=0.05) and high serum IgE levels (OR=2.9, 95% CI: 0.9-9.0, p=0.05) at borderline significance. Our study was the first epidemiological study in preschool children in the Mediterranean region of Turkey and demonstrated a high prevalence of asthma and allergic diseases, probably related to humid climatic properties in addition to other environmental and genetic factors. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  18. Inhaled budesonide for treatment of recurrent wheezing in early childhood

    DEFF Research Database (Denmark)

    Bisgaard, H; Munck, Susanne; Nielsen, J P

    1990-01-01

    77 children, aged 11 to 36 months (mean 24) with moderately severe recurrent wheezing, were treated with budesonide pressurised aerosol 400 micrograms twice daily or placebo for 12 weeks in a double-blind, parallel-group trial. Aerosols were inhaled from a spacer with a facemask. Budesonide...... be ascribed to the active treatment. The findings indicate that young children below 3 years of age can inhale a pressurised aerosol from a spacer with a facemask. Use of topically active glucocorticosteroids with this simple device may reduce symptoms and distress in young children with moderately severe...

  19. Increased wheeze but not bronchial hyperreactivity near power stations.

    Science.gov (United States)

    Halliday, J A; Henry, R L; Hankin, R G; Hensley, M J

    1993-08-01

    In a previous study a higher than expected prevalence of asthma was found in Lake Munmorah, a coastal town near two power stations, compared with another coastal control town. This study aimed to compare atopy, bronchial hyperreactivity, and reported symptoms of asthma in the power station town and a second control area with greater socioeconomic similarity. A cross sectional survey was undertaken. Lake Munmorah, a coastal town near two power stations, and Dungog, a country town in the Hunter Valley, NSW, Australia. All children attending kindergarten to year 6 at all schools in the two towns were invited to participate in 1990. The response rates for the questionnaire for reported symptoms and associated demographic data were 92% in Lake Munmorah and 93% in Dungog, with 84% and 90% of children respectively being measured for lung function, atopy, and bronchial reactivity. There were 419 boys and 432 girls aged 5 to 12 years. Main outcome measures were current wheeze and bronchial hyper-reactivity, defined as a fall in forced expiratory volume in 1 second (FEV1) or peak expiratory flow (PEF) of 20% or more. Current wheeze was reported in 24.8% of the Lake Munmorah children compared with 14.6% of the Dungog children. Bronchial hyper-reactivity was similar for both groups--25.2% in Lake Munmorah and 22.3% in Dungog. The mean baseline FEV1 was lower in Lake Munmorah than in Dungog (p power station town, but bronchial hyper-reactivity and skin test defined atopy were similar in the two communities. These results are consistent with the previous study and confirm the increased presence of reported symptomatic illness in the town near power stations.

  20. Childhood exposure to infection and risk of adult onset wheeze and atopy

    OpenAIRE

    Bodner, C; Anderson, W; Reid, T; Godden, D

    2000-01-01

    BACKGROUND—The prevalence of asthma and allergic diseases in children and young adults is inversely associated with family size. It has been suggested that more frequent exposure to infections in a large family group, particularly those spread by the faecal-oral route, may protect against atopic diseases, although not all published data support this hypothesis. Whether similar considerations apply to adult onset wheeze is unknown. The relationship between adult onset whee...

  1. [Respiratory viral infections in a cohort of children during the first year of life and their role in the development of wheezing].

    Science.gov (United States)

    Calvo, Cristina; Aguado, Isabel; García-García, María Luz; Ruiz-Chercoles, Esther; Díaz-Martinez, Eloisa; Albañil, Rosa María; Campelo, Olga; Olivas, Antonio; Muñóz-Gonzalez, Luisa; Pozo, Francisco; Fernandez-Arroyo, Rosa; Fernandez-Rincón, Adelaida; Calderon, Ana; Casas, Inmaculada

    2017-08-01

    It is known that infants with viral respiratory infections severe enough to require hospital admission have a high risk of developing recurrent wheezing. Few data have been published on unselected populations. The main aim of this study was to analyse symptomatic and asymptomatic respiratory viral infections during the first year of life in a cohort of infants, recruited at birth, and the development of recurrent wheezing. A total of 302 newborns were recruited. A nasopharyngeal aspirate was taken when the patients had a respiratory infection, as well as in the visits for vaccination at 2, 4, 6, and 12 months. RT-nested PCR assays were performed to detect 16 viruses. A total of 1,293 samples were analysed (1,005 healthy controls and 288 respiratory infections). Samples taken during routine check-ups were positive in 30.8% of cases, while those with respiratory infection were positive in 77.8%, P<.001 (OR: 3, 95% CI: 2.4-3.8). A total of 239 (79%) infants had at least 1 positive respiratory viral infection detected. The most frequent virus (71%) was rhinovirus (RV). Recurrent wheezing was found in 27 (11%) children during their first year of life (1.2 episodes, SD 2.9). Recurrent wheezing was present in 58.3% of patients admitted to hospital during their first viral infection, vs. 8.6% of infants when the first infection was mild or who had asymptomatic viral detection, P<.001 (OR: 2.18; 95% CI: 1.05-4.5). In our series, severe respiratory infections leading to hospitalisation in the first months of life are risk factors for developing wheezing, but not in the case of mild RV infections. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Zileuton

    Science.gov (United States)

    ... asthma. Zileuton is not used to treat an asthma attack (sudden episode of shortness of breath, wheezing, and ... Do not use zileuton to treat a sudden asthma attack. Your doctor will prescribe a short-acting inhaler ...

  3. Omalizumab Injection

    Science.gov (United States)

    ... injection is used to decrease the number of asthma attacks (sudden episodes of wheezing, shortness of breath, and ... about how to treat symptoms of a sudden asthma attack. If your asthma symptoms get worse or if ...

  4. Mediterranean diet adherence during pregnancy and risk of wheeze and eczema in the first year of life: INMA (Spain) and RHEA (Greece) mother-child cohort studies.

    Science.gov (United States)

    Chatzi, Leda; Garcia, Raquel; Roumeliotaki, Theano; Basterrechea, Mikel; Begiristain, Haizea; Iñiguez, Carmen; Vioque, Jesus; Kogevinas, Manolis; Sunyer, Jordi

    2013-12-14

    Maternal diet during pregnancy might influence the development of childhood allergic disorders. The aim of the present study was to evaluate the impact of Mediterranean diet (MD) adherence during pregnancy on wheeze and eczema in the first year of life in two population-based mother-child cohorts in Spain and Greece. We studied 1771 mother-newborn pairs from the Spanish multi-centre 'INMA' (INfancia y Medio Ambiente) study (Gipuzkoa, Sabadell and Valencia) and 745 pairs from the 'RHEA' study in Crete, Greece. The symptoms of wheeze and eczema were based on the criteria of the International Study of Asthma and Allergies in Childhood. Maternal diet during pregnancy was assessed by FFQ and MD adherence was evaluated through an a priori score. Multivariate log-binomial regression models were used to adjust for several confounders in each cohort and summary estimates were obtained by a meta-analysis. MD adherence was not associated with the risk of wheeze and eczema in any cohort, and similar results were identified in the meta-analysis approach. High meat intake (relative risk (RR) 1·22, 95 % CI 1·00, 1·49) and 'processed' meat intake (RR 1·18, 95 % CI 1·02, 1·37) during pregnancy were associated with an increased risk of wheeze in the first year of life, while a high intake of dairy products was significantly associated with a decreased risk of infantile wheeze (RR 0·83, 95 % CI 0·72, 0·96). The results of the present study show that high meat intake during pregnancy may increase the risk of wheeze in the first year of life, while a high intake of dairy products may decrease it.

  5. Health effects of people living close to a petrochemical industrial estate in Thailand.

    Science.gov (United States)

    Kongtip, Pornpimol; Singkaew, Panawadee; Yoosook, Witaya; Chantanakul, Suttinun; Sujiratat, Dusit

    2013-12-01

    An acute health effect of people living near the petrochemical industrial estate in Thailand was assessed using a panel study design. The populations in communities near the petrochemical industrial estates were recruited. The daily air pollutant concentrations, daily percentage of respiratory and other health symptoms reported were collected for 63 days. The effect of air pollutants to reported symptoms of people were estimated by adjusted odds ratios and 95% confidence interval using binary logistic regression. The significant associations were found with the adjusted odds ratios of 38.01 for wheezing, 18.63 for shortness of breath, 4.30 for eye irritation and 3.58 for dizziness for total volatile organic compounds (Total VOCs). The adjusted odds ratio for carbon monoxide (CO2) was 7.71 for cough, 4.55 for eye irritation and 3.53 for weakness and the adjusted odds ratio for ozone (O3) was 1.02 for nose congestion, sore throat and 1.05 for phlegm. The results showed that the people living near petrochemical industrial estate had acute adverse health effects, shortness of breath, eye irritation, dizziness, cough, nose congestion, sore throat, phlegm and weakness from exposure to industrial air pollutants.

  6. Inalador dosimetrado com espaçador artesanal versus nebulizador no tratamento da crise de sibilância na criança Metered-dose inhaler with home-made spacer versus nebulizers to treat moderate wheezing attacks in children

    Directory of Open Access Journals (Sweden)

    Liana Consuelo Santana Vilarinho

    2003-10-01

    oximetria. A comparação dos parâmetros clínicos e de saturação de oxigênio, entre os grupos, não mostrou diferença significativa após as doses de salbutamol, havendo equivalência clínica entre doses diferentes (três vezes menor no grupo IDE, em relação ao grupo NEB; os tempos de preparo e administração da medicação e o custo do tratamento foram significativamente menores no grupo IDE. O grau de satisfação das famílias foi semelhante nos dois grupos. CONCLUSÃO: O inalador dosimetrado com espaçador artesanal pode ser utilizado na admini stração de salbutamol a crianças em crise de sibilância, com algumas vantagens em relação ao nebulizador.OBJECTIVE: To compare the effectiveness of salbutamol administration by metered-dose inhaler with a home-made spacer versus jet nebulizer in children with moderate wheezing attacks. MATERIAL AND METHODS: A randomized, single-blinded trial was performed with a convenience sample of children presenting wheezing. The children were enrolled in an emergency room and randomly assigned to one of two treatment groups: home-made spacer group or nebulizer group. Clinical scores and oxygen saturation were recorded at baseline and 15 minutes after salbutamol administration. Treatment with salbutamol (100 µg/3 kg in the spacer group, and 250 µg/3 kg in the nebulizer group was repeated at 20-minute intervals, until the child was considered to have improved significantly, with no need of any further dose, or until three doses were delivered. Treatment cost, time spent to prepare and deliver the drug, and level of parental satisfaction with the treatment were recorded. RESULTS: Fifty-four children with age between 22 days and 11.7 years were enrolled - 27 in each group. Baseline and demographic characteristics were similar for both groups. The spacer was as effective as the nebulizer in terms of clinical score and oxygen saturation. The different doses (100 µg/3 kg with the spacer, and 250 µg/3 kg with the nebulizer were

  7. Pulmonary Function Tests in Emergency Department Pediatric Patients with Acute Wheezing/Asthma Exacerbation

    Directory of Open Access Journals (Sweden)

    Kathryn Giordano

    2012-01-01

    Full Text Available Background. Pulmonary function tests (PFT have been developed to analyze tidal breathing in patients who are minimally cooperative due to age and respiratory status. This study used tidal breathing tests in the ED to measure asthma severity. Design/Method. A prospective pilot study in pediatric patients (3 to 18 yrs with asthma/wheezing was conducted in an ED setting using respiratory inductance plethysmography and pneumotachography. The main outcome measures were testing feasibility, compliance, and predictive value for admission versus discharge. Results. Forty patients were studied, of which, 14 (35% were admitted. Fifty-five percent of the patients were classified as a mild-intermittent asthmatic, 30% were mild-persistent asthmatics, 12.5% were moderate-persistent asthmatics, and 2.5% were severe-persistent. Heart rate was higher in admitted patients as was labored breathing index, phase angle, and asthma score. Conclusions. Tidal breathing tests provide feasible, objective assessment of patient status in the enrolled age group and may assist in the evaluation of acute asthma exacerbation in the ED. Our results demonstrate that PFT measurements, in addition to asthma scores, may be useful in indicating the severity of wheezing/asthma and the need for admission.

  8. Human Rhinovirus C Associated with Wheezing in Hospitalized Children in the Middle East

    Science.gov (United States)

    Miller, E. Kathryn; Khuri-Bulos, Najwa; Williams, John V.; Shehabi, Asem A.; Faouri, Samir; Jundi, Ihsan Al; Chen, Qingxia; Heil, Luke; Mohamed, Yassir; Morin, Laura-Lee; Ali, Asad; Halasa, Natasha B.

    2009-01-01

    Background Few studies have investigated the disease burden and genetic diversity of human rhinoviruses (HRV) in developing countries. Objectives To assess the burden of HRV in Amman, Jordan and to characterize clinical differences between HRV groups. Study Design We prospectively studied children <5 years old hospitalized with respiratory symptoms and/or fever in Amman, Jordan. Viruses were identified by real-time RT-PCR. VP4/VP2 gene sequencing was performed on HRV-positive specimens. Results Of 728 enrolled children, 266 (37%) tested positive for picornaviruses, 240 of which were HRV. Of the HRV-positive samples, 62 (26%) were of the recently identified group HRVC, 131 (55%) were HRVA, and 7 (3%) were HRVB. The HRVC strains clustered into at least 19 distinct genotypes. Compared with HRVA-infected children, children with HRVC were more likely to require supplemental oxygen (63% vs. 42%, p=0.007) and, when co-infections were excluded, were more likely to have wheezing (100% vs. 82%, p=0.016). Conclusions There is a significant burden of HRV-associated hospitalizations in young children in Jordan. Infection with the recently identified group HRVC is associated with wheezing and more severe illness. PMID:19581125

  9. The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children

    Directory of Open Access Journals (Sweden)

    Alcântara-Neves Neuza M

    2010-08-01

    Full Text Available Abstract Background The elucidation of factors that trigger the development of transient wheezing in early childhood may be an important step toward understanding the pathogenesis of asthma and other allergic diseases later in life. Transient wheezing has been mainly attributed to viral infections, although sensitisation to aeroallergens and food allergens may occur at an early age. In developing countries, intestinal helminthic infections have also been associated with allergy or atopy-related disorders. Objective The aim of this study was to explore the association of Trichuris trichiura and Ascaris lumbricoides infections with wheezing and atopy in early childhood. Study design A cross-sectional study using a Portuguese-language ISAAC phase I questionnaire, adapted for preschool-aged children, nested in a cohort study of childhood diarrhoea, was conducted on 682 children. Two faecal samples per child were examined for the presence of intestinal helminthic infection. IgE antibodies against three allergenic preparations (Dermatophagoides pteronyssinus, Blomia tropicalis and common child food, as well as against A. lumbricoides antigens, were measured in a sub-sample of these children, whose parents allowed the procedure. Atopy was defined by the presence of levels of serum IgE antibodies ≥0.35 kU/L against at least one of the three tested allergenic preparations. Results Active T. trichiura infection but not A. lumbricoides infection was positively associated with wheezing in the total studied children population [adjusted OR = 2.60; CI = 1.54;4.38] and in the atopic children sub-population [adjusted OR = 3.07; CI = 1.00;9.43]. The association with atopy was also positive and statistically significant only in the brute analysis [OR = 2.13; CI = 1.03;4.40]. Anti-A. lumbricoides IgE antibodies, but not current A. lumbricoides infection, were positively associated with wheezing in atopic children [adjusted OR = 2.01; CI = 1.00;4.50] and in non

  10. SAJCH 598.indd

    African Journals Online (AJOL)

    that 16.3% had experienced attacks of shortness of breath with wheeze during the last 12 months, and that 10% had ever been diagnosed with asthma.[15]. The ISAAC-based prevalences show wide variation between countries in Africa, prevalences of wheeze symptoms ranging from 4.0% to 21.5%.[7] Our rates of 14.8% ...

  11. Vitamin D supplementation in pregnancy, prenatal 25(OH)D levels, race, and subsequent asthma or recurrent wheeze in offspring: Secondary analyses from the Vitamin D Antenatal Asthma Reduction Trial.

    Science.gov (United States)

    Wolsk, Helene M; Harshfield, Benjamin J; Laranjo, Nancy; Carey, Vincent J; O'Connor, George; Sandel, Megan; Strunk, Robert C; Bacharier, Leonard B; Zeiger, Robert S; Schatz, Michael; Hollis, Bruce W; Weiss, Scott T; Litonjua, Augusto A

    2017-11-01

    Nutrient trials differ from drug trials because participants have varying circulating levels at entry into the trial. We sought to study the effect of a vitamin D intervention in pregnancy between subjects of different races and the association between 25-hydroxyvitamin D 3 (25[OH]D) levels in pregnancy and the risk of asthma/recurrent wheeze in offspring. The Vitamin D Antenatal Asthma Reduction Trial is a randomized trial of pregnant women at risk of having children with asthma randomized to 4400 international units/d vitamin D or placebo plus 400 international units/d vitamin D. Asthma and recurrent wheezing until age 3 years were recorded. African American (AA) women (n = 312) had lower initial levels of 25(OH)D (mean [SD], 17.6 ng/mL [8.3 ng/mL]) compared with non-AA women (n = 400; 27.1 ng/mL [9.7 ng/mL], P asthma/recurrent wheezing in offspring (P for interaction = .77). Having an initial level of greater than 30 ng/mL and being randomized to the intervention group was associated with the lowest risk for asthma/recurrent wheeze by age 3 years compared with having an initial level of less than 20 ng/mL and receiving placebo (adjusted odds ratio, 0.42; 95% CI, 0.19-0.91). We did not find differences between AA and non-AA mothers in the effect of maternal vitamin D supplementation and asthma/recurrent wheeze in offspring at 3 years. Maternal supplementation of vitamin D, particularly in mothers with initial 25(OH)D levels of greater than 30 ng/mL, reduced asthma/recurrent wheeze in the offspring through age 3 years, suggesting that higher vitamin D status beginning in early pregnancy is necessary for asthma/recurrent wheeze prevention in early life. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  12. Maternal employment in child-care institutions and the risk of infant wheeze and atopic dermatitis in the offspring

    DEFF Research Database (Denmark)

    Hersoug, L.G.; Benn, C.S.; Simonsen, J.B.

    2008-01-01

    in the Danish National Birth Cohort were followed prospectively. Information on wheezing episodes, AD, maternal employment, and other variables were collected by interview at 12 and 30 wk of gestation, and 6 and 18 months of age, and by linkage to the Danish Medical Birth Register and the Child-care Database......% CI: 1.05-1.77), and 1.03 (95% CI: 0.81-1.31), respectively, for first-born infants of mothers employed in child-care institutions compared with infants of mothers not so employed. There was no effect of maternal employment in child-care institutions among infants with older siblings. In conclusion......, the results did not support the hypothesis that maternal microbial exposure before or during pregnancy as reflected by maternal employment in child-care institutions protects the offspring against infant wheeze and AD....

  13. Risk factors for X-ray pneumonia in the first year of life and its relation to wheezing: a longitudinal study in a socioeconomic disadvantaged population.

    Science.gov (United States)

    Castro-Rodriguez, J A; Mallol, J; Rodriguez, J; Auger, F; Andrade, R

    2008-01-01

    Although thousands of infants under the age of 12 months die each year from pneumonia in Latin America, little is known regarding the true occurrence of pneumonia, wheezing and other related respiratory illnesses in this age group. In order to describe the prevalence and risk factors for radiologically confirmed pneumonia during the first year of life, a birth-cohort (n = 188) of infants born in a low-income area in Santiago, Chile was followed up monthly. The prevalence of pneumonia during the first year of life was 13.3 % and there were no fatal events. Exclusive breastfeeding during the first 4 months of life was more prevalent in the non pneumonia group; conversely, wheezing episodes during 0-3 and 3-6 months of age, and hospitalization due to lower respiratory infection during 3-6 and 9-12 months of age were more prevalent in the pneumonia group. After a logistic multivariate analysis, the only risk factor that remained related with pneumonia was wheezing during the first 3 months of life (adjusted OR: 7.7, 95 CI: 1.32-44.92, p = 0.024); while breastfeeding during the first 4 months was an independent protective factor for pneumonia (adjusted OR: 0.11, 95 CI: 0.03-0.44, p = 0.002). The significant protective effect of exclusive breast feeding against pneumonia in this cohort and the evident role of recurrent wheezing as risk factor for pneumonia during the first year of life support the implementation or reinforcement of public policies encouraging exclusive breastfeeding and an adequate management of wheezing since the first months of life.

  14. Cord serum 25-hydroxyvitamin D and risk of early childhood transient wheezing and atopic dermatitis.

    Science.gov (United States)

    Baïz, Nour; Dargent-Molina, Patricia; Wark, John D; Souberbielle, Jean-Claude; Annesi-Maesano, Isabella

    2014-01-01

    There is increasing evidence of the effect of maternal vitamin D intake during pregnancy on the risk of asthma and allergic outcomes in offspring. However, studies on the relationship between cord levels of 25-hydroxyvitamin D (25[OH]D) and asthma and allergic diseases are very few. Our aim was to investigate the associations between cord serum 25(OH)D levels and asthma, wheezing, allergic rhinitis, and atopic dermatitis in the offspring from birth to 5 years. Cord blood samples were collected at birth and analyzed for 25(OH)D levels in 239 newborns from the Etude des Déterminants pré et post natals du développement et de la santé de l'Enfant (EDEN) birth cohort. The children were followed up until age 5 years by using International Study of Asthma and Allergies in Childhood-based symptom questionnaires. The median cord serum level of 25(OH)D was 17.8 ng/mL (interquartile range, 15.1 ng/mL). By using multivariable-adjusted logistic regression models, a significant inverse association was observed between cord serum 25(OH)D levels and risk of transient early wheezing and early- and late-onset atopic dermatitis, as well as atopic dermatitis, by the ages of 1, 2, 3, and 5 years. We found no association between cord serum 25(OH)D levels and asthma and allergic rhinitis at age 5 years. Cord serum 25(OH)D levels were inversely associated with the risk of transient early wheezing and atopic dermatitis by the age of 5 years, but no association was found with asthma and allergic rhinitis. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  15. Toxocara seropositivity, atopy and wheezing in children living in poor neighbourhoods in urban Latin American.

    Directory of Open Access Journals (Sweden)

    Lívia Ribeiro Mendonça

    Full Text Available Toxocara canis and T. cati are parasites of dogs and cats, respectively, that infect humans and cause human toxocariasis. Infection may cause asthma-like symptoms but is often asymptomatic and is associated with a marked eosinophilia. Previous epidemiological studies indicate that T. canis infection may be associated with the development of atopy and asthma.To investigate possible associations between Toxocara spp. seropositivity and atopy and childhood wheezing in a population of children living in non-affluent areas of a large Latin American city.The study was conducted in the city of Salvador, Brazil. Data on wheezing symptoms were collected by questionnaire, and atopy was measured by the presence of aeroallergen-specific IgE (sIgE. Skin prick test (SPT, total IgE and peripheral eosinophilia were measured. Toxocara seropositivity was determined by the presence of anti-Toxocara IgG antibodies, and intestinal helminth infections were determined by stool microscopy.Children aged 4 to 11 years were studied, of whom 47% were seropositive for anti-Toxocara IgG; eosinophilia >4% occurred in 74.2% and >10% in 25.4%; 59.6% had elevated levels of total IgE; 36.8% had sIgE≥0.70 kU/L and 30.4% had SPT for at least one aeroallergen; 22.4% had current wheezing symptoms. Anti-Toxocara IgG was positively associated with elevated eosinophils counts, total IgE and the presence of specific IgE to aeroallergens but was inversely associated with skin prick test reactivity.The prevalence of Toxocara seropositivity was high in the studied population of children living in conditions of poverty in urban Brazil. Toxocara infection, although associated with total IgE, sIgE and eosinophilia, may prevent the development of skin hypersensitivity to aeroallergens, possibly through increased polyclonal IgE and the induction of a modified Th2 immune reaction.

  16. Pre-natal exposure to paracetamol and risk of wheezing and asthma in children: A birth cohort study

    DEFF Research Database (Denmark)

    Rebordosa, Cristina; Kogevinas, Manolis; Sørensen, Henrik T

    2008-01-01

    BACKGROUND: Paracetamol use has been associated with increased prevalence of asthma in children and adults, and one study reported an association between pre-natal exposure to paracetamol and asthma in early childhood. METHODS: To examine if pre-natal exposure to paracetamol is associated...... with the risk of asthma or wheezing in early childhood, we selected 66 445 women from the Danish National Birth Cohort for whom we had information on paracetamol use during pregnancy and who participated in an interview when their children were 18-months-old and 12 733 women whose children had reached the age...... of 7 and estimated the prevalence of physician-diagnosed asthma and wheezing at the ages of 18 months and 7 years. We also linked our population to the Danish National Hospital Registry to record all hospitalizations due to asthma up to age of 18 months. RESULTS: Paracetamol use during any time...

  17. System-Level Power Consumption Analysis of the Wearable Asthmatic Wheeze Quantification

    Directory of Open Access Journals (Sweden)

    Dinko Oletic

    2018-01-01

    Full Text Available Long-term quantification of asthmatic wheezing envisions an m-Health sensor system consisting of a smartphone and a body-worn wireless acoustic sensor. As both devices are power constrained, the main criterion guiding the system design comes down to minimization of power consumption, while retaining sufficient respiratory sound classification accuracy (i.e., wheeze detection. Crucial for assessment of the system-level power consumption is the understanding of trade-off between power cost of computationally intensive local processing and communication. Therefore, we analyze power requirements of signal acquisition, processing, and communication in three typical operating scenarios: (1 streaming of uncompressed respiratory signal to a smartphone for classification, (2 signal streaming utilizing compressive sensing (CS for reduction of data rate, and (3 respiratory sound classification onboard the wearable sensor. Study shows that the third scenario featuring the lowest communication cost enables the lowest total sensor system power consumption ranging from 328 to 428 μW. In such scenario, 32-bit ARM Cortex M3/M4 cores typically embedded within Bluetooth 4 SoC modules feature the optimal trade-off between onboard classification performance and consumption. On the other hand, study confirms that CS enables the most power-efficient design of the wearable sensor (216 to 357 μW in the compressed signal streaming, the second scenario. In such case, a single low-power ARM Cortex-A53 core is sufficient for simultaneous real-time CS reconstruction and classification on the smartphone, while keeping the total system power within budget for uncompressed streaming.

  18. Large observer variation of clinical assessment of dyspnoeic wheezing children.

    Science.gov (United States)

    Bekhof, Jolita; Reimink, Roelien; Bartels, Ine-Marije; Eggink, Hendriekje; Brand, Paul L P

    2015-07-01

    In children with acute dyspnoea, the assessment of severity of dyspnoea and response to treatment is often performed by different professionals, implying that knowledge of the interobserver variation of this clinical assessment is important. To determine intraobserver and interobserver variation in clinical assessment of children with dyspnoea. From September 2009 to September 2010, we recorded a convenience sample of 27 acutely wheezing children (aged 3 months-7 years) in the emergency department of a general teaching hospital in the Netherlands, on video before and after treatment with inhaled bronchodilators. These video recordings were independently assessed by nine observers scoring wheeze, prolonged expiratory phase, retractions, nasal flaring and a general assessment of dyspnoea on a Likert scale (0-10). Assessment was repeated after 2 weeks to evaluate intraobserver variation. We analysed 972 observations. Intraobserver reliability was the highest for supraclavicular retractions (κ 0.84) and moderate-to-substantial for other items (κ 0.49-0.65). Interobserver reliability was considerably worse, with κ3 points) was larger than the minimal important change (meaning that in 69% of observations a clinically important change after treatment cannot be distinguished from measurement error. Intraobserver variation is modest, and interobserver variation is large for most clinical findings in children with dyspnoea. The measurement error induced by this variation is too large to distinguish potentially clinically relevant changes in dyspnoea after treatment in two-thirds of observations. The poor interobserver reliability of clinical dyspnoea assessment in children limits its usefulness in clinical practice and research, and highlights the need to use more objective measurements in these patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. [Retrospective analysis of risk factors in 900 patients with ischemic cerebral stroke of wind-phlegm collateral obstruction syndrome and qi deficiency blood stasis syndrome in Wuhan District].

    Science.gov (United States)

    Qiu, Xin; Wang, Kai-xin; Chen, Guo-hua

    2011-11-01

    To analyze the correlation between risk factors and ischemic cerebral stroke of wind-phlegm collateral obstruction syndrome and qi deficiency blood stasis syndrome. Totally 900 patients of the two syndrome types were recruited. Risk factors correlated to ischemic cerebral stroke such as gender, age, time of onset, site of infarction, tongue proper, tongue fur, pulse picture, hypertension, diabetes, past stroke history, hyperlipidemia, hematocrit, smoking, drinking, genetic factor, blood type, complications were analyzed using Chi-square test and non-conditional Logistic regression analysis. Statistical significance existed between the two syndrome types in age (X2 = 8.2392, P = 0.0413), hyperlipidemia (X2 = 4.8386, P = 0.0278), tongue proper (X2 = 7.9470, P = 0.0048), and tongue fur (X2 = 4.3298, P = 0.0375). Statistical significance existed between the two syndrome types in hyperlipidemia, tongue proper, and tongue fur, and their OR value was 0.699 (P = 0.0282), 0.332 (P =0.0071), and 0.667 (P = 0.0382) respectively. The OR value of the past stroke history was 3.226 (P = 0.0314), that of complications 0.203 (P = 0.0705), and that of anterior circulation infarction 0.214 (P = 0.0098). Among different ages groups, the constituent ratio of qi deficiency blood stasis syndrome was obviously higher than that of wind-phlegm collateral obstruction syndrome. Besides, patients of qi deficiency blood stasis syndrome were liable to suffer from hyperlipidemia, anterior circulation infarction, and complications. The age, blood lipid levels, site of infarction, complications are closely correlated with Chinese syndrome types of ischemic cerebral stroke, which can provide objective indices for typing ischemic cerebral stroke.

  20. [Acupuncture and Chinese medicine of artificial cycle therapy for insulin resistance of polycystic ovary syndrome with phlegm damp type and its mechanism].

    Science.gov (United States)

    Yang, Juan; Liu, Ying; Huang, Jian; Xu, Jinbang; You, Xiumi; Lin, Qiuping; Zhang, Junxin; Dun, Jingjing; Huang, Shan

    2017-11-12

    To explore the effect difference between acupuncture combined with Chinese medicine of artificial cycle therapy on the basis of western medication and simple western medication for polycystic ovarian syndrome (PCOS) of phlegm damp type with insulin resistance, and to explore its mechanism. Sixty patients were randomly assigned into an observation group and a control group, 30 cases in each group. Patients of the control group began to take letrozole and metformin orally on the third menstrual day. Patients of the observation group were treated with acupuncture combined with Chinese medicine of artificial cycle therapy on the basis of the treatment of the control group. The main acupoints were Guanyuan (CV 4), Qihai (CV 6) and bilateral Zigong (EX-CA 1), Luanchao (Extra), Fenglong (ST 40), Yinlingquan (SP 9), Zusanli (ST 36), Sanyinjiao (SP 6). Dahe (KI 12) was matched in the follicular phase, and warm acupuncture was applied at Guanyuan (CV 4) and Qihai (CV 6); Zhongji (CV 3) and Xuehai (SP 10) were matched in the ovulatory phase, and electroacupuncture were used at Qihai (CV 6) and Zhongji (CV 3), Xuehai (SP 10) and Yinlingquan (SP 9), 2 Hz and continuous wave; The acupoints in the luteal phase were the above main acupoints, at the same time, moxibustion was used at Guanyuan (CV 4) and Qihai (CV 6), the treatment was given once every other day, 30 min a time. There was no treatment in the menstrual phase. Chinese medicine was applied for tonifying kidney and nourishing blood, strengthening spleen and eliminating phlegm. The patients of the two groups were treated for continuous three menstrual cycles. The indexes before and after treatment were detected, including serum microRNA-29 (miR-29) expression, TCM symptom score, insulin (INS), blood-sugar content and homeostasis model assessment-insulin resistance (HOMA-IR) index, the endocrine hormone values of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), LH/FSH ratio, prolactin (PRL

  1. Prevalence of bronchial asthma among school-going children in Mangalore, South India

    Directory of Open Access Journals (Sweden)

    Sowmini P Kamath

    2017-03-01

    Full Text Available Background: Asthma in childhood is a major public health issue. Objective: To estimate prevalence and associated housing environment factors of asthma among school children. Material & Methods: We conducted a cross sectional study among school children aged six to fifteen years. Standard ISAAC (International Study of Asthma and Allergies in Children Core Questionnaire for Asthma was used for determining the prevalence of wheezing and asthma. Demographic, housing and indoor pollution factors were collected. Data were analyzed by SPSS version 15. Results: Prevalence of ‘wheeze ever’ and ‘current wheezers’ was 10% and 9% respectively.  Physician diagnosed asthma was seen in 6.3 %. Severe asthma was noted in 28.6% of current wheezerswith 84.6% and 8.8% having one to two and four to 12 wheezing attacks per year respectively. Wheezing was present post exercise in 5.4%, nocturnal cough in 6.1%, sleep disturbance less than one night/week (40.7%, one or more nights/week (3.3% and wheezing limiting speech to few words between breaths (20.9%. Prevalence was greater among boys (9.8% than girls (7.5% and maximal in age group eight to nine years. On multiple logistic regression presence of overcrowding and absence of smoke outlet were significantly associated with current wheeze. Socio-economic status, beedi rolling practices and absence of separate kitchen was statistically significant with severe asthma. Conclusions: Current wheezer prevalence was9% and more in boys. Adoption of improved housing conditions and avoiding environmental tobacco exposure may aid in reducing childhood asthma attacks in this developing city.

  2. Calculating Adversarial Risk from Attack Trees: Control Strength and Probabilistic Attackers

    NARCIS (Netherlands)

    Pieters, Wolter; Davarynejad, Mohsen

    2015-01-01

    Attack trees are a well-known formalism for quantitative analysis of cyber attacks consisting of multiple steps and alternative paths. It is possible to derive properties of the overall attacks from properties of individual steps, such as cost for the attacker and probability of success. However, in

  3. The relationship of serum triglycerides, serum HDL, and obesity to the risk of wheezing in 85,555 adults

    DEFF Research Database (Denmark)

    Fenger, R V; Gonzalez-Quintela, A; Linneberg, A

    2013-01-01

    Asthma has been linked to obesity and the presence of the metabolic syndrome. Objective: To explore which components of the metabolic syndrome that were associated with wheezing, a main symptom of asthma. Further, to explore whether these associations were different in individuals with and withou...

  4. Bluetooth security attacks comparative analysis, attacks, and countermeasures

    CERN Document Server

    Haataja, Keijo; Pasanen, Sanna; Toivanen, Pekka

    2013-01-01

    This overview of Bluetooth security examines network vulnerabilities and offers a comparative analysis of recent security attacks. It also examines related countermeasures and proposes a novel attack that works against all existing Bluetooth versions.

  5. The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life.

    NARCIS (Netherlands)

    Casas, L.; Zock, J.P.; Carsin, A.E.; Fernández-Somoano, A.; Esplugues, A.; Santa-Marina, L.; Tardón, A.; Ballester, F.; Basterrechea, M.; Sunyer, J.

    2013-01-01

    To evaluate the effects of household use of cleaning products during pregnancy on infant wheezing and lower respiratory tract infections (LRTI). In four prospective Spanish birth cohorts (n = 2,292), pregnant women reported the use of household cleaning products. When infants were 12-18 months old,

  6. How to match the optimal currently available inhaler device to an individual child with asthma or recurrent wheeze

    NARCIS (Netherlands)

    van Aalderen, Wim M.; Garcia-Marcos, Luis; Gappa, Monika; Lenney, Warren; Pedersen, Søren; Dekhuijzen, Richard; Price, David

    2015-01-01

    Inhaled medications are the cornerstone of treatment in early childhood wheezing and paediatric asthma. A match between patient and device and a correct inhalation technique are crucial for good asthma control. The aim of this paper is to propose an inhaler strategy that will facilitate an inhaler

  7. Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza, Brazil: temporal changes.

    Science.gov (United States)

    Luna, Maria de Fátima Gomes de; Fischer, Gilberto Bueno; Luna, João Rafael Gomes de; Silva, Marcelo Gurgel Carlos da; Almeida, Paulo César de; Chiesa, Daniela

    2013-01-01

    To describe the prevalences of asthma and rhinitis in adolescents (13-14 years of age) in the city of Fortaleza, Brazil, in 2010, comparing the results with those obtained in a prevalence survey conducted in 2006-2007. This was a cross-sectional study involving probabilistic samples of 3,015 and 3,020 adolescents in surveys conducted in 2006-2007 and 2010, respectively. The International Study of Asthma and Allergies in Childhood protocol was used on both occasions. Comparing the two periods, there were no significant differences regarding cumulative wheezing, active asthma, four or more wheezing attacks within the last year, sleep disturbed by wheezing more than one night per week, and speech-limiting wheezing. The prevalences of exercise-induced wheezing, dry cough at night, and physician-diagnosed asthma were significantly higher in 2010 than in the 2006-2007 period (p school students than in public school students (p school students.

  8. All that wheezes is not asthma: a 6-year-old with foreign body aspiration and no suggestive history.

    Science.gov (United States)

    Maguire, Amy; Gopalakaje, Saikiran; Eastham, Katherine

    2012-12-12

    The authors report the case of a 6-year-old girl, presenting with a 4-month history of wheeze associated with barking cough which frequently became wet requiring antibiotics. Her care was transferred to a paediatrician with specialist interest in paediatric respiratory medicine when she had continued symptoms despite bronchodilators and oral steroids for suspected asthma. Spirometry showed a forced expiratory volume 1 of 79% with no evidence of reversibility. The child was investigated for chronic wet cough. Immunoglobulins, sweat test and chest x-ray were all normal. There was no history suggestive of foreign body aspiration (FBA). Tracheomalacia was considered in view of the nature of the cough. The recurrence of an unusual inspiratory noise prompted referral for bronchoscopy. A small piece of plastic tube was removed from the bronchus intermedius. All symptoms resolved. The importance of clinical assessment to ascertain 'wheeze' when acutely unwell is emphasised. Current literature concerning FBA is reviewed.

  9. Diagnostic Accuracy of Chinese Medicine Diagnosis Scale of Phlegm and Blood Stasis Syndrome in Coronary Heart Disease: A Study Protocol.

    Science.gov (United States)

    Liu, Xiao-Qi; Peng, Dan-Hong; Wang, Yan-Ping; Xie, Rong; Chen, Xin-Lin; Yu, Chun-Quan; Li, Xian-Tao

    2018-05-03

    Phlegm and blood stasis syndrome (PBSS) is one of the main syndromes in coronary heart disease (CHD). Syndromes of Chinese medicine (CM) are lack of quantitative and easyimplementation diagnosis standards. To quantify and standardize the diagnosis of PBSS, scales are usually applied. To evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. Six hundred patients with stable angina pectoris of CHD, 300 in case group and 300 in control group, will be recruited from 5 hospitals across China. Diagnosis from 2 experts will be considered as the "gold standard". The study design consists of 2 phases: pilot test is used to evaluate the reliability and validity, and diagnostic test is used to assess the diagnostic accuracy of the scale, including sensitivity, specififi city, likelihood ratio and area under the receiver operator characteristic (ROC) curve. This study will evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. The consensus of 2 experts may not be ideal as a "gold standard", and itself still requires further study. (No. ChiCTR-OOC-15006599).

  10. Regulatory cells, cytokine pattern and clinical risk factors for asthma in infants and young children with recurrent wheeze.

    Science.gov (United States)

    Borrego, L M; Arroz, M J; Videira, P; Martins, C; Guimarães, H; Nunes, G; Papoila, A L; Trindade, H

    2009-08-01

    Several risk factors for asthma have been identified in infants and young children with recurrent wheeze. However, published literature has reported contradictory findings regarding the underlying immunological mechanisms. This study was designed to assess and compare the immunological status during the first 2 years in steroid-naive young children with >or= three episodes of physician-confirmed wheeze (n=50), with and without clinical risk factors for developing subsequent asthma (i.e. parental asthma or a personal history of eczema and/or two of the following: wheezing without colds, a personal history of allergic rhinitis and peripheral blood eosinophilia >4%), with age-matched healthy controls (n=30). Peripheral blood CD4(+)CD25(+) and CD4(+)CD25(high) T cells and their cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), GITR and Foxp3 expression were analysed by flow cytometry. Cytokine (IFN-gamma, TGF-beta and IL-10), CTLA-4 and Foxp3 mRNA expression were evaluated (real-time PCR) after peripheral blood mononuclear cell stimulation with phorbol 12-myristate 13-acetate (PMA) (24 h) and house dust mite (HDM) extracts (7th day). Flow cytometry results showed a significant reduction in the absolute number of CD4(+)CD25(high) and the absolute and percentage numbers of CD4(+)CD25(+)CTLA-4(+) in wheezy children compared with healthy controls. Wheezy children at a high risk of developing asthma had a significantly lower absolute number of CD4(+)CD25(+) (P=0.01) and CD4(+)CD25(high) (P=0.04), compared with those at a low risk. After PMA stimulation, CTLA-4 (P=0.03) and Foxp3 (P=0.02) expression was diminished in wheezy children compared with the healthy children. After HDM stimulation, CTLA-4 (P=0.03) and IFN-gamma (P=0.04) expression was diminished in wheezy children compared with healthy children. High-risk children had lower expression of IFN-gamma (P=0.03) compared with low-risk and healthy children and lower expression of CTLA-4 (P=0.01) compared with healthy

  11. Distinguishing attack and second-preimage attack on encrypted message authentication codes (EMAC)

    Science.gov (United States)

    Ariwibowo, Sigit; Windarta, Susila

    2016-02-01

    In this paper we show that distinguisher on CBC-MAC can be applied to Encrypted Message Authentication Code (EMAC) scheme. EMAC scheme in general is vulnerable to distinguishing attack and second preimage attack. Distinguishing attack simulation on AES-EMAC using 225 message modifications, no collision have been found. According to second preimage attack simulation on AES-EMAC no collision found between EMAC value of S1 and S2, i.e. no second preimage found for messages that have been tested. Based on distinguishing attack simulation on truncated AES-EMAC we found collision in every message therefore we cannot distinguish truncated AES-EMAC with random function. Second-preimage attack is successfully performed on truncated AES-EMAC.

  12. Cooperating attackers in neural cryptography.

    Science.gov (United States)

    Shacham, Lanir N; Klein, Einat; Mislovaty, Rachel; Kanter, Ido; Kinzel, Wolfgang

    2004-06-01

    A successful attack strategy in neural cryptography is presented. The neural cryptosystem, based on synchronization of neural networks by mutual learning, has been recently shown to be secure under different attack strategies. The success of the advanced attacker presented here, called the "majority-flipping attacker," does not decay with the parameters of the model. This attacker's outstanding success is due to its using a group of attackers which cooperate throughout the synchronization process, unlike any other attack strategy known. An analytical description of this attack is also presented, and fits the results of simulations.

  13. Effect of Prenatal Supplementation With Vitamin D on Asthma or Recurrent Wheezing in Offspring by Age 3 Years: The VDAART Randomized Clinical Trial.

    Science.gov (United States)

    Litonjua, Augusto A; Carey, Vincent J; Laranjo, Nancy; Harshfield, Benjamin J; McElrath, Thomas F; O'Connor, George T; Sandel, Megan; Iverson, Ronald E; Lee-Paritz, Aviva; Strunk, Robert C; Bacharier, Leonard B; Macones, George A; Zeiger, Robert S; Schatz, Michael; Hollis, Bruce W; Hornsby, Eve; Hawrylowicz, Catherine; Wu, Ann Chen; Weiss, Scott T

    2016-01-26

    Asthma and wheezing begin early in life, and prenatal vitamin D deficiency has been variably associated with these disorders in offspring. To determine whether prenatal vitamin D (cholecalciferol) supplementation can prevent asthma or recurrent wheeze in early childhood. The Vitamin D Antenatal Asthma Reduction Trial was a randomized, double-blind, placebo-controlled trial conducted in 3 centers across the United States. Enrollment began in October 2009 and completed follow-up in January 2015. Eight hundred eighty-one pregnant women between the ages of 18 and 39 years at high risk of having children with asthma were randomized at 10 to 18 weeks' gestation. Five participants were deemed ineligible shortly after randomization and were discontinued. Four hundred forty women were randomized to receive daily 4000 IU vitamin D plus a prenatal vitamin containing 400 IU vitamin D, and 436 women were randomized to receive a placebo plus a prenatal vitamin containing 400 IU vitamin D. Coprimary outcomes of (1) parental report of physician-diagnosed asthma or recurrent wheezing through 3 years of age and (2) third trimester maternal 25-hydroxyvitamin D levels. Eight hundred ten infants were born in the study, and 806 were included in the analyses for the 3-year outcomes. Two hundred eighteen children developed asthma or recurrent wheeze: 98 of 405 (24.3%; 95% CI, 18.7%-28.5%) in the 4400-IU group vs 120 of 401 (30.4%, 95% CI, 25.7%-73.1%) in the 400-IU group (hazard ratio, 0.8; 95% CI, 0.6-1.0; P = .051). Of the women in the 4400-IU group whose blood levels were checked, 289 (74.9%) had 25-hydroxyvitamin D levels of 30 ng/mL or higher by the third trimester of pregnancy compared with 133 of 391 (34.0%) in the 400-IU group (difference, 40.9%; 95% CI, 34.2%-47.5%, P d of vitamin D compared with 400 IU/d significantly increased vitamin D levels in the women. The incidence of asthma and recurrent wheezing in their children at age 3 years was lower by 6.1%, but this did not

  14. Crony Attack: Strategic Attack’s Silver Bullet

    Science.gov (United States)

    2006-11-01

    physical assets or financial assets. The form of crony attack that most closely resembles classic strategic attack is to deny, degrade, or destroy a money...February 1951. Reprinted in Airpower Studies Coursebook , Air Command and Staff College, Maxwell AFB, AL, 2002, 152–58. Hirsch, Michael. “NATO’s Game of

  15. Associations between pesticide use and respiratory symptoms: A cross-sectional study in Southern Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Quansah, Reginald, E-mail: reginald.quansah@ug.edu.gh [Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Bend, John R. [Department of Pathology & Laboratory Medicine, Siebens-Drake Medical Research Institute, Schulich School of Medicine & Dentistry, Western University, London (Canada); Abdul-Rahaman, Abukari [Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Armah, Frederick Ato [Department of Environmental Science, School of Biological Sciences, College of Agriculture & Natural Sciences, University of Cape Coast, Cape Coast (Ghana); Luginaah, Isaac [Department of Geography, Western University, Ontario (Canada); Essumang, David Kofi [Environmental Health Group, Department of Chemistry, University of Cape Coast, Cape Coast (Ghana); Iddi, Samuel [Department of Statistics, University of Ghana, Legon, Accra (Ghana); Chevrier, Jonathan [Department of Epidemiology, Biostatistics and Occupational Health McGill University, Montréal, Québec (Canada); Cobbina, Samuel Jerry [Department of Ecotourism and Environmental Management, Faculty of Renewable Natural Resources, University for Development Studies, Nyankpala (Ghana); Nketiah-Amponsah, Edward [Department of Economics, University of Ghana, Legon (Ghana); Adu-Kumi, Samuel [Chemicals Control and Management Centre, Environmental Protection Agency, Accra (Ghana); Darko, Godfred [Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi (Ghana); Afful, Samuel [Nuclear Chemistry and Environmental Research Centre, Ghana Atomic Energy Commission, Accra (Ghana)

    2016-10-15

    Background: Indiscriminate use of pesticides is a common practice amongst farmers in Low and Middle Income Countries (LMIC) across the globe. However, there is little evidence defining whether pesticide use is associated with respiratory symptoms. Objectives: This cross-sectional study was conducted with 300 vegetable farmers in southern Ghana (Akumadan). Data on pesticide use was collected with an interviewed-administered questionnaire. The concentration of seven organochlorine pesticides and 3 pyrethroid pesticides was assayed in urine collected from a sub-population of 100 vegetable farmers by a gas chromatograph equipped with an electron capture detector (GC-ECD). Results: A statistically significant exposure-response relationship of years per day spent mixing/applying fumigant with wheezing [30–60 days/year: prevalence ratio (PR)=1.80 (95% CI 1.30, 2.50); >60days/year: 3.25 (1.70–6.33), p for trend=0.003] and hours per day spent mixing/applying fumigant with wheezing [1–2 h/day: 1.20 (1.02–1.41), 3–5 h/day: 1.45 (1.05–1.99), >5 h/day: 1.74 (1.07–2.81), p for trend=0.0225]; days per year spent mixing/applying fungicide with wheezing [30–60 days/year: 2.04 (1.31–3.17); >60days/year: 4.16 (1.72–10.08), p for trend=0.0017] and h per day spent mixing/applying fungicide with phlegm production [1–2 h/day: 1.25 (1.05–1.47), 3–5 h/day: 1.55 (1.11–2.17), >5 h/day: 1.93 (1.17–3.19), p for trend=0.0028] and with wheezing [1–2 h/day: 1.10 (1.00–1.50), 3–5 h/day: 1.20 (1.11–1.72), >5 h/day: 1.32 (1.09–2.53), p for trend=0.0088]; h per day spent mixing/applying insecticide with phlegm production [1–2 h/day: 1.23 (1.09–1.62), 3–5 h/day: 1.51 (1.20–2.58), >5 h/day: 1.85 (1.31–4.15), p for trend=0.0387] and wheezing [1–2 h/day: 1.22 (1.02–1.46), 3–5 h/day: 1.49 (1.04–2.12), >5 h/day: 1.81 (1.07–3.08), p for trend=0.0185] were observed. Statistically significant exposure-response association was also observed for a

  16. Associations between pesticide use and respiratory symptoms: A cross-sectional study in Southern Ghana

    International Nuclear Information System (INIS)

    Quansah, Reginald; Bend, John R.; Abdul-Rahaman, Abukari; Armah, Frederick Ato; Luginaah, Isaac; Essumang, David Kofi; Iddi, Samuel; Chevrier, Jonathan; Cobbina, Samuel Jerry; Nketiah-Amponsah, Edward; Adu-Kumi, Samuel; Darko, Godfred; Afful, Samuel

    2016-01-01

    Background: Indiscriminate use of pesticides is a common practice amongst farmers in Low and Middle Income Countries (LMIC) across the globe. However, there is little evidence defining whether pesticide use is associated with respiratory symptoms. Objectives: This cross-sectional study was conducted with 300 vegetable farmers in southern Ghana (Akumadan). Data on pesticide use was collected with an interviewed-administered questionnaire. The concentration of seven organochlorine pesticides and 3 pyrethroid pesticides was assayed in urine collected from a sub-population of 100 vegetable farmers by a gas chromatograph equipped with an electron capture detector (GC-ECD). Results: A statistically significant exposure-response relationship of years per day spent mixing/applying fumigant with wheezing [30–60 days/year: prevalence ratio (PR)=1.80 (95% CI 1.30, 2.50); >60days/year: 3.25 (1.70–6.33), p for trend=0.003] and hours per day spent mixing/applying fumigant with wheezing [1–2 h/day: 1.20 (1.02–1.41), 3–5 h/day: 1.45 (1.05–1.99), >5 h/day: 1.74 (1.07–2.81), p for trend=0.0225]; days per year spent mixing/applying fungicide with wheezing [30–60 days/year: 2.04 (1.31–3.17); >60days/year: 4.16 (1.72–10.08), p for trend=0.0017] and h per day spent mixing/applying fungicide with phlegm production [1–2 h/day: 1.25 (1.05–1.47), 3–5 h/day: 1.55 (1.11–2.17), >5 h/day: 1.93 (1.17–3.19), p for trend=0.0028] and with wheezing [1–2 h/day: 1.10 (1.00–1.50), 3–5 h/day: 1.20 (1.11–1.72), >5 h/day: 1.32 (1.09–2.53), p for trend=0.0088]; h per day spent mixing/applying insecticide with phlegm production [1–2 h/day: 1.23 (1.09–1.62), 3–5 h/day: 1.51 (1.20–2.58), >5 h/day: 1.85 (1.31–4.15), p for trend=0.0387] and wheezing [1–2 h/day: 1.22 (1.02–1.46), 3–5 h/day: 1.49 (1.04–2.12), >5 h/day: 1.81 (1.07–3.08), p for trend=0.0185] were observed. Statistically significant exposure-response association was also observed for a

  17. Neonatal BCG vaccination has no effect on recurrent wheeze in the first year of life

    DEFF Research Database (Denmark)

    Thøstesen, Lisbeth Marianne; Stensballe, Lone Graff; Pihl, Gitte Thybo

    2017-01-01

    Background: Recurrent wheeze (RW) is frequent in childhood. Studies have suggested that BCG vaccination can have nonspecific effects, reducing general nontuberculosis morbidity, including respiratory tract infections and atopic diseases. The mechanisms behind these nonspecific effects of BCG...... (relative risk, 1.07; 95% CI, 0.89-1.28). Supplementary analyses were made, including an analysis of baseline risk factors for development of RW. Conclusion: Neonatal BCG had no effect on the development of RW before 13 months of age....

  18. Composite Dos Attack Model

    Directory of Open Access Journals (Sweden)

    Simona Ramanauskaitė

    2012-04-01

    Full Text Available Preparation for potential threats is one of the most important phases ensuring system security. It allows evaluating possible losses, changes in the attack process, the effectiveness of used countermeasures, optimal system settings, etc. In cyber-attack cases, executing real experiments can be difficult for many reasons. However, mathematical or programming models can be used instead of conducting experiments in a real environment. This work proposes a composite denial of service attack model that combines bandwidth exhaustion, filtering and memory depletion models for a more real representation of similar cyber-attacks. On the basis of the introduced model, different experiments were done. They showed the main dependencies of the influence of attacker and victim’s properties on the success probability of denial of service attack. In the future, this model can be used for the denial of service attack or countermeasure optimization.

  19. Heart Attack Recovery FAQs

    Science.gov (United States)

    ... recommendations to make a full recovery. View an animation of a heart attack . Heart Attack Recovery Questions ... Support Network Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  20. High Incidence of Recurrent Wheeze in Children With Down Syndrome With and Without Previous Respiratory Syncytial Virus Lower Respiratory Tract Infection

    NARCIS (Netherlands)

    Bloemers, B.; van Furth, A.M.; Weijerman, M.E.; Gemke, R.J.B.J.; Broers, C.J.M.; Kimpen, J.L.L.; Bont, L.

    2010-01-01

    Background: Respiratory syncytial virus (RSV)-induced lower respiratory tract infection (LRTI) is associated with the subsequent development of recurrent wheeze. In a recent study, we found a high incidence (9.9%) of hospitalization for RSV-induced LRTI among children with Down syndrome (DS),

  1. Seven Deadliest Wireless Technologies Attacks

    CERN Document Server

    Haines, Brad

    2010-01-01

    How can an information security professional keep up with all of the hacks, attacks, and exploits? One way to find out what the worst of the worst are is to read the seven books in our Seven Deadliest Attacks Series. Not only do we let you in on the anatomy of these attacks but we also tell you how to get rid of them and how to defend against them in the future. Countermeasures are detailed so that you can fight against similar attacks as they evolve. Attacks featured in this book include:Bluetooth AttacksCredit Card, Access Card, and Passport AttacksBad Encryption

  2. Blocking of Brute Force Attack

    OpenAIRE

    M.Venkata Krishna Reddy

    2012-01-01

    A common threat Web developers face is a password-guessing attack known as a brute-force attack. A brute-force attack is an attempt to discover a password by systematically trying every possible combination of letters, numbers, and symbols until you discover the one correct combination that works. If your Web site requires user authentication, you are a good target for a brute-force attack. An attacker can always discover a password through a brute-force attack, but the downside is that it co...

  3. Effect of Vitamin D3 Supplementation During Pregnancy on Risk of Persistent Wheeze in the Offspring A Randomized Clinical Trial

    DEFF Research Database (Denmark)

    Chawes, Bo L.; Bonnelykke, Klaus; Stokholm, Jakob

    2016-01-01

    with a goal of 708 participants, but due to delayed ethical approval, only 623 women were recruited at 24 weeks of pregnancy. Follow-up of the children (N = 581) was completed when the youngest child reached age 3 years in March 2014. INTERVENTIONS Vitamin D3 (2400 IU/d; n = 315) or matching placebo tablets......IMPORTANCE: Observational studies have suggested that increased dietary vitamin D intake during pregnancy may protect against wheezing in the offspring, but the preventive effect of vitamin D supplementation to pregnant women is unknown. OBJECTIVE: To determine whether supplementation of vitamin D3...... during the third trimester of pregnancy reduces the risk of persistent wheeze in the offspring. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, single-center, randomized clinical trial conducted within the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort. Enrollment began March 2009...

  4. Solidarity under Attack

    DEFF Research Database (Denmark)

    Meret, Susi; Goffredo, Sergio

    2017-01-01

    https://www.opendemocracy.net/can-europe-make-it/susi-meret-sergio-goffredo/solidarity-under-attack......https://www.opendemocracy.net/can-europe-make-it/susi-meret-sergio-goffredo/solidarity-under-attack...

  5. The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children

    DEFF Research Database (Denmark)

    Vardavas, C. I.; Hohmann, C; Patelarou, Evridiki

    2016-01-01

    Maternal smoking during pregnancy increases childhood asthma risk, but health effects in children of nonsmoking mothers passively exposed to tobacco smoke during pregnancy are unclear. We examined the association of maternal passive smoking during pregnancy and wheeze in children aged ≤2 years. I...

  6. Attack surfaces

    DEFF Research Database (Denmark)

    Gruschka, Nils; Jensen, Meiko

    2010-01-01

    The new paradigm of cloud computing poses severe security risks to its adopters. In order to cope with these risks, appropriate taxonomies and classification criteria for attacks on cloud computing are required. In this work-in-progress paper we present one such taxonomy based on the notion...... of attack surfaces of the cloud computing scenario participants....

  7. Local interleukin-10 production during respiratory syncytial virus bronchiolitis is associated with post-bronchiolitis wheeze

    Directory of Open Access Journals (Sweden)

    Hodemaekers Hennie M

    2011-09-01

    Full Text Available Abstract Background Respiratory syncytial virus (RSV is the most common cause of bronchiolitis in infants. Following RSV bronchiolitis, 50% of children develop post-bronchiolitis wheeze (PBW. Animal studies have suggested that interleukin (IL-10 plays a critical role in the pathogenesis of RSV bronchiolitis and subsequent airway hyperresponsiveness. Previously, we showed that ex vivo monocyte IL-10 production is a predictor of PBW. Additionally, heterozygosity of the single-nucleotide polymorphism (SNP rs1800872 in the IL10 promoter region was associated with protection against RSV bronchiolitis. Methods This study aimed to determine the in vivo role of IL-10 in RSV pathogenesis and recurrent wheeze in a new cohort of 235 infants hospitalized for RSV bronchiolitis. IL-10 levels in nasopharyngeal aspirates (NPAs were measured at the time of hospitalization and the IL10 SNP rs1800872 genotype was determined. Follow-up data were available for 185 children (79%. Results Local IL-10 levels during RSV infection turned out to be higher in infants that later developed physician diagnosed PBW as compared to infants without PBW in the first year after RSV infection (958 vs 692 pg/ml, p = 0.02. The IL10 promoter SNP rs1800872 was not associated with IL-10 concentration in NPAs. Conclusion The relationship between high local IL-10 levels during the initial RSV infection and physician diagnosed PBW provides further evidence of the importance of the IL-10 response during RSV bronchiolitis.

  8. Asthma mimic: Case report and literature review of vocal cord nodule associated with wheezing.

    Science.gov (United States)

    Kashif, Muhammad; Singh, Tushi; Aslam, Ahsan; Khaja, Misbahuddin

    2017-01-01

    Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various clinical conditions can mimic asthma, such as foreign body aspiration, subglottic stenosis, congestive heart failure, diffuse panbronchiolitis, aortic arch anomalies, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, retrosternal goiter, vocal cord tumors, other airway tumors, and vocal cord dysfunction. Upper airway obstruction can be a life-threatening emergency. Here, we present the case of a 58-year-old female with recurrent hospital visits for wheezing and exacerbations of asthma, who was later found to have a vocal cord nodule confirmed to be squamous cell carcinoma, which was mimicking like asthma.

  9. Seven Deadliest Microsoft Attacks

    CERN Document Server

    Kraus, Rob; Borkin, Mike; Alpern, Naomi

    2010-01-01

    Do you need to keep up with the latest hacks, attacks, and exploits effecting Microsoft products? Then you need Seven Deadliest Microsoft Attacks. This book pinpoints the most dangerous hacks and exploits specific to Microsoft applications, laying out the anatomy of these attacks including how to make your system more secure. You will discover the best ways to defend against these vicious hacks with step-by-step instruction and learn techniques to make your computer and network impenetrable. Windows Operating System-Password AttacksActive Directory-Escalat

  10. Estimation of the site of wheezes in pulmonary emphysema: airflow simulation study by the use of A 4D lung model.

    Science.gov (United States)

    Kitaoka, Hiroko; Cok, Salim

    2013-01-01

    Adventitious lung sounds in pulmonary emphysema, wheezes, are continuous musical sounds during expiration with 400 Hz or more. The textbook tells that expiratory airflow limitation in emphysema occurs at the peripheral airways and that wheezes are generated there. We have recently proposed a novel hypothesis based on image analysis and theoretical consideration that expiratory airflow limitation in emphysema occurs at the intra-mediastinal airway (trachea, main bronchi, and right lobar bronchi) due to compression by overinflated lungs. We performed expiratory airflow simulation by the use of a 4D finite element lung model, and found periodical vortex release with 300-900 Hz at the end of protrusion of the the tracheal posterior wall. Relationship between the peak frequency of pressure fluctuation and airflow velocity was in agreement with Strahal's law either in normal or emphysematous condition. Contrarily, airflow simulation in a small bronchus (1.5 mm in diameter) indicated no apparent periodic vortex release.

  11. Comparison of Body, Auricular, and Abdominal Acupuncture Treatments for Insomnia Differentiated as Internal Harassment of Phlegm-Heat Syndrome: An Orthogonal Design

    Directory of Open Access Journals (Sweden)

    Yue Jiao

    2015-01-01

    Full Text Available Objective. To identify the optimum treatment protocol for insomnia among auricular, body, and abdominal needling methods. Methods. A three-factor (3 needling protocols and three-level experimental scheme was designed based on orthogonal method. 54 patients of insomnia differentiated as internal harassment of phlegm-heat syndrome were given two courses of acupuncture treatment (each with 20 times of acupuncture. The therapeutic effects were evaluated by comparing the Pittsburgh sleep quality index (PSQI, Hamilton Depression Scale (HAMD scores, and Hamilton Anxiety Scale (HAMA scores of patients before treatment, after one course of treatment, and after two courses of treatment as well as one month after treatment. Results. Body, auricular, and abdominal acupuncture treatments all alleviated symptoms of insomnia, depression, and anxiety, but body and auricular acupuncture had stronger therapeutic effects. Conclusions. Body acupuncture at basic points shall be given priority in protocol selection for insomnia. The second-best choice is auricular acupuncture with basic points combined with points based on Traditional Chinese Medicine (TCM theories. Abdominal needling with very quick effect can be an alternative protocol with basic points combined with syndrome differentiation points.

  12. Is childhood wheeze and asthma in Latin America associated with poor hygiene and infection? A systematic review

    OpenAIRE

    Ardura Garcia, Cristina; Garner, Paul; Cooper, Philip J

    2018-01-01

    Abstract\\ud Introduction High asthma prevalence in Latin-American cities is thought to be caused by poor hygiene and infections. This contradicts the widely accepted ‘hygiene hypothesis’ for asthma aetiology.\\ud Methods Systematic review of observational studies evaluating the association between poor hygiene exposures or infections and asthma/wheeze among Latin-American children aged 4–16 years. MEDLINE, EMBASE, LILACS and CINAHL electronic databases were searched following a predefined stra...

  13. Whispering through DDoS attack

    OpenAIRE

    Miralem Mehic; Jiri Slachta; Miroslav Voznak

    2016-01-01

    Denial of service (DoS) attack is an attempt of the attacker to disable victim's machine by depleting network or computing resources. If this attack is performed with more than one machine, it is called distributed denial of service (DDoS) attack. Covert channels are those channels which are used for information transmission even though they are neither designed nor intended to transfer information at all. In this article, we investigated the possibility of using of DDoS attack for purposes o...

  14. Protecting Cryptographic Memory against Tampering Attack

    DEFF Research Database (Denmark)

    Mukherjee, Pratyay

    In this dissertation we investigate the question of protecting cryptographic devices from tampering attacks. Traditional theoretical analysis of cryptographic devices is based on black-box models which do not take into account the attacks on the implementations, known as physical attacks. In prac......In this dissertation we investigate the question of protecting cryptographic devices from tampering attacks. Traditional theoretical analysis of cryptographic devices is based on black-box models which do not take into account the attacks on the implementations, known as physical attacks....... In practice such attacks can be executed easily, e.g. by heating the device, as substantiated by numerous works in the past decade. Tampering attacks are a class of such physical attacks where the attacker can change the memory/computation, gains additional (non-black-box) knowledge by interacting...... with the faulty device and then tries to break the security. Prior works show that generically approaching such problem is notoriously difficult. So, in this dissertation we attempt to solve an easier question, known as memory-tampering, where the attacker is allowed tamper only with the memory of the device...

  15. Exploiting Hardware Vulnerabilities to Attack Embedded System Devices: a Survey of Potent Microarchitectural Attacks

    Directory of Open Access Journals (Sweden)

    Apostolos P. Fournaris

    2017-07-01

    Full Text Available Cyber-Physical system devices nowadays constitute a mixture of Information Technology (IT and Operational Technology (OT systems that are meant to operate harmonically under a security critical framework. As security IT countermeasures are gradually been installed in many embedded system nodes, thus securing them from many well-know cyber attacks there is a lurking danger that is still overlooked. Apart from the software vulnerabilities that typical malicious programs use, there are some very interesting hardware vulnerabilities that can be exploited in order to mount devastating software or hardware attacks (typically undetected by software countermeasures capable of fully compromising any embedded system device. Real-time microarchitecture attacks such as the cache side-channel attacks are such case but also the newly discovered Rowhammer fault injection attack that can be mounted even remotely to gain full access to a device DRAM (Dynamic Random Access Memory. Under the light of the above dangers that are focused on the device hardware structure, in this paper, an overview of this attack field is provided including attacks, threat directives and countermeasures. The goal of this paper is not to exhaustively overview attacks and countermeasures but rather to survey the various, possible, existing attack directions and highlight the security risks that they can pose to security critical embedded systems as well as indicate their strength on compromising the Quality of Service (QoS such systems are designed to provide.

  16. Seven deadliest USB attacks

    CERN Document Server

    Anderson, Brian

    2010-01-01

    Do you need to keep up with the latest hacks, attacks, and exploits effecting USB technology? Then you need Seven Deadliest USB Attacks. This book pinpoints the most dangerous hacks and exploits specific to USB, laying out the anatomy of these attacks including how to make your system more secure. You will discover the best ways to defend against these vicious hacks with step-by-step instruction and learn techniques to make your computer and network impenetrable. Attacks detailed in this book include: USB Hacksaw USB Switchblade USB Based Virus/Malicous Code Launch USB Device Overflow RAMdum

  17. Seven Deadliest Unified Communications Attacks

    CERN Document Server

    York, Dan

    2010-01-01

    Do you need to keep up with the latest hacks, attacks, and exploits effecting Unified Communications technology? Then you need Seven Deadliest Unified Communication Attacks. This book pinpoints the most dangerous hacks and exploits specific to Unified Communications, laying out the anatomy of these attacks including how to make your system more secure. You will discover the best ways to defend against these vicious hacks with step-by-step instruction and learn techniques to make your computer and network impenetrable. Attacks featured in this book include: UC Ecosystem Attacks Insecure Endpo

  18. Invisible Trojan-horse attack.

    Science.gov (United States)

    Sajeed, Shihan; Minshull, Carter; Jain, Nitin; Makarov, Vadim

    2017-08-21

    We demonstrate the experimental feasibility of a Trojan-horse attack that remains nearly invisible to the single-photon detectors employed in practical quantum key distribution (QKD) systems, such as Clavis2 from ID Quantique. We perform a detailed numerical comparison of the attack performance against Scarani-Ac´ın-Ribordy-Gisin (SARG04) QKD protocol at 1924 nm versus that at 1536 nm. The attack strategy was proposed earlier but found to be unsuccessful at the latter wavelength, as reported in N. Jain et al., New J. Phys. 16, 123030 (2014). However at 1924 nm, we show experimentally that the noise response of the detectors to bright pulses is greatly reduced, and show by modeling that the same attack will succeed. The invisible nature of the attack poses a threat to the security of practical QKD if proper countermeasures are not adopted.

  19. Whispering through DDoS attack

    Directory of Open Access Journals (Sweden)

    Miralem Mehic

    2016-03-01

    Full Text Available Denial of service (DoS attack is an attempt of the attacker to disable victim's machine by depleting network or computing resources. If this attack is performed with more than one machine, it is called distributed denial of service (DDoS attack. Covert channels are those channels which are used for information transmission even though they are neither designed nor intended to transfer information at all. In this article, we investigated the possibility of using of DDoS attack for purposes of hiding data or concealing the existing covert channel. In addition, in this paper we analyzed the possibility of detection of such covert communication with the well-known statistical method. Also, we proposed the coordination mechanisms of the attack which may be used. A lot of research has been done in order to describe and prevent DDoS attacks, yet research on steganography on this field is still scarce.

  20. Heart attack - discharge

    Science.gov (United States)

    ... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Deep vein thrombosis - discharge Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass ... pacemaker - discharge High blood pressure - what to ask your doctor How to read ...

  1. Respiratory symptoms and bronchial responsiveness are related to dietary salt intake and urinary potassium excretion in male children.

    Science.gov (United States)

    Pistelli, R; Forastiere, F; Corbo, G M; Dell'Orco, V; Brancato, G; Agabiti, N; Pizzabiocca, A; Perucci, C A

    1993-04-01

    To investigate whether dietary salt intake and urinary sodium and potassium levels are related to respiratory symptoms and bronchial responsiveness, a cross-sectional study among 2593 subjects aged 9 to 16 was conducted in four communities of the Latium region (Italy). Questionnaires were administered to the parents, urine samples were collected, lung function, methacholine challenge tests and prick tests were performed. Information about familial and personal dietary salt use and respiratory health was collected from the parents of 2439 (94%) subjects. A total of 2020 methacholine challenge tests and 916 urinary sodium and potassium levels were available for analysis. Personal table salt use was strongly related to cough and phlegm apart from colds (adjusted odds ratios, OR, 1.87, 95% confidence intervals, CI, 1.20-2.90), wheezing apart from colds (OR, 2.19, 95% CI, 1.27-3.77), wheezing with dyspnoea (OR, 1.45, 95% CI, 0.98-2.12) and wheezing after exercise (OR, 2.16, 95% CI, 1.35-3.44). These associations were mainly found in boys. Use of familial table salt and canned food showed no relation to respiratory symptoms. Increased bronchial responsiveness was associated with a higher urinary potassium excretion in boys, but not with urinary sodium. In conclusion, personal table salt use is related to an increased prevalence of bronchial symptoms; an increase in bronchial responsiveness among those with higher potassium excretion also seems to be implied. Although it is difficult to interpret the results of this study in causal terms, the findings might be relevant to the distribution of bronchial symptoms and diseases in the population.

  2. Attack Trees for Practical Security Assessment: Ranking of Attack Scenarios with ADTool 2.0

    NARCIS (Netherlands)

    Gadyatskaya, Olga; Jhawar, Ravi; Kordy, P.T.; Lounis, Karim; Mauw, Sjouke; Trujillo-Rasua, Rolando

    2016-01-01

    In this tool demonstration paper we present the ADTool2.0: an open-source software tool for design, manipulation and analysis of attack trees. The tool supports ranking of attack scenarios based on quantitative attributes entered by the user; it is scriptable; and it incorporates attack trees with

  3. The work-averse cyber attacker model : theory and evidence from two million attack signatures

    NARCIS (Netherlands)

    Allodi, L.; Massacci, F.; Williams, J.

    The typical cyber attacker is assumed to be all powerful and to exploit all possible vulnerabilities. In this paper we present, and empirically validate, a novel and more realistic attacker model. The intuition of our model is that an attacker will optimally choose whether to act and weaponize a new

  4. Web server attack analyzer

    OpenAIRE

    Mižišin, Michal

    2013-01-01

    Web server attack analyzer - Abstract The goal of this work was to create prototype of analyzer of injection flaws attacks on web server. Proposed solution combines capabilities of web application firewall and web server log analyzer. Analysis is based on configurable signatures defined by regular expressions. This paper begins with summary of web attacks, followed by detection techniques analysis on web servers, description and justification of selected implementation. In the end are charact...

  5. Network Protection Against DDoS Attacks

    Directory of Open Access Journals (Sweden)

    Petr Dzurenda

    2015-03-01

    Full Text Available The paper deals with possibilities of the network protection against Distributed Denial of Service attacks (DDoS. The basic types of DDoS attacks and their impact on the protected network are presented here. Furthermore, we present basic detection and defense techniques thanks to which it is possible to increase resistance of the protected network or device against DDoS attacks. Moreover, we tested the ability of current commercial Intrusion Prevention Systems (IPS, especially Radware DefensePro 6.10.00 product against the most common types of DDoS attacks. We create five scenarios that are varied in type and strength of the DDoS attacks. The attacks intensity was much greater than the normal intensity of the current DDoS attacks.

  6. Attack Tree Generation by Policy Invalidation

    DEFF Research Database (Denmark)

    Ivanova, Marieta Georgieva; Probst, Christian W.; Hansen, Rene Rydhof

    2015-01-01

    through brainstorming of experts. In this work we formalize attack tree generation including human factors; based on recent advances in system models we develop a technique to identify possible attacks analytically, including technical and human factors. Our systematic attack generation is based......Attacks on systems and organisations increasingly exploit human actors, for example through social engineering, complicating their formal treatment and automatic identification. Formalisation of human behaviour is difficult at best, and attacks on socio-technical systems are still mostly identified...... on invalidating policies in the system model by identifying possible sequences of actions that lead to an attack. The generated attacks are precise enough to illustrate the threat, and they are general enough to hide the details of individual steps....

  7. Airway Epithelial Changes in Smokers but Not in Ex-Smokers with Asthma

    NARCIS (Netherlands)

    Broekema, Martine; ten Hacken, Nick H. T.; Volbeda, Franke; Lodewijk, Monique E.; Hylkema, Machteld N.; Postma, Dirkje S.; Timens, Wim

    2009-01-01

    Rationale: Smoking has detrimental effects on asthma outcome, such as increased cough, wheezing, sputum production, and frequency of asthma attacks. This results in accelerated lung function decline. The underlying pathological process of smoke-induced deterioration of asthma is unknown. Objectives:

  8. Terrorists and Suicide Attacks

    National Research Council Canada - National Science Library

    Cronin, Audrey K

    2003-01-01

    Suicide attacks by terrorist organizations have become more prevalent globally, and assessing the threat of suicide attacks against the United States and its interests at home and abroad has therefore...

  9. Stochastic Model of TCP SYN Attacks

    Directory of Open Access Journals (Sweden)

    Simona Ramanauskaitė

    2011-08-01

    Full Text Available A great proportion of essential services are moving into internet space making the threat of DoS attacks even more actual. To estimate the real risk of some kind of denial of service (DoS attack in real world is difficult, but mathematical and software models make this task easier. In this paper we overview the ways of implementing DoS attack models and offer a stochastic model of SYN flooding attack. It allows evaluating the potential threat of SYN flooding attacks, taking into account both the legitimate system flow as well as the possible attack power. At the same time we can assess the effect of such parameters as buffer capacity, open connection storage in the buffer or filte­ring efficiency on the success of different SYN flooding attacks. This model can be used for other type of memory depletion denial of service attacks.Article in Lithuanian

  10. Attack Trees with Sequential Conjunction

    NARCIS (Netherlands)

    Jhawar, Ravi; Kordy, Barbara; Mauw, Sjouke; Radomirović, Sasa; Trujillo-Rasua, Rolando

    2015-01-01

    We provide the first formal foundation of SAND attack trees which are a popular extension of the well-known attack trees. The SAND at- tack tree formalism increases the expressivity of attack trees by intro- ducing the sequential conjunctive operator SAND. This operator enables the modeling of

  11. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  12. [The standardized perioperative treatment of chronic rhinosinusitis with nasal polyps and asthma].

    Science.gov (United States)

    Li, Tingting; Ju, Jianbao; Yu, Hailing; Xie, Daoyu

    2015-04-01

    To discuss the perioperative treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma. Retrospective analysis of perioperative clinical data of 43 cases with CRSwNP and asthma. The admitted and under endoscopic surgery. Patients with preventing perioperative asthma attacks and corresponding standardized treatment were Observed. Thirty-five cases were stable during perioperative period and without asthma. Seven patients diagnosed as mild and moderate asthma attacks because of low pulse oximetry (SpO2 92%-95%) and scattered wheeze heard in the lungs. So these patients were sent to ICU for the treatment. They went back to ward after their conditions turned to stable and no asthma during perioperative. One patient diagnosed as severe asthma attack, because irritability and suffocation happened, SpO2 decreased from 99% to 84%-81%, diffuse wheeze could be heard in the whole lung . So we give him tracheal intubation and sent him to ICU for advanced treatment after breathing smooth. Five days later the patient retuned to the ward in stable condition and with no asthma attack again. Before operation the patients should be give some corresponding standardized comprehensive treatment according to the nasal symptoms and the degree of asthma attack, such as the application of topical steroid and antiallergic medicine. And some special treatment should be given to reduce airway hyperresponsiveness mucosa during anesthesia. These methods can reduce the risk of the asthma attacks and improve perioperative safety, prevent serious complications.

  13. Investigating the Possibility to Individualize Asthma Attack Therapy Based on Attack Severity and Patient Characteristics

    Directory of Open Access Journals (Sweden)

    Sárkány Zoltán

    2016-03-01

    Full Text Available Introduction: The objective of this study was to investigate with the help of a computerized simulation model whether the treatment of an acute asthma attack can be individualized based on the severity of the attack and the characteristics of the patient. Material and Method: A stochastic lung model was used to simulate the deposition of 1 nm - 10 μm particles during a mild and a moderate asthma attack. Breathing parameters were varied to maximize deposition, and simulation results were compared with those obtained in the case of a severe asthma attack. In order to investigate the effect of height on the deposition of inhaled particles, another series of simulations was carried out with identical breathing parameters, comparing patient heights of 155 cm, 175 cm and 195 cm. Results: The optimization process yielded an increase in the maximum deposition values of around 6-7% for each type of investigated asthma attack, and the difference between attacks of different degree of severity was around 5% for both the initial and the optimized values, a higher degree of obstruction increasing the amount of deposited particles. Conclusions: Our results suggest that the individualization of asthma attack treatment cannot be based on particles of different size, as the highest deposited fraction in all three types of attacks can be obtained using 0.01 μm particles. The use of a specific set of breathing parameters yields a difference between a mild and a moderate, as well as a moderate and a severe asthma attack of around 5%.

  14. Analytical Characterization of Internet Security Attacks

    Science.gov (United States)

    Sellke, Sarah H.

    2010-01-01

    Internet security attacks have drawn significant attention due to their enormously adverse impact. These attacks includes Malware (Viruses, Worms, Trojan Horse), Denial of Service, Packet Sniffer, and Password Attacks. There is an increasing need to provide adequate defense mechanisms against these attacks. My thesis proposal deals with analytical…

  15. Anger attacks in obsessive compulsive disorder

    Directory of Open Access Journals (Sweden)

    Nitesh Prakash Painuly

    2011-01-01

    Full Text Available Background: Research on anger attacks has been mostly limited to depression, and only a few studies have focused on anger attacks in obsessive compulsive disorder. Materials and Methods: In a cross-sectional study all new obsessive compulsive disorder patients aged 20-60 years attending an outpatient clinic were assessed using the anger attack questionnaire, irritability, depression and anxiety scale (for the direction of the aggressive behavior and quality of life (QOL. Results: The sample consisted of 42 consecutive subjects with obsessive compulsive disorder, out of which 21 (50% had anger attacks. The obsessive compulsive disorder subjects with and without anger attacks did not show significant differences in terms of sociodemographic variables, duration of illness, treatment, and family history. However, subjects with anger attacks had significantly higher prevalence of panic attacks and comorbid depression. Significantly more subjects with anger attacks exhibited aggressive acts toward spouse, parents, children, and other relatives in the form of yelling and threatening to hurt, trying to hurt, and threatening to leave. However, the two groups did not differ significantly in terms of QOL, except for the psychological domain being worse in the subjects with anger attacks. Conclusion: Anger attacks are present in half of the patients with obsessive compulsive disorder, and they correlate with the presence of comorbid depression.

  16. Seven Deadliest Social Network Attacks

    CERN Document Server

    Timm, Carl

    2010-01-01

    Do you need to keep up with the latest hacks, attacks, and exploits effecting social networks? Then you need Seven Deadliest Social Network Attacks. This book pinpoints the most dangerous hacks and exploits specific to social networks like Facebook, Twitter, and MySpace, laying out the anatomy of these attacks including how to make your system more secure. You will discover the best ways to defend against these vicious hacks with step-by-step instruction and learn techniques to make your computer and network impenetrable. Attacks detailed in this book include: Social Networking Infrastruct

  17. Pericarditis - after heart attack

    Science.gov (United States)

    ... include: A previous heart attack Open heart surgery Chest trauma A heart attack that has affected the thickness of your heart muscle Symptoms Symptoms include: Anxiety Chest pain from the swollen pericardium rubbing on the ...

  18. Serum vitamin D and IgE levels in infants and children under 2 years ...

    African Journals Online (AJOL)

    Ehab

    Serum vitamin D and IgE levels in infants and children under 2 years of age with recurrent chest ... from 6-24 months, diagnosed to have recurrent wheeze (>3 attacks), recruited ... IgE and the development of allergic sensitization29. Hence this ...

  19. WILD PIG ATTACKS ON HUMANS

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, J.

    2013-04-12

    Attacks on humans by wild pigs (Sus scrofa) have been documented since ancient times. However, studies characterizing these incidents are lacking. In an effort to better understand this phenomenon, information was collected from 412 wild pig attacks on humans. Similar to studies of large predator attacks on humans, data came from a variety of sources. The various attacks compiled occurred in seven zoogeographic realms. Most attacks occurred within the species native range, and specifically in rural areas. The occurrence was highest during the winter months and daylight hours. Most happened under non-hunting circumstances and appeared to be unprovoked. Wounded animals were the chief cause of these attacks in hunting situations. The animals involved were typically solitary, male and large in size. The fate of the wild pigs involved in these attacks varied depending upon the circumstances, however, most escaped uninjured. Most human victims were adult males traveling on foot and alone. The most frequent outcome for these victims was physical contact/mauling. The severity of resulting injuries ranged from minor to fatal. Most of the mauled victims had injuries to only one part of their bodies, with legs/feet being the most frequent body part injured. Injuries were primarily in the form of lacerations and punctures. Fatalities were typically due to blood loss. In some cases, serious infections or toxemia resulted from the injuries. Other species (i.e., pets and livestock) were also accompanying some of the humans during these attacks. The fates of these animals varied from escaping uninjured to being killed. Frequency data on both non-hunting and hunting incidents of wild pig attacks on humans at the Savannah River Site, South Carolina, showed quantitatively that such incidents are rare.

  20. Cache timing attacks on recent microarchitectures

    DEFF Research Database (Denmark)

    Andreou, Alexandres; Bogdanov, Andrey; Tischhauser, Elmar Wolfgang

    2017-01-01

    Cache timing attacks have been known for a long time, however since the rise of cloud computing and shared hardware resources, such attacks found new potentially devastating applications. One prominent example is S$A (presented by Irazoqui et al at S&P 2015) which is a cache timing attack against...... AES or similar algorithms in virtualized environments. This paper applies variants of this cache timing attack to Intel's latest generation of microprocessors. It enables a spy-process to recover cryptographic keys, interacting with the victim processes only over TCP. The threat model is a logically...... separated but CPU co-located attacker with root privileges. We report successful and practically verified applications of this attack against a wide range of microarchitectures, from a two-core Nehalem processor (i5-650) to two-core Haswell (i7-4600M) and four-core Skylake processors (i7-6700). The attack...

  1. Prevalence of asthma and asthma-like symptoms in inner-city schoolchildren.

    Science.gov (United States)

    Mvula, Mosanda; Larzelere, Michele; Kraus, Marjorie; Moisiewicz, Kathleen; Morgan, Connie; Pierce, Stephanie; Post, Robert; Nash, Theresa; Moore, Cleveland

    2005-02-01

    This study investigates the prevalence of asthma and asthma-related symptoms in New Orleans inner-city schoolchildren. A cross-sectional survey of 1535 elementary, middle, and high school children (aged 5-18) was conducted by using the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire. Lifetime prevalence of wheezing was 39.4%, and lifetime prevalence of asthma was 24.4%. Wheezing during the previous 12 months was reported by 25.7% of the sample. Twenty-one percent of respondents reported having one or more attacks of wheezing per year, with 5.6% reporting four or more attacks per year. Many participants reported sleep disturbance (15.4%), with 6.2% reporting sleep disturbance more than once a week. The 12-month rate of speech limitation due to asthma exacerbation was 6.6%. Exercise-induced asthma was reported by 16.9% of the students, and nocturnal cough (not associated with cold) was reported by 27.3%. Overall, boys reported higher rates of symptoms than girls, and younger children (aged 6-7) reported greater symptoms than older children (aged 13-14). These findings show that prevalence of asthma in this population is elevated, and the ISAAC written questionnaire successfully identified inner-city children at risk for asthma in New Orleans.

  2. Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE).

    Science.gov (United States)

    Lannerö, Eva; Wickman, Magnus; Pershagen, Goran; Nordvall, Lennart

    2006-01-05

    Exposure to cigarette smoking during foetal and early postnatal life may have implications for lung health. The aim of this study was to assess the possible effects of such exposure in utero on lower respiratory disease in children up to two years of age. A birth cohort of 4089 newborn infants was followed for two years using parental questionnaires. When the infant was two months old the parents completed a questionnaire on various lifestyle factors, including maternal smoking during pregnancy and after birth. At one and two years of age information was obtained by questionnaire on symptoms of allergic and respiratory diseases as well as on environmental exposures, particularly exposure to environmental tobacco smoke (ETS). Adjustments were made for potential confounders. When the mother had smoked during pregnancy but not after that, there was an increased risk of recurrent wheezing up to two years' age, ORadj = 2.2, (95% CI 1.3-3.6). The corresponding OR was 1.6, (95% CI 1.2-2.3) for reported exposure to ETS with or without maternal smoking in utero. Maternal smoking during pregnancy but no exposure to ETS also increased the risk of doctor's diagnosed asthma up to two years of age, ORadj = 2.1, (95% CI 1.2-3.7). Exposure to maternal cigarette smoking in utero is a risk factor for recurrent wheezing, as well as doctor's diagnosed asthma in children up to two years of age.

  3. The Cyber-Physical Attacker

    DEFF Research Database (Denmark)

    Vigo, Roberto

    2012-01-01

    The world of Cyber-Physical Systems ranges from industrial to national interest applications. Even though these systems are pervading our everyday life, we are still far from fully understanding their security properties. Devising a suitable attacker model is a crucial element when studying...... the security properties of CPSs, as a system cannot be secured without defining the threats it is subject to. In this work an attacker scenario is presented which addresses the peculiarities of a cyber-physical adversary, and we discuss how this scenario relates to other attacker models popular in the security...

  4. Forensics Investigation of Web Application Security Attacks

    OpenAIRE

    Amor Lazzez; Thabet Slimani

    2015-01-01

    Nowadays, web applications are popular targets for security attackers. Using specific security mechanisms, we can prevent or detect a security attack on a web application, but we cannot find out the criminal who has carried out the security attack. Being unable to trace back an attack, encourages hackers to launch new attacks on the same system. Web application forensics aims to trace back and attribute a web application security attack to its originator. This may significantly reduce the sec...

  5. Smoke-free air laws and asthma prevalence, symptoms, and severity among nonsmoking youth.

    Science.gov (United States)

    Dove, Melanie S; Dockery, Douglas W; Connolly, Gregory N

    2011-01-01

    We investigated the association between smoke-free laws and asthma prevalence, symptoms, and severity among nonsmoking youth (aged 3-15 years). We examined data from the 1999-2006 National Health and Nutrition Examination Survey, a cross-sectional survey designed to monitor the health and nutritional status of the US population. Survey locations were dichotomized as having or not having at least 1 smoke-free workplace, restaurant, or bar law at the county or state level that covered the entire county population. Asthma prevalence was assessed as self-reported current asthma and as ever having asthma with current symptoms. Asthmatic symptoms included persistent wheeze, chronic night cough, and wheeze-medication use. We also examined asthma severity (asthma attack or emergency-department visit for asthma) and persistent ear infection. Smoke-free laws were not associated with current asthma but were significantly associated with lower odds of asthmatic symptoms (odds ratio [OR]: 0.67 [95% confidence interval (CI): 0.48-0.93]) among nonsmoking youth. The association between smoke-free laws and ever having asthma with current symptoms approached significance (OR: 0.74 [95% CI: 0.53-1.03]). Smoke-free laws were associated with lower odds of asthma attacks (OR: 0.66 [95% CI: 0.28-1.56]) and emergency-department visits for asthma (OR: 0.55 [95% CI: 0.27-1.13]), although these results were not statistically significant. Our results suggest that smoke-free laws reduce asthmatic symptoms, including persistent wheeze, chronic night cough, and wheeze-medication use in nonsmoking youth.

  6. Adaptive cyber-attack modeling system

    Science.gov (United States)

    Gonsalves, Paul G.; Dougherty, Edward T.

    2006-05-01

    The pervasiveness of software and networked information systems is evident across a broad spectrum of business and government sectors. Such reliance provides an ample opportunity not only for the nefarious exploits of lone wolf computer hackers, but for more systematic software attacks from organized entities. Much effort and focus has been placed on preventing and ameliorating network and OS attacks, a concomitant emphasis is required to address protection of mission critical software. Typical software protection technique and methodology evaluation and verification and validation (V&V) involves the use of a team of subject matter experts (SMEs) to mimic potential attackers or hackers. This manpower intensive, time-consuming, and potentially cost-prohibitive approach is not amenable to performing the necessary multiple non-subjective analyses required to support quantifying software protection levels. To facilitate the evaluation and V&V of software protection solutions, we have designed and developed a prototype adaptive cyber attack modeling system. Our approach integrates an off-line mechanism for rapid construction of Bayesian belief network (BN) attack models with an on-line model instantiation, adaptation and knowledge acquisition scheme. Off-line model construction is supported via a knowledge elicitation approach for identifying key domain requirements and a process for translating these requirements into a library of BN-based cyber-attack models. On-line attack modeling and knowledge acquisition is supported via BN evidence propagation and model parameter learning.

  7. Predicting Factors of Zone 4 Attack in Volleyball.

    Science.gov (United States)

    Costa, Gustavo C; Castro, Henrique O; Evangelista, Breno F; Malheiros, Laura M; Greco, Pablo J; Ugrinowitsch, Herbert

    2017-06-01

    This study examined 142 volleyball games of the Men's Super League 2014/2015 seasons in Brazil from which we analyzed 24-26 games of each participating team, identifying 5,267 Zone 4 attacks for further analysis. Within these Zone 4 attacks, we analyzed the association between the effect of the attack carried out and the separate effects of serve reception, tempo and type of attack. We found that the reception, tempo of attack, second tempo of attack, and power of diagonal attack were predictors of the attack effect in Zone 4. Moreover, placed attacks showed a tendency to not yield a score. In conclusion, winning points in high-level men's volleyball requires excellent receptions, a fast attack tempo and powerfully executed of attacks.

  8. Attack Potential Evaluation in Desktop and Smartphone Fingerprint Sensors: Can They Be Attacked by Anyone?

    Directory of Open Access Journals (Sweden)

    Ines Goicoechea-Telleria

    2018-01-01

    Full Text Available The use of biometrics keeps growing. Every day, we use biometric recognition to unlock our phones or to have access to places such as the gym or the office, so we rely on the security manufacturers offer when protecting our privileges and private life. It is well known that it is possible to hack into a fingerprint sensor using fake fingers made of Play-Doh and other easy-to-obtain materials but to what extent? Is this true for all users or only for specialists with a deep knowledge on biometrics? Are smartphone fingerprint sensors as reliable as desktop sensors? To answer these questions, we performed 3 separate evaluations. First, we evaluated 4 desktop fingerprint sensors of different technologies by attacking them with 7 different fake finger materials. All of them were successfully attacked by an experienced attacker. Secondly, we carried out a similar test on 5 smartphones with embedded sensors using the most successful materials, which also hacked the 5 sensors. Lastly, we gathered 15 simulated attackers with no background in biometrics to create fake fingers of several materials, and they had one week to attack the fingerprint sensors of the same 5 smartphones, with the starting point of a short video with the techniques to create them. All 5 smartphones were successfully attacked by an inexperienced attacker. This paper will provide the results achieved, as well as an analysis on the attack potential of every case. All results are given following the metrics of the standard ISO/IEC 30107-3.

  9. Risk factors of bronchial hyperresponsiveness in children with wheezing-associated respiratory infection.

    Science.gov (United States)

    Futrakul, Sitthivuddhi; Deerojanawong, Jitladda; Prapphal, Nuanchan

    2005-07-01

    The objectives of this study were to identify possible risk factors of bronchial hyperesponsiveness (BHR) in children up to 5 years of age with wheezing-associated respiratory infection (WARI), and to study the prevalence of BHR. Children up to 5 years of age with WARI were enrolled in the study. The parents or caregivers of children were asked about their demographic data and clinical histories. Physical examination and clinical score assessment were performed. Pulmonary function tests, i.e., tidal breathing flow volume (TBFV), were performed to measure tidal breathing parameters before and after salbutamol nebulization. If volume at peak tidal expiratory flow/expiratory tidal volume and time to peak expiratory flow/total expiratory time increased > or = 20%, or tidal expiratory flow at 25% of tidal volume/peak tidal expiratory flow increased > or = 20% after nebulization therapy, BHR was diagnosed. The number in the positive BHR group was used to calculate the prevalence of BHR, and clinical features were compared with those of the negative BHR group. Categorical data were analyzed for statistical significance (P < 0.05) by chi-square test or Fisher's exact test, or Student's t-test, as appropriate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for those with statistical significance. One hundred and six wheezing children underwent pulmonary function tests before and after salbutamol nebulization. With the aforementioned criteria, 41 cases (38.7%) were diagnosed with BHR. History of reactive airway disease, (OR, 6.31; 95% CI, 1.68-25), maternal history of asthma (OR, 3.45; 95% CI, 1.34-9), breastfeeding less than 3 months (OR, 3.18; 95% CI, 1.26-8.12), and passive smoking (OR, 3; 95% CI, 1.15-7.62) were significant risk factors of BHR. The eosinophil count was significantly higher in the BHR (+) group particularly, in children 1-5 years of age (P < or = 0.01). Patchy infiltrates were more commonly found in patients with negative BHR but not

  10. Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia.

    Science.gov (United States)

    Chim, Harvey; Yew, Woon Si; Song, Colin

    2007-01-01

    Terror attacks in Southeast Asia were almost nonexistent until the 2002 Bali bomb blast, considered the deadliest attack in Indonesian history. Further attacks in 2003 (Jakarta), 2004 (Jakarta), and 2005 (Bali) have turned terrorist attacks into an ever-present reality. The authors reviewed medical charts of victims evacuated to the Singapore General Hospital (SGH) Burns Centre during three suicide attacks involving Bali (2002 and 2005) and the Jakarta Marriott hotel (2003). Problems faced, lessons learnt, and costs incurred are discussed. A burns disaster plan drawing on lessons learnt from these attacks is presented. Thirty-one patients were treated at the SGH Burns Centre in three attacks (2002 Bali attack [n = 15], 2003 Jakarta attack [n = 14], and 2005 Bali attack [n = 2]). For the 2002 Bali attack, median age was 29 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 9). A large number of patients had other injuries. Problems faced included manpower issues, lack of bed space, shortage of blood products, and lack of cadaver skin. The changing nature of terror attacks mandates continued vigilance and disaster preparedness. The multidimensional burns patient, complicated by other injuries, is likely to become increasingly common. A burns disaster plan with emphasis on effective command, control, and communication as well as organisation of health care personnel following a 'team concept' will do much to ensure that the sudden onset of a crisis situation at an unexpected time does not overwhelm hospital manpower and resources.

  11. Overview of DOS attacks on wireless sensor networks and experimental results for simulation of interference attacks

    Directory of Open Access Journals (Sweden)

    Željko Gavrić

    2018-01-01

    Full Text Available Wireless sensor networks are now used in various fields. The information transmitted in the wireless sensor networks is very sensitive, so the security issue is very important. DOS (denial of service attacks are a fundamental threat to the functioning of wireless sensor networks. This paper describes some of the most common DOS attacks and potential methods of protection against them. The case study shows one of the most frequent attacks on wireless sensor networks – the interference attack. In the introduction of this paper authors assume that the attack interference can cause significant obstruction of wireless sensor networks. This assumption has been proved in the case study through simulation scenario and simulation results.

  12. Securing internet by eliminating DDOS attacks

    Science.gov (United States)

    Niranchana, R.; Gayathri Devi, N.; Santhi, H.; Gayathri, P.

    2017-11-01

    The major threat caused to the authorised usage of Internet is Distributed Denial of Service attack. The mechanisms used to prevent the DDoS attacks are said to overcome the attack’s ability in spoofing the IP packets source addresses. By utilising Internet Protocol spoofing, the attackers cause a consequential load over the networks destination for policing attack packets. To overcome the IP Spoofing level on the Internet, We propose an Inter domain Packet Filter (IPF) architecture. The proposed scheme is not based on global routing information. The packets with reliable source addresses are not rejected, the IPF frame work works in such a manner. The spoofing capability of attackers is confined by IPF, and also the filter identifies the source of an attack packet by minimal number of candidate network.

  13. Plants under dual attack

    NARCIS (Netherlands)

    Ponzio, C.A.M.

    2016-01-01

    Though immobile, plants are members of complex environments, and are under constant threat from a wide range of attackers, which includes organisms such as insect herbivores or plant pathogens. Plants have developed sophisticated defenses against these attackers, and include chemical responses

  14. New attacks on Wi-Fi Protected Setup

    OpenAIRE

    Hamed Mohtadi; Alireza Rahimi

    2015-01-01

    Wi-Fi Protected Setup (WPS) is a network security standard that is used to secure networks in home and office, introduced in 2006 by the Wi-Fi Alliance. It provides easier configuration setup and is used in almost all recent Wi-Fi devices. In this paper we propose two attacks on this standard. The first attack is an offline brute force attack that uses imbalance on registration protocol. This attack needs user action, but it is more efficient than previous attacks. The second attack uses weak...

  15. A Game Theoretic Approach to Cyber Attack Prediction

    Energy Technology Data Exchange (ETDEWEB)

    Peng Liu

    2005-11-28

    The area investigated by this project is cyber attack prediction. With a focus on correlation-based prediction, current attack prediction methodologies overlook the strategic nature of cyber attack-defense scenarios. As a result, current cyber attack prediction methodologies are very limited in predicting strategic behaviors of attackers in enforcing nontrivial cyber attacks such as DDoS attacks, and may result in low accuracy in correlation-based predictions. This project develops a game theoretic framework for cyber attack prediction, where an automatic game-theory-based attack prediction method is proposed. Being able to quantitatively predict the likelihood of (sequences of) attack actions, our attack prediction methodology can predict fine-grained strategic behaviors of attackers and may greatly improve the accuracy of correlation-based prediction. To our best knowledge, this project develops the first comprehensive framework for incentive-based modeling and inference of attack intent, objectives, and strategies; and this project develops the first method that can predict fine-grained strategic behaviors of attackers. The significance of this research and the benefit to the public can be demonstrated to certain extent by (a) the severe threat of cyber attacks to the critical infrastructures of the nation, including many infrastructures overseen by the Department of Energy, (b) the importance of cyber security to critical infrastructure protection, and (c) the importance of cyber attack prediction to achieving cyber security.

  16. Invisible Trojan-horse attack

    DEFF Research Database (Denmark)

    Sajeed, Shihan; Minshull, Carter; Jain, Nitin

    2017-01-01

    We demonstrate the experimental feasibility of a Trojan-horse attack that remains nearly invisible to the single-photon detectors employed in practical quantum key distribution (QKD) systems, such as Clavis2 from ID Quantique. We perform a detailed numerical comparison of the attack performance...

  17. Radiological attacks and accidents. Medical consequences

    International Nuclear Information System (INIS)

    Sakuta, Hidenari

    2007-01-01

    Probability of the occurrence of radiological attacks appears to be elevated after the terrorist attacks against the United States on September 11 in 2001. There are a lot of scenarios of radiological attack: simple radiological device, radiological disperse device (RDD or dirty bomb), attacks against nuclear reactor, improvised nuclear device, and nuclear weapons. Of these, RDD attack is the most probable scenario, because it can be easily made and can generate enormous psychological and economic damages. Radiological incidents are occurring to and fro in the world, including several cases of theft to nuclear facilities and unsuccessful terrorist attacks against them. Recently, a former Russian spy has allegedly been killed using polonium-210. In addition, serious radiological accidents have occurred in Chernobyl, Goiania, and Tokai-mura. Planning, preparation, education, and training exercise appear to be essential factors to cope with radiological attacks and accidents effectively without feeling much anxiety. Triage and psychological first aid are prerequisite to manage and provide effective medial care for mass casualties without inducing panic. (author)

  18. Script-viruses Attacks on UNIX OS

    Directory of Open Access Journals (Sweden)

    D. M. Mikhaylov

    2010-06-01

    Full Text Available In this article attacks on UNIX OS are considered. Currently antivirus developers are concentrated on protecting systems from viruses that are most common and attack popular operating systems. If the system or its components are not often attacked then the antivirus products are not protecting these components as it is not profitable. The same situation is with script-viruses for UNIX OS as most experts consider that it is impossible for such viruses to get enough rights to attack. Nevertheless the main conclusion of this article is the fact that such viruses can be very powerful and can attack systems and get enough rights.

  19. Hybrid attacks on model-based social recommender systems

    Science.gov (United States)

    Yu, Junliang; Gao, Min; Rong, Wenge; Li, Wentao; Xiong, Qingyu; Wen, Junhao

    2017-10-01

    With the growing popularity of the online social platform, the social network based approaches to recommendation emerged. However, because of the open nature of rating systems and social networks, the social recommender systems are susceptible to malicious attacks. In this paper, we present a certain novel attack, which inherits characteristics of the rating attack and the relation attack, and term it hybrid attack. Furtherly, we explore the impact of the hybrid attack on model-based social recommender systems in multiple aspects. The experimental results show that, the hybrid attack is more destructive than the rating attack in most cases. In addition, users and items with fewer ratings will be influenced more when attacked. Last but not the least, the findings suggest that spammers do not depend on the feedback links from normal users to become more powerful, the unilateral links can make the hybrid attack effective enough. Since unilateral links are much cheaper, the hybrid attack will be a great threat to model-based social recommender systems.

  20. Fresh fruit intake and asthma symptoms in young British adults: confounding or effect modification by smoking?

    Science.gov (United States)

    Butland, B K; Strachan, D P; Anderson, H R

    1999-04-01

    Antioxidant vitamins have been postulated as a protective factor in asthma. The associations between the frequency of fresh fruit consumption in summer, and the prevalence of self-reported asthma symptoms were investigated. The analysis was based on 5,582 males and 5,770 females, born in England, Wales and Scotland between March 3-9, 1958 and aged 33 yrs at the time of survey. The 12-month period prevalence of wheeze and frequent wheeze were inversely associated with frequent intakes of fresh fruit and salad/raw vegetables and positively associated with smoking and lower social class. After adjustment for mutual confounding and sex, associations with smoking persisted, but those with social class and salad/raw vegetable consumption lost significance. The frequency of fresh fruit intake was no longer associated with wheeze after adjustment, but was inversely associated with frequent wheeze and speech-limiting attacks. The association with frequent wheeze differed significantly between smoking groups (never, former, current) and appeared to be confined to exsmokers and current smokers. These findings support postulated associations between infrequent fresh fruit consumption and the prevalence of frequent or severe asthma symptoms in adults. Associations appeared to be restricted to smokers, with effect modification as a more likely explanation of this pattern than residual confounding by smoking.

  1. Prevalence of asthma in schoolchildren in Alta Floresta- a municipality in the southeast of the Brazilian Amazon.

    Science.gov (United States)

    de Farias, Márcia Regina de Col; Rosa, Antonia Maria; Hacon, Sandra de Souza; de Castro, Hermano Albuquerque; Ignotti, Eliane

    2010-03-01

    To analyze the prevalence and symptoms of asthma in students of the Brazilian Amazon municipality of Alta Floresta-MT. Cross-sectional study on the prevalence of asthma in 6 and 7 year-old children and 13 to 14 year-old adolescents, using the Study of Asthma and Allergies in Childhood - ISAAC method, phase I in 2007. Students who answered affirmatively question 2 - "presence of wheezing in the past 12 months" were considered asthmatic. Of the total 2,071 students, 1,072 (51.7%) were children and 999 (48.3%) were teenagers. The prevalence of asthma was 21.4% among schoolchildren, and 12.4% among adolescents (chi2 = 29.29; rho = 0.00). Children presented a higher prevalence than adolescents of the following asthma symptoms: wheezing sometime in life (49.9%), wheezing in the past 12 months (21.4%), 1 to 3 wheezing attacks in the past 12 months (16.4%), and dry cough at night (38.2%). Regarding physician-diagnosed asthma, no difference was observed between the two age groups, with a prevalence of around 6.0%. Male schoolchildren presented a higher prevalence of asthma, physician-diagnosed asthma and four or more wheezing episodes in the past 12 months (rho asthma in Latin America among schoolchildren in the 6 and 7 year-old age group.

  2. An Analysis of Attacks on Blockchain Consensus

    OpenAIRE

    Bissias, George; Levine, Brian Neil; Ozisik, A. Pinar; Andresen, Gavin

    2016-01-01

    We present and validate a novel mathematical model of the blockchain mining process and use it to conduct an economic evaluation of the double-spend attack, which is fundamental to all blockchain systems. Our analysis focuses on the value of transactions that can be secured under a conventional double-spend attack, both with and without a concurrent eclipse attack. Our model quantifies the importance of several factors that determine the attack's success, including confirmation depth, attacke...

  3. Automated classification of computer network attacks

    CSIR Research Space (South Africa)

    Van Heerden, R

    2013-11-01

    Full Text Available according to the relevant types of attack scenarios depicted in the ontology. The two network attack instances are the Distributed Denial of Service attack on SpamHaus in 2013 and the theft of 42 million Rand ($6.7 million) from South African Postbank...

  4. Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE

    Directory of Open Access Journals (Sweden)

    Wickman Magnus

    2006-01-01

    Full Text Available Abstract Background Exposure to cigarette smoking during foetal and early postnatal life may have implications for lung health. The aim of this study was to assess the possible effects of such exposure in utero on lower respiratory disease in children up to two years of age. Methods A birth cohort of 4089 newborn infants was followed for two years using parental questionnaires. When the infant was two months old the parents completed a questionnaire on various lifestyle factors, including maternal smoking during pregnancy and after birth. At one and two years of age information was obtained by questionnaire on symptoms of allergic and respiratory diseases as well as on environmental exposures, particularly exposure to environmental tobacco smoke (ETS. Adjustments were made for potential confounders. Results When the mother had smoked during pregnancy but not after that, there was an increased risk of recurrent wheezing up to two years' age, ORadj = 2.2, (95% CI 1.3 – 3.6. The corresponding OR was 1.6, (95% CI 1.2 – 2.3 for reported exposure to ETS with or without maternal smoking in utero. Maternal smoking during pregnancy but no exposure to ETS also increased the risk of doctor's diagnosed asthma up to two years of age, ORadj = 2.1, (95% CI 1.2 – 3.7. Conclusion Exposure to maternal cigarette smoking in utero is a risk factor for recurrent wheezing, as well as doctor's diagnosed asthma in children up to two yearsof age.

  5. Cyber Attacks and Combat Behavior

    Directory of Open Access Journals (Sweden)

    Carataș Maria Alina

    2017-01-01

    Full Text Available Cyber terrorism is an intangible danger, a real over the corner threat in the life of individuals,organizations, and governments and is getting harder to deal with its damages. The motivations forthe cyber-attacks are different, depending on the terrorist group, from cybercrime to hacktivism,attacks over the authorities’ servers. Organizations constantly need to find new ways ofstrengthening protection against cyber-attacks, assess their cyber readiness, expand the resiliencecapacity and adopts international security regulations.

  6. An international comparison of asthma, wheeze, and breathing medication use among children.

    Science.gov (United States)

    Lawson, Joshua A; Brozek, Grzegorz; Shpakou, Andrei; Fedortsiv, Olga; Vlaski, Emilija; Beridze, Vakhtangi; Rennie, Donna C; Afanasieva, Anna; Beridze, Sophio; Zejda, Jan

    2017-12-01

    There is variation in childhood asthma between countries with typically higher prevalence in "Westernized" nations. We compared asthma, respiratory symptoms, and medication prevalence in Eastern and Central European regions and Canada. We conducted a cross-sectional survey study of children (5-15 years) from one urban centre in each of Canada, Belarus, Poland, Republic of Georgia (Adjara), Republic of Macedonia, and Ukraine. Surveys were distributed through randomly selected schools to parents (2013-2015). The prevalence of asthma differed by country from 20.6% in Canada to 1.5% in Ukraine (p year. Finally, except for Georgia (12.1%), all countries had a prevalence of ever wheeze above 20% (23.8% in Poland to 30.9% in Macedonia). Despite large differences in asthma prevalence, respiratory morbidity was more comparable suggesting asthma prevalence may be underestimated. Further validation of asthma diagnosis is needed. It is important to promote best diagnostic practices among first contact physicians. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Attacks on public telephone networks: technologies and challenges

    Science.gov (United States)

    Kosloff, T.; Moore, Tyler; Keller, J.; Manes, Gavin W.; Shenoi, Sujeet

    2003-09-01

    Signaling System 7 (SS7) is vital to signaling and control in America's public telephone networks. This paper describes a class of attacks on SS7 networks involving the insertion of malicious signaling messages via compromised SS7 network components. Three attacks are discussed in detail: IAM flood attacks, redirection attacks and point code spoofing attacks. Depending on their scale of execution, these attacks can produce effects ranging from network congestion to service disruption. Methods for detecting these denial-of-service attacks and mitigating their effects are also presented.

  8. Defense and attack of complex and dependent systems

    International Nuclear Information System (INIS)

    Hausken, Kjell

    2010-01-01

    A framework is constructed for how to analyze the strategic defense of an infrastructure subject to attack by a strategic attacker. Merging operations research, reliability theory, and game theory for optimal analytical impact, the optimization program for the defender and attacker is specified. Targets can be in parallel, series, combined series-parallel, complex, k-out-of-n redundancy, independent, interdependent, and dependent. The defender and attacker determine how much to invest in defending versus attacking each of multiple targets. A target can have economic, human, and symbolic values, subjectively assessed by the defender and attacker. A contest success function determines the probability of a successful attack on each target, dependent on the investments by the defender and attacker into each target, and on characteristics of the contest. The defender minimizes the expected damage plus the defense costs. The attacker maximizes the expected damage minus the attack costs. Each agent is concerned about how his investments vary across the targets, and the impact on his utilities. Interdependent systems are analyzed where the defense and attack on one target impacts all targets. Dependent systems are analyzed applying Markov analysis and repeated games where a successful attack on one target in the first period impacts the unit costs of defense and attack, and the contest intensity, for the other target in the second period.

  9. Defense and attack of complex and dependent systems

    Energy Technology Data Exchange (ETDEWEB)

    Hausken, Kjell, E-mail: kjell.hausken@uis.n [Faculty of Social Sciences, University of Stavanger, N-4036 Stavanger (Norway)

    2010-01-15

    A framework is constructed for how to analyze the strategic defense of an infrastructure subject to attack by a strategic attacker. Merging operations research, reliability theory, and game theory for optimal analytical impact, the optimization program for the defender and attacker is specified. Targets can be in parallel, series, combined series-parallel, complex, k-out-of-n redundancy, independent, interdependent, and dependent. The defender and attacker determine how much to invest in defending versus attacking each of multiple targets. A target can have economic, human, and symbolic values, subjectively assessed by the defender and attacker. A contest success function determines the probability of a successful attack on each target, dependent on the investments by the defender and attacker into each target, and on characteristics of the contest. The defender minimizes the expected damage plus the defense costs. The attacker maximizes the expected damage minus the attack costs. Each agent is concerned about how his investments vary across the targets, and the impact on his utilities. Interdependent systems are analyzed where the defense and attack on one target impacts all targets. Dependent systems are analyzed applying Markov analysis and repeated games where a successful attack on one target in the first period impacts the unit costs of defense and attack, and the contest intensity, for the other target in the second period.

  10. Automated Generation of Attack Trees

    DEFF Research Database (Denmark)

    Vigo, Roberto; Nielson, Flemming; Nielson, Hanne Riis

    2014-01-01

    Attack trees are widely used to represent threat scenarios in a succinct and intuitive manner, suitable for conveying security information to non-experts. The manual construction of such objects relies on the creativity and experience of specialists, and therefore it is error-prone and impractica......Attack trees are widely used to represent threat scenarios in a succinct and intuitive manner, suitable for conveying security information to non-experts. The manual construction of such objects relies on the creativity and experience of specialists, and therefore it is error......-prone and impracticable for large systems. Nonetheless, the automated generation of attack trees has only been explored in connection to computer networks and levering rich models, whose analysis typically leads to an exponential blow-up of the state space. We propose a static analysis approach where attack trees...... are automatically inferred from a process algebraic specification in a syntax-directed fashion, encompassing a great many application domains and avoiding incurring systematically an exponential explosion. Moreover, we show how the standard propositional denotation of an attack tree can be used to phrase...

  11. How to match the optimal currently available inhaler device to an individual child with asthma or recurrent wheeze

    DEFF Research Database (Denmark)

    van Aalderen, W. M.; Garcia-Marcos, L.; Gappa, M.

    2015-01-01

    Inhaled medications are the cornerstone of treatment in early childhood wheezing and paediatric asthma. A match between patient and device and a correct inhalation technique are crucial for good asthma control. The aim of this paper is to propose an inhaler strategy that will facilitate an inhaler...... in the lungs, and (3) we will propose a practical and easy way to make the best match between the inhaler device and the individual patient. We hope that this paper will contribute to an increased likelihood of treatment success and improved adherence to therapy....

  12. Pareto Efficient Solutions of Attack-Defence Trees

    DEFF Research Database (Denmark)

    Aslanyan, Zaruhi; Nielson, Flemming

    2015-01-01

    Attack-defence trees are a promising approach for representing threat scenarios and possible countermeasures in a concise and intuitive manner. An attack-defence tree describes the interaction between an attacker and a defender, and is evaluated by assigning parameters to the nodes, such as proba......Attack-defence trees are a promising approach for representing threat scenarios and possible countermeasures in a concise and intuitive manner. An attack-defence tree describes the interaction between an attacker and a defender, and is evaluated by assigning parameters to the nodes......, such as probability or cost of attacks and defences. In case of multiple parameters most analytical methods optimise one parameter at a time, e.g., minimise cost or maximise probability of an attack. Such methods may lead to sub-optimal solutions when optimising conflicting parameters, e.g., minimising cost while...... maximising probability. In order to tackle this challenge, we devise automated techniques that optimise all parameters at once. Moreover, in the case of conflicting parameters our techniques compute the set of all optimal solutions, defined in terms of Pareto efficiency. The developments are carried out...

  13. Cross-site scripting attacks procedure and Prevention Strategies

    Directory of Open Access Journals (Sweden)

    Wang Xijun

    2016-01-01

    Full Text Available Cross-site scripting attacks and defense has been the site of attack and defense is an important issue, this paper, the definition of cross-site scripting attacks, according to the current understanding of the chaos on the cross-site scripting, analyzes the causes and harm cross-site scripting attacks formation of attacks XXS complete process XSS attacks made a comprehensive analysis, and then for the web program includes Mobility there are cross-site scripting filter laxity given from ordinary users browse the web and web application developers two the defense cross-site scripting attacks effective strategy.

  14. Heart Attack Symptoms in Women

    Science.gov (United States)

    ... fat, cholesterol and other substances (plaque). Watch an animation of a heart attack . Many women think the ... Support Network Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  15. On the anatomy of social engineering attacks : A literature-based dissection of successful attacks

    NARCIS (Netherlands)

    Bullee, Jan-Willem; Montoya, L.; Pieters, Wolter; Junger, Marianne; Hartel, Pieter H.

    The aim of this studywas to explore the extent towhich persuasion principles are used in successful social engineering attacks. Seventy-four scenarioswere extracted from 4 books on social engineering (written by social engineers) and analysed. Each scenariowas split into attack steps, containing

  16. DDOS ATTACK DETECTION SIMULATION AND HANDLING MECHANISM

    Directory of Open Access Journals (Sweden)

    Ahmad Sanmorino

    2013-11-01

    Full Text Available In this study we discuss how to handle DDoS attack that coming from the attacker by using detection method and handling mechanism. Detection perform by comparing number of packets and number of flow. Whereas handling mechanism perform by limiting or drop the packets that detected as a DDoS attack. The study begins with simulation on real network, which aims to get the real traffic data. Then, dump traffic data obtained from the simulation used for detection method on our prototype system called DASHM (DDoS Attack Simulation and Handling Mechanism. From the result of experiment that has been conducted, the proposed method successfully detect DDoS attack and handle the incoming packet sent by attacker.

  17. Model checking exact cost for attack scenarios

    DEFF Research Database (Denmark)

    Aslanyan, Zaruhi; Nielson, Flemming

    2017-01-01

    Attack trees constitute a powerful tool for modelling security threats. Many security analyses of attack trees can be seamlessly expressed as model checking of Markov Decision Processes obtained from the attack trees, thus reaping the benefits of a coherent framework and a mature tool support....... However, current model checking does not encompass the exact cost analysis of an attack, which is standard for attack trees. Our first contribution is the logic erPCTL with cost-related operators. The extended logic allows to analyse the probability of an event satisfying given cost bounds and to compute...... the exact cost of an event. Our second contribution is the model checking algorithm for erPCTL. Finally, we apply our framework to the analysis of attack trees....

  18. The role of endotoxin in grain dust-induced lung disease.

    Science.gov (United States)

    Schwartz, D A; Thorne, P S; Yagla, S J; Burmeister, L F; Olenchock, S A; Watt, J L; Quinn, T J

    1995-08-01

    To identify the role of endotoxin in grain dust-induced lung disease, we conducted a population-based, cross-sectional investigation among grain handlers and postal workers. The study subjects were selected by randomly sampling all grain facilities and post offices within 100 miles of Iowa City. Our study population consisted of 410 grain workers and 201 postal workers. Grain workers were found to be exposed to higher concentrations of airborne dust (p = 0.0001) and endotoxin (p = 0.0001) when compared with postal workers. Grain workers had a significantly higher prevalence of work-related (cough, phlegm, wheezing, chest tightness, and dyspnea) and chronic (usual cough or phlegm production) respiratory symptoms than postal workers. Moreover, after controlling for age, gender, and cigarette smoking status, work-related respiratory symptoms were strongly associated with the concentration of endotoxin in the bioaerosol in the work setting. The concentration of total dust in the bioaerosol was marginally related to these respiratory problems. After controlling for age, gender, and cigarette smoking status, grain workers were found to have reduced spirometric measures of airflow (FEV1, FEV1/FVC, and FEF25-75) and enhanced airway reactivity to inhaled histamine when compared with postal workers. Although the total dust concentration in the work environment appeared to have little effect on these measures of airflow obstruction, higher concentrations of endotoxin in the bioaerosol were associated with diminished measures of airflow and enhanced bronchial reactivity. Our results indicate that the concentration of endotoxin in the bioaerosol may be particularly important in the development of grain dust-induced lung disease.

  19. NETWORK SECURITY ATTACKS. ARP POISONING CASE STUDY

    Directory of Open Access Journals (Sweden)

    Luminiţa DEFTA

    2010-12-01

    Full Text Available Arp poisoning is one of the most common attacks in a switched network. A switch is a network device that limits the ability of attackers that use a packet sniffer to gain access to information from internal network traffic. However, using ARP poisoning the traffic between two computers can be intercepted even in a network that uses switches. This method is known as man in the middle attack. With this type of attack the affected stations from a network will have invalid entries in the ARP table. Thus, it will contain only the correspondence between the IP addresses of the stations from the same network and a single MAC address (the station that initiated the attack. In this paper we present step by step the initiation of such an attack in a network with three computers. We will intercept the traffic between two stations using the third one (the attacker.

  20. Early life exposure to antibiotics and the subsequent development of eczema, wheeze, and allergic sensitization in the first 2 years of life: the KOALA Birth Cohort Study

    NARCIS (Netherlands)

    Kummeling, Ischa; Stelma, Foekje F.; Dagnelie, Pieter C.; Snijders, Bianca E. P.; Penders, John; Huber, Machteld; van Ree, Ronald; van den Brandt, Piet A.

    2007-01-01

    OBJECTIVES: Antibiotic exposure in early life may be associated with atopic disease development either by interfering with bacterial commensal flora or by modifying the course of bacterial infections. We evaluated early life exposure to antibiotics and the subsequent development of eczema, wheeze,

  1. Understanding How Components of Organisations Contribute to Attacks

    DEFF Research Database (Denmark)

    Gu, Min; Aslanyan, Zaruhi; Probst, Christian W.

    2016-01-01

    Attacks on organisations today explore many different layers, including buildings infrastructure, IT infrastructure, and human factor – the physical, virtual, and social layer. Identifying possible attacks, understanding their impact, and attributing their origin and contributing factors is diffi......Attacks on organisations today explore many different layers, including buildings infrastructure, IT infrastructure, and human factor – the physical, virtual, and social layer. Identifying possible attacks, understanding their impact, and attributing their origin and contributing factors...... is difficult. Recently, system models have been used for automatically identifying possible attacks on the modelled organisation. The generated attacks consider all three layers, making the contribution of building infrastructure, computer infrastructure, and humans (insiders and outsiders) explicit. However......, this contribution is only visible in the attack trees as part of the performed steps; it cannot be mapped back to the model directly since the actions usually involve several elements (attacker and targeted actor or asset). Especially for large attack trees, understanding the relations between several model...

  2. Attack Graph Construction for Security Events Analysis

    Directory of Open Access Journals (Sweden)

    Andrey Alexeevich Chechulin

    2014-09-01

    Full Text Available The paper is devoted to investigation of the attack graphs construction and analysis task for a network security evaluation and real-time security event processing. Main object of this research is the attack modeling process. The paper contains the description of attack graphs building, modifying and analysis technique as well as overview of implemented prototype for network security analysis based on attack graph approach.

  3. Automated Discovery of Mimicry Attacks

    National Research Council Canada - National Science Library

    Giffin, Jonathon T; Jha, Somesh; Miller, Barton P

    2006-01-01

    .... These systems are useful only if they detect actual attacks. Previous research developed manually-constructed mimicry and evasion attacks that avoided detection by hiding a malicious series of system calls within a valid sequence allowed by the model...

  4. The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations.

    Science.gov (United States)

    Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus F C; Simkhada, Padam; Smith, William C S; Ayres, Jon G

    2014-11-06

    Half of the world's population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor PM2.5. Both men and women exposed to biomass smoke reported more respiratory symptoms compared to those exposed to clean fuel. Women exposed to biomass were more likely to complain of ever wheeze (32.0 % vs. 23.5%; p = 0.004) and breathlessness (17.8% vs. 12.0%, p = 0.017) compared to males with tobacco smoking being a major risk factor. Chronic cough was similar in both the biomass and non-biomass smoke exposed groups whereas chronic phlegm was reported less frequently by participants exposed to biomass smoke. Higher PM2.5 levels (≥2 SDs of the 24-hour mean) were associated with breathlessness (OR = 2.10, 95% CI 1.47, 2.99) and wheeze (1.76, 1.37, 2.26). The study suggests that while those exposed to biomass smoke had higher prevalence of respiratory symptoms, urban dwellers (who were exposed to higher ambient air pollution) were more at risk of having productive cough.

  5. Transforming Graphical System Models to Graphical Attack Models

    DEFF Research Database (Denmark)

    Ivanova, Marieta Georgieva; Probst, Christian W.; Hansen, Rene Rydhof

    2016-01-01

    Manually identifying possible attacks on an organisation is a complex undertaking; many different factors must be considered, and the resulting attack scenarios can be complex and hard to maintain as the organisation changes. System models provide a systematic representation of organisations...... approach to transforming graphical system models to graphical attack models in the form of attack trees. Based on an asset in the model, our transformations result in an attack tree that represents attacks by all possible actors in the model, after which the actor in question has obtained the asset....

  6. When Sinuses Attack! (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Search English Español When Sinuses Attack! KidsHealth / For Kids / When Sinuses Attack! What's in this article? What ...

  7. Heart Attack

    Science.gov (United States)

    ... properly causes your body's blood sugar levels to rise, increasing your risk of heart attack. Metabolic syndrome. This occurs when you have obesity, high blood pressure and high blood sugar. Having metabolic ...

  8. Software-based Microarchitectural Attacks

    OpenAIRE

    Gruss, Daniel

    2017-01-01

    Modern processors are highly optimized systems where every single cycle of computation time matters. Many optimizations depend on the data that is being processed. Software-based microarchitectural attacks exploit effects of these optimizations. Microarchitectural side-channel attacks leak secrets from cryptographic computations, from general purpose computations, or from the kernel. This leakage even persists across all common isolation boundaries, such as processes, containers, and virtual ...

  9. Integrating cyber attacks within fault trees

    International Nuclear Information System (INIS)

    Nai Fovino, Igor; Masera, Marcelo; De Cian, Alessio

    2009-01-01

    In this paper, a new method for quantitative security risk assessment of complex systems is presented, combining fault-tree analysis, traditionally used in reliability analysis, with the recently introduced Attack-tree analysis, proposed for the study of malicious attack patterns. The combined use of fault trees and attack trees helps the analyst to effectively face the security challenges posed by the introduction of modern ICT technologies in the control systems of critical infrastructures. The proposed approach allows considering the interaction of malicious deliberate acts with random failures. Formal definitions of fault tree and attack tree are provided and a mathematical model for the calculation of system fault probabilities is presented.

  10. Integrating cyber attacks within fault trees

    Energy Technology Data Exchange (ETDEWEB)

    Nai Fovino, Igor [Joint Research Centre - EC, Institute for the Protection and Security of the Citizen, Ispra, VA (Italy)], E-mail: igor.nai@jrc.it; Masera, Marcelo [Joint Research Centre - EC, Institute for the Protection and Security of the Citizen, Ispra, VA (Italy); De Cian, Alessio [Department of Electrical Engineering, University di Genova, Genoa (Italy)

    2009-09-15

    In this paper, a new method for quantitative security risk assessment of complex systems is presented, combining fault-tree analysis, traditionally used in reliability analysis, with the recently introduced Attack-tree analysis, proposed for the study of malicious attack patterns. The combined use of fault trees and attack trees helps the analyst to effectively face the security challenges posed by the introduction of modern ICT technologies in the control systems of critical infrastructures. The proposed approach allows considering the interaction of malicious deliberate acts with random failures. Formal definitions of fault tree and attack tree are provided and a mathematical model for the calculation of system fault probabilities is presented.

  11. Attack and Vulnerability Penetration Testing: FreeBSD

    Directory of Open Access Journals (Sweden)

    Abdul Hanan Abdullah

    2013-07-01

    Full Text Available Computer system security has become a major concern over the past few years. Attacks, threasts or intrusions, against computer system and network have become commonplace events. However, there are some system devices and other tools that are available to overcome the threat of these attacks. Currently, cyber attack is a major research and inevitable. This paper presents some steps of penetration in FreeBSD operating system, some tools and new steps to attack used in this experiment, probes for reconnaissance, guessing password via brute force, gaining privilege access and flooding victim machine to decrease availability. All these attacks were executed and infiltrate within the environment of Intrusion Threat Detection Universiti Teknologi Malaysia (ITD UTM data set. This work is expected to be a reference for practitioners to prepare their systems from Internet attacks.

  12. Superposition Attacks on Cryptographic Protocols

    DEFF Research Database (Denmark)

    Damgård, Ivan Bjerre; Funder, Jakob Løvstad; Nielsen, Jesper Buus

    2011-01-01

    of information. In this paper, we introduce a fundamentally new model of quantum attacks on classical cryptographic protocols, where the adversary is allowed to ask several classical queries in quantum superposition. This is a strictly stronger attack than the standard one, and we consider the security......Attacks on classical cryptographic protocols are usually modeled by allowing an adversary to ask queries from an oracle. Security is then defined by requiring that as long as the queries satisfy some constraint, there is some problem the adversary cannot solve, such as compute a certain piece...... of several primitives in this model. We show that a secret-sharing scheme that is secure with threshold $t$ in the standard model is secure against superposition attacks if and only if the threshold is lowered to $t/2$. We use this result to give zero-knowledge proofs for all of NP in the common reference...

  13. Recurrent spontaneous attacks of dizziness.

    Science.gov (United States)

    Lempert, Thomas

    2012-10-01

    This article describes the common causes of recurrent vertigo and dizziness that can be diagnosed largely on the basis of history. Ninety percent of spontaneous recurrent vertigo and dizziness can be explained by six disorders: (1) Ménière disease is characterized by vertigo attacks, lasting 20 minutes to several hours, with concomitant hearing loss, tinnitus, and aural fullness. Aural symptoms become permanent during the course of the disease. (2) Attacks of vestibular migraine may last anywhere from minutes to days. Most patients have a previous history of migraine headaches, and many experience migraine symptoms during the attack. (3) Vertebrobasilar TIAs affect older adults with vascular risk factors. Most attacks last less than 1 hour and are accompanied by other symptoms from the posterior circulation territory. (4) Vestibular paroxysmia is caused by vascular compression of the eighth cranial nerve. It manifests itself with brief attacks of vertigo that recur many times per day, sometimes with concomitant cochlear symptoms. (5) Orthostatic hypotension causes brief episodes of dizziness lasting seconds to a few minutes after standing up and is relieved by sitting or lying down. In older adults, it may be accompanied by supine hypertension. (6) Panic attacks usually last minutes, occur in specific situations, and are accompanied by choking, palpitations, tremor, heat, and anxiety. Less common causes of spontaneous recurrent vertigo and dizziness include perilymph fistula, superior canal dehiscence, autoimmune inner ear disease, otosclerosis, cardiac arrhythmia, and medication side effects. Neurologists need to venture into otolaryngology, internal medicine, and psychiatry to master the differential diagnosis of recurrent dizziness.

  14. Shark Attack Project - Marine Attack at Towed Hydrophone Arrays

    National Research Council Canada - National Science Library

    Kalmijn, Adrianus J

    2005-01-01

    The original objective of the SIO Marine Attack project was to identify the electric and magnetic fields causing sharks to inflict serious damage upon the towed hydrophone arrays of US Navy submarines...

  15. Novel Method For Low-Rate Ddos Attack Detection

    Science.gov (United States)

    Chistokhodova, A. A.; Sidorov, I. D.

    2018-05-01

    The relevance of the work is associated with an increasing number of advanced types of DDoS attacks, in particular, low-rate HTTP-flood. Last year, the power and complexity of such attacks increased significantly. The article is devoted to the analysis of DDoS attacks detecting methods and their modifications with the purpose of increasing the accuracy of DDoS attack detection. The article details low-rate attacks features in comparison with conventional DDoS attacks. During the analysis, significant shortcomings of the available method for detecting low-rate DDoS attacks were found. Thus, the result of the study is an informal description of a new method for detecting low-rate denial-of-service attacks. The architecture of the stand for approbation of the method is developed. At the current stage of the study, it is possible to improve the efficiency of an already existing method by using a classifier with memory, as well as additional information.

  16. Heart Attack

    Science.gov (United States)

    ... family history of heart attack race – African Americans, Mexican Americans, Native Americans, and native Hawaiians are at ... Your doctor will prescribe the medicines that are right for you. If you have had a heart ...

  17. Automatic Classification of Attacks on IP Telephony

    Directory of Open Access Journals (Sweden)

    Jakub Safarik

    2013-01-01

    Full Text Available This article proposes an algorithm for automatic analysis of attack data in IP telephony network with a neural network. Data for the analysis is gathered from variable monitoring application running in the network. These monitoring systems are a typical part of nowadays network. Information from them is usually used after attack. It is possible to use an automatic classification of IP telephony attacks for nearly real-time classification and counter attack or mitigation of potential attacks. The classification use proposed neural network, and the article covers design of a neural network and its practical implementation. It contains also methods for neural network learning and data gathering functions from honeypot application.

  18. Further attacks on Yeung-Mintzer fragile watermarking scheme

    Science.gov (United States)

    Fridrich, Jessica; Goljan, Miroslav; Memon, Nasir D.

    2000-05-01

    In this paper, we describe new and improved attacks on the authentication scheme previously proposed by Yeung and Mintzer. Previous attacks assumed that the binary watermark logo inserted in an image for the purposes of authentication was known. Here we remove that assumption and show how the scheme is still vulnerable, even if the binary logo is not known but the attacker has access to multiple images that have been watermarked with the same secret key and contain the same (but unknown) logo. We present two attacks. The first attack infers the secret watermark insertion function and the binary logo, given multiple images authenticated with the same key and containing the same logo. We show that a very good approximation to the logo and watermark insertion function can be constructed using as few as two images. With color images, one needs many more images, nevertheless the attack is still feasible. The second attack we present, which we call the 'collage-attack' is a variation of the Holliman-Memon counterfeiting attack. The proposed variation does not require knowledge of the watermark logo and produces counterfeits of superior quality by means of a suitable dithering process that we develop.

  19. Pareto Efficient Solution of Attack-Defence Trees

    NARCIS (Netherlands)

    Aslanyan, Zaruhi; Nielson, Flemming

    Attack-defence trees are a promising approach for representing threat scenarios and possible countermeasures in a concise and intuitive manner. An attack-defence tree describes the interaction between an attacker and a defender, and is evaluated by assigning parameters to the nodes, such as

  20. Genetic attack on neural cryptography.

    Science.gov (United States)

    Ruttor, Andreas; Kinzel, Wolfgang; Naeh, Rivka; Kanter, Ido

    2006-03-01

    Different scaling properties for the complexity of bidirectional synchronization and unidirectional learning are essential for the security of neural cryptography. Incrementing the synaptic depth of the networks increases the synchronization time only polynomially, but the success of the geometric attack is reduced exponentially and it clearly fails in the limit of infinite synaptic depth. This method is improved by adding a genetic algorithm, which selects the fittest neural networks. The probability of a successful genetic attack is calculated for different model parameters using numerical simulations. The results show that scaling laws observed in the case of other attacks hold for the improved algorithm, too. The number of networks needed for an effective attack grows exponentially with increasing synaptic depth. In addition, finite-size effects caused by Hebbian and anti-Hebbian learning are analyzed. These learning rules converge to the random walk rule if the synaptic depth is small compared to the square root of the system size.

  1. Genetic attack on neural cryptography

    International Nuclear Information System (INIS)

    Ruttor, Andreas; Kinzel, Wolfgang; Naeh, Rivka; Kanter, Ido

    2006-01-01

    Different scaling properties for the complexity of bidirectional synchronization and unidirectional learning are essential for the security of neural cryptography. Incrementing the synaptic depth of the networks increases the synchronization time only polynomially, but the success of the geometric attack is reduced exponentially and it clearly fails in the limit of infinite synaptic depth. This method is improved by adding a genetic algorithm, which selects the fittest neural networks. The probability of a successful genetic attack is calculated for different model parameters using numerical simulations. The results show that scaling laws observed in the case of other attacks hold for the improved algorithm, too. The number of networks needed for an effective attack grows exponentially with increasing synaptic depth. In addition, finite-size effects caused by Hebbian and anti-Hebbian learning are analyzed. These learning rules converge to the random walk rule if the synaptic depth is small compared to the square root of the system size

  2. Genetic attack on neural cryptography

    Science.gov (United States)

    Ruttor, Andreas; Kinzel, Wolfgang; Naeh, Rivka; Kanter, Ido

    2006-03-01

    Different scaling properties for the complexity of bidirectional synchronization and unidirectional learning are essential for the security of neural cryptography. Incrementing the synaptic depth of the networks increases the synchronization time only polynomially, but the success of the geometric attack is reduced exponentially and it clearly fails in the limit of infinite synaptic depth. This method is improved by adding a genetic algorithm, which selects the fittest neural networks. The probability of a successful genetic attack is calculated for different model parameters using numerical simulations. The results show that scaling laws observed in the case of other attacks hold for the improved algorithm, too. The number of networks needed for an effective attack grows exponentially with increasing synaptic depth. In addition, finite-size effects caused by Hebbian and anti-Hebbian learning are analyzed. These learning rules converge to the random walk rule if the synaptic depth is small compared to the square root of the system size.

  3. Asma em escolares do Recife - comparação de prevalências: 1994-95 e 2002 Asthma in schoolchildren from Recife, Brazil. Prevalence comparison: 1994-95 and 2002

    Directory of Open Access Journals (Sweden)

    Murilo C. A. Britto

    2004-01-01

    written questionnaire in 1994-95 and 2002, as part of the International Study of Asthma and Allergies in Childhood. RESULTS: The following prevalence rates were observed in 1994-95 and 2002, respectively: cumulative prevalence of referred asthma: 21 vs. 18.2%; cumulative prevalence of wheezing: 39 vs. 38%; yearly prevalence of wheezing: 19.7 vs. 19.4%; yearly prevalence of night cough: 31 vs. 38%; yearly prevalence of exercise-induced wheezing: 20.6 vs. 23.8%. The yearly prevalence of asthma attacks was 16.3% vs. 15.2% for 1 to 3 attacks; 2.7% vs. 1.2% for 4 to 12 attacks; and 1% vs. 0.4% for more than 12 attacks. The yearly prevalence of attacks that disturbed sleep was 13 and 10.3%. The yearly prevalence of attacks with compromised speech was 4.8 and 4.1%. Higher levels of maternal schooling were related to higher cumulative prevalence of referred asthma and to cumulative and yearly prevalence of wheezing. CONCLUSIONS: The prevalence of asthma and its severe forms is high in teenager students in Recife. It is also related to higher levels of maternal schooling.

  4. Attacks on the AJPS Mersenne-based cryptosystem

    NARCIS (Netherlands)

    K. de Boer (Koen); L. Ducas (Léo); S. Jeffery (Stacey); R. M. de Wolf (Ronald)

    2018-01-01

    textabstractAggarwal, Joux, Prakash and Santha recently introduced a new potentially quantum-safe public-key cryptosystem, and suggested that a brute-force attack is essentially optimal against it. They consider but then dismiss both Meet-in-the-Middle attacks and LLL-based attacks. Very soon after

  5. The political attack ad

    Directory of Open Access Journals (Sweden)

    Palma Peña-Jiménez, Ph.D.

    2011-01-01

    Full Text Available During election campaigns the political spot has a clear objective: to win votes. This message is communicated to the electorate through television and Internet, and usually presents a negative approach, which includes a direct critical message against the opponent, rather than an exposition of proposals. This article is focused on the analysis of the campaign attack video ad purposely created to encourage the disapproval of the political opponent among voters. These ads focus on discrediting the opponent, many times, through the transmission of ad hominem messages, instead of disseminating the potential of the political party and the virtues and manifesto of its candidate. The article reviews the development of the attack ad since its first appearance, which in Spain dates back to 1996, when the famous Doberman ad was broadcast, and examines the most memorable campaign attack ads.

  6. Robust Detection of Stepping-Stone Attacks

    National Research Council Canada - National Science Library

    He, Ting; Tong, Lang

    2006-01-01

    The detection of encrypted stepping-stone attack is considered. Besides encryption and padding, the attacker is capable of inserting chaff packets and perturbing packet timing and transmission order...

  7. A Framework for Attack-Resilient Industrial Control Systems : Attack Detection and Controller Reconfiguration

    OpenAIRE

    Paridari, Kaveh; O'Mahony, Niamh; Mady, Alie El-Din; Chabukswar, Rohan; Boubekeur, Menouer; Sandberg, Henrik

    2017-01-01

    Most existing industrial control systems (ICSs), such as building energy management systems (EMSs), were installed when potential security threats were only physical. With advances in connectivity, ICSs are now, typically, connected to communications networks and, as a result, can be accessed remotely. This extends the attack surface to include the potential for sophisticated cyber attacks, which can adversely impact ICS operation, resulting in service interruption, equipment damage, safety c...

  8. An Adaptive Approach for Defending against DDoS Attacks

    Directory of Open Access Journals (Sweden)

    Muhai Li

    2010-01-01

    Full Text Available In various network attacks, the Distributed Denial-of-Service (DDoS attack is a severe threat. In order to deal with this kind of attack in time, it is necessary to establish a special type of defense system to change strategy dynamically against attacks. In this paper, we introduce an adaptive approach, which is used for defending against DDoS attacks, based on normal traffic analysis. The approach can check DDoS attacks and adaptively adjust its configurations according to the network condition and attack severity. In order to insure the common users to visit the victim server that is being attacked, we provide a nonlinear traffic control formula for the system. Our simulation test indicates that the nonlinear control approach can prevent the malicious attack packets effectively while making legitimate traffic flows arrive at the victim.

  9. Countermeasures for unintentional and intentional video watermarking attacks

    Science.gov (United States)

    Deguillaume, Frederic; Csurka, Gabriela; Pun, Thierry

    2000-05-01

    These last years, the rapidly growing digital multimedia market has revealed an urgent need for effective copyright protection mechanisms. Therefore, digital audio, image and video watermarking has recently become a very active area of research, as a solution to this problem. Many important issues have been pointed out, one of them being the robustness to non-intentional and intentional attacks. This paper studies some attacks and proposes countermeasures applied to videos. General attacks are lossy copying/transcoding such as MPEG compression and digital/analog (D/A) conversion, changes of frame-rate, changes of display format, and geometrical distortions. More specific attacks are sequence edition, and statistical attacks such as averaging or collusion. Averaging attack consists of averaging locally consecutive frames to cancel the watermark. This attack works well for schemes which embed random independent marks into frames. In the collusion attack the watermark is estimated from single frames (based on image denoising), and averaged over different scenes for better accuracy. The estimated watermark is then subtracted from each frame. Collusion requires that the same mark is embedded into all frames. The proposed countermeasures first ensures robustness to general attacks by spread spectrum encoding in the frequency domain and by the use of an additional template. Secondly, a Bayesian criterion, evaluating the probability of a correctly decoded watermark, is used for rejection of outliers, and to implement an algorithm against statistical attacks. The idea is to embed randomly chosen marks among a finite set of marks, into subsequences of videos which are long enough to resist averaging attacks, but short enough to avoid collusion attacks. The Bayesian criterion is needed to select the correct mark at the decoding step. Finally, the paper presents experimental results showing the robustness of the proposed method.

  10. Link-layer Jamming Attacks on S-MAC

    NARCIS (Netherlands)

    Law, Y.W.; Hartel, Pieter H.; den Hartog, Jeremy; Havinga, Paul J.M.

    2004-01-01

    We argue that among denial-of-service (DoS) attacks, link-layer jamming is a more attractive option to attackers than radio jamming is. By exploiting the semantics of the link-layer protocol (aka MAC protocol), an attacker can achieve better efficiency than blindly jamming the radio signals alone.

  11. Link-layer jamming attacks on S-MAC

    NARCIS (Netherlands)

    Law, Y.W.; Hartel, Pieter H.; den Hartog, Jeremy; Havinga, Paul J.M.

    We argue that among denial-of-service (DoS) attacks, link-layer jamming is a more attractive option to attackers than radio jamming is. By exploiting the semantics of the link-layer protocol (aka MAC protocol), an attacker can achieve better efficiency than blindly jamming the radio signals alone.

  12. A computer network attack taxonomy and ontology

    CSIR Research Space (South Africa)

    Van Heerden, RP

    2012-01-01

    Full Text Available of the attack that occur after the attack goal has been achieved, and occurs because the attacker loses control of some systems. For example, after the launch of a DDOS (Distributed Denial of Service) attack, zombie computers may still connect to the target...-scrap- value-of-a-hacked-pc-revisited/ . Lancor, L., & Workman, R. (2007). Using Google Hacking to Enhance Defense Strategies. ACM SIGCSE Bulletin, 39 (1), 491-495. Lau, F., Rubin, S. H., Smith, M. H., & Trajkovic, L. (2000). Distributed Denial of Service...

  13. Unified communications forensics anatomy of common UC attacks

    CERN Document Server

    Grant, Nicholas Mr

    2013-01-01

    Unified Communications Forensics: Anatomy of Common UC Attacks is the first book to explain the issues and vulnerabilities and demonstrate the attacks, forensic artifacts, and countermeasures required to establish a secure (UC) environment. This book is written by leading UC experts Nicholas Grant and Joseph W. Shaw II and provides material never before found on the market, including: analysis of forensic artifacts in common UC attacks an in-depth look at established UC technologies and attack exploits hands-on understanding of UC attack vectors and associated countermeasures

  14. Attacks and countermeasures on AES and ECC

    DEFF Research Database (Denmark)

    Tange, Henrik; Andersen, Birger

    2013-01-01

    AES (Advanced Encryption Standard) is widely used in LTE and Wi-Fi communication systems. AES has recently been exposed to new attacks which have questioned the overall security of AES. The newest attack is a so called biclique attack, which is using the fact that the content of the state array...

  15. Classifying network attack scenarios using an ontology

    CSIR Research Space (South Africa)

    Van Heerden, RP

    2012-03-01

    Full Text Available ) or to the target?s reputation. The Residue sub-phase refers to damage or artefacts of the attack that occur after the attack goal has been achieved, and occurs because the attacker loses control of some systems. For example after the launch of a DDOS..., A. (1995). Hacking theft of $10 million from citibank revealed. Retrieved 10/10, 2011, from http://articles.latimes.com/1995-08-19/business/fi-36656_1_citibank-system Hurley, E. (2004). SCO site succumbs to DDoS attack. Retrieved 10/10, 2011, from...

  16. Modelling Social-Technical Attacks with Timed Automata

    DEFF Research Database (Denmark)

    David, Nicolas; David, Alexandre; Hansen, Rene Rydhof

    2015-01-01

    . In this paper we develop an approach towards modelling socio-technical systems in general and socio-technical attacks in particular, using timed automata and illustrate its application by a complex case study. Thanks to automated model checking and automata theory, we can automatically generate possible attacks...... in our model and perform analysis and simulation of both model and attack, revealing details about the specific interaction between attacker and victim. Using timed automata also allows for intuitive modelling of systems, in which quantities like time and cost can be easily added and analysed....

  17. Quantitative Verification and Synthesis of Attack-Defence Scenarios

    DEFF Research Database (Denmark)

    Aslanyan, Zaruhi; Nielson, Flemming; Parker, David

    2016-01-01

    analysis of quantitative properties of complex attack-defence scenarios, using an extension of attack-defence trees which models temporal ordering of actions and allows explicit dependencies in the strategies adopted by attackers and defenders. We adopt a game-theoretic approach, translating attack...... which guarantee or optimise some quantitative property, such as the probability of a successful attack, the expected cost incurred, or some multi-objective trade-off between the two. We implement our approach, building upon the PRISM-games model checker, and apply it to a case study of an RFID goods...

  18. Situational awareness of a coordinated cyber attack

    Science.gov (United States)

    Sudit, Moises; Stotz, Adam; Holender, Michael

    2005-03-01

    As technology continues to advance, services and capabilities become computerized, and an ever increasing amount of business is conducted electronically the threat of cyber attacks gets compounded by the complexity of such attacks and the criticality of the information which must be secured. A new age of virtual warfare has dawned in which seconds can differentiate between the protection of vital information and/or services and a malicious attacker attaining their goal. In this paper we present a novel approach in the real-time detection of multistage coordinated cyber attacks and the promising initial testing results we have obtained. We introduce INFERD (INformation Fusion Engine for Real-time Decision-making), an adaptable information fusion engine which performs fusion at levels zero, one, and two to provide real-time situational assessment and its application to the cyber domain in the ECCARS (Event Correlation for Cyber Attack Recognition System) system. The advantages to our approach are fourfold: (1) The complexity of the attacks which we consider, (2) the level of abstraction in which the analyst interacts with the attack scenarios, (3) the speed at which the information fusion is presented and performed, and (4) our disregard for ad-hoc rules or a priori parameters.

  19. Anti-discrimination Analysis Using Privacy Attack Strategies

    KAUST Repository

    Ruggieri, Salvatore

    2014-09-15

    Social discrimination discovery from data is an important task to identify illegal and unethical discriminatory patterns towards protected-by-law groups, e.g., ethnic minorities. We deploy privacy attack strategies as tools for discrimination discovery under hard assumptions which have rarely tackled in the literature: indirect discrimination discovery, privacy-aware discrimination discovery, and discrimination data recovery. The intuition comes from the intriguing parallel between the role of the anti-discrimination authority in the three scenarios above and the role of an attacker in private data publishing. We design strategies and algorithms inspired/based on Frèchet bounds attacks, attribute inference attacks, and minimality attacks to the purpose of unveiling hidden discriminatory practices. Experimental results show that they can be effective tools in the hands of anti-discrimination authorities.

  20. Cyberprints: Identifying Cyber Attackers by Feature Analysis

    Science.gov (United States)

    Blakely, Benjamin A.

    2012-01-01

    The problem of attributing cyber attacks is one of increasing importance. Without a solid method of demonstrating the origin of a cyber attack, any attempts to deter would-be cyber attackers are wasted. Existing methods of attribution make unfounded assumptions about the environment in which they will operate: omniscience (the ability to gather,…

  1. Simulation of Attacks for Security in Wireless Sensor Network.

    Science.gov (United States)

    Diaz, Alvaro; Sanchez, Pablo

    2016-11-18

    The increasing complexity and low-power constraints of current Wireless Sensor Networks (WSN) require efficient methodologies for network simulation and embedded software performance analysis of nodes. In addition, security is also a very important feature that has to be addressed in most WSNs, since they may work with sensitive data and operate in hostile unattended environments. In this paper, a methodology for security analysis of Wireless Sensor Networks is presented. The methodology allows designing attack-aware embedded software/firmware or attack countermeasures to provide security in WSNs. The proposed methodology includes attacker modeling and attack simulation with performance analysis (node's software execution time and power consumption estimation). After an analysis of different WSN attack types, an attacker model is proposed. This model defines three different types of attackers that can emulate most WSN attacks. In addition, this paper presents a virtual platform that is able to model the node hardware, embedded software and basic wireless channel features. This virtual simulation analyzes the embedded software behavior and node power consumption while it takes into account the network deployment and topology. Additionally, this simulator integrates the previously mentioned attacker model. Thus, the impact of attacks on power consumption and software behavior/execution-time can be analyzed. This provides developers with essential information about the effects that one or multiple attacks could have on the network, helping them to develop more secure WSN systems. This WSN attack simulator is an essential element of the attack-aware embedded software development methodology that is also introduced in this work.

  2. Simulation of Attacks for Security in Wireless Sensor Network

    Science.gov (United States)

    Diaz, Alvaro; Sanchez, Pablo

    2016-01-01

    The increasing complexity and low-power constraints of current Wireless Sensor Networks (WSN) require efficient methodologies for network simulation and embedded software performance analysis of nodes. In addition, security is also a very important feature that has to be addressed in most WSNs, since they may work with sensitive data and operate in hostile unattended environments. In this paper, a methodology for security analysis of Wireless Sensor Networks is presented. The methodology allows designing attack-aware embedded software/firmware or attack countermeasures to provide security in WSNs. The proposed methodology includes attacker modeling and attack simulation with performance analysis (node’s software execution time and power consumption estimation). After an analysis of different WSN attack types, an attacker model is proposed. This model defines three different types of attackers that can emulate most WSN attacks. In addition, this paper presents a virtual platform that is able to model the node hardware, embedded software and basic wireless channel features. This virtual simulation analyzes the embedded software behavior and node power consumption while it takes into account the network deployment and topology. Additionally, this simulator integrates the previously mentioned attacker model. Thus, the impact of attacks on power consumption and software behavior/execution-time can be analyzed. This provides developers with essential information about the effects that one or multiple attacks could have on the network, helping them to develop more secure WSN systems. This WSN attack simulator is an essential element of the attack-aware embedded software development methodology that is also introduced in this work. PMID:27869710

  3. Using agility to combat cyber attacks.

    Science.gov (United States)

    Anderson, Kerry

    2017-06-01

    Some incident response practitioners feel that they have been locked in a battle with cyber criminals since the popular adoption of the internet. Initially, organisations made great inroads in preventing and containing cyber attacks. In the last few years, however, cyber criminals have become adept at eluding defence security technologies and rapidly modifying their exploit strategies for financial or political gains. Similar to changes in military combat tactics, cyber criminals utilise distributed attack cells, real-time communications, and rapidly mutating exploits to minimise the potential for detection. Cyber criminals have changed their attack paradigm. This paper describes a new incident response paradigm aimed at combating the new model of cyber attacks with an emphasis on agility to increase the organisation's ability to respond rapidly to these new challenges.

  4. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter ... most common heart attack symptom in men and women is chest pain or discomfort. However, women also ...

  5. A novel proposed network security management approach for cyber attacks

    International Nuclear Information System (INIS)

    Ahmed, Z.; Nazir, B.; Zafar, M.F.; Anwar, M.M.; Azam, K.; Asar, A.U.

    2007-01-01

    Network security is a discipline that focuses on securing networks from unauthorized access. Given the Escalating threats of malicious cyber attacks, modern enterprises employ multiple lines of defense. A comprehensive defense strategy against such attacks should include (I) an attack detection component that deter- mines the fact that a program is compromised, (2) an attack identification and prevention component that identifies attack packets so that one can block such packets in the future and prevents the attack from further propagation. Over the last decade, a significant amount of research has been vested in the systems that can detect cyber attacks either statically at compile time or dynamically at run time, However, not much effort is spent on automated attack packet identification or attack prevention. In this paper we present a unified solution to the problems mentioned above. We implemented this solution after the forward engineering of Open Source Security Information Management (OSSIM) system called Preventive Information Security management (PrISM) system that correlates input from different sensors so that the resulting product can automatically detect any cyber attack against it and prevents by identifying the actual attack packet(s). The PrISM was always able to detect the attacks, identify the attack packets and most often prevent by blocking the attacker's IP address to continue normal execution. There is no additional run-time performance overhead for attack prevention. (author)

  6. Adaptive optimisation-offline cyber attack on remote state estimator

    Science.gov (United States)

    Huang, Xin; Dong, Jiuxiang

    2017-10-01

    Security issues of cyber-physical systems have received increasing attentions in recent years. In this paper, deception attacks on the remote state estimator equipped with the chi-squared failure detector are considered, and it is assumed that the attacker can monitor and modify all the sensor data. A novel adaptive optimisation-offline cyber attack strategy is proposed, where using the current and previous sensor data, the attack can yield the largest estimation error covariance while ensuring to be undetected by the chi-squared monitor. From the attacker's perspective, the attack is better than the existing linear deception attacks to degrade the system performance. Finally, some numerical examples are provided to demonstrate theoretical results.

  7. Cyber-physical attacks a growing invisible threat

    CERN Document Server

    Loukas, George

    2015-01-01

    Cyber-Physical Attacks: A Growing Invisible Threat presents the growing list of harmful uses of computers and their ability to disable cameras, turn off a building's lights, make a car veer off the road,  or a drone land in enemy hands. In essence, it details the ways cyber-physical attacks are replacing physical attacks in crime, warfare, and terrorism. The book explores how attacks using computers affect the physical world in ways that were previously only possible through physical means. Perpetrators can now cause damage without the same risk, and without the political, social, or moral

  8. Use of Attack Graphs in Security Systems

    Directory of Open Access Journals (Sweden)

    Vivek Shandilya

    2014-01-01

    Full Text Available Attack graphs have been used to model the vulnerabilities of the systems and their potential exploits. The successful exploits leading to the partial/total failure of the systems are subject of keen security interest. Considerable effort has been expended in exhaustive modeling, analyses, detection, and mitigation of attacks. One prominent methodology involves constructing attack graphs of the pertinent system for analysis and response strategies. This not only gives the simplified representation of the system, but also allows prioritizing the security properties whose violations are of greater concern, for both detection and repair. We present a survey and critical study of state-of-the-art technologies in attack graph generation and use in security system. Based on our research, we identify the potential, challenges, and direction of the current research in using attack graphs.

  9. A fatal elephant attack.

    Science.gov (United States)

    Hejna, Petr; Zátopková, Lenka; Safr, Miroslav

    2012-01-01

    A rare case of an elephant attack is presented. A 44-year-old man working as an elephant keeper was attacked by a cow elephant when he tripped over a foot chain while the animal was being medically treated. The man fell down and was consequently repeatedly attacked with elephant tusks. The man sustained multiple stab injuries to both groin regions, a penetrating injury to the abdominal wall with traumatic prolapse of the loops of the small bowel, multiple defects of the mesentery, and incomplete laceration of the abdominal aorta with massive bleeding into the abdominal cavity. In addition to the penetrating injuries, the man sustained multiple rib fractures with contusion of both lungs and laceration of the right lobe of the liver, and comminuted fractures of the pelvic arch and left femoral body. The man died shortly after he had been received at the hospital. The cause of death was attributed to traumatic shock. © 2011 American Academy of Forensic Sciences.

  10. Cyber Attacks, Information Attacks, and Postmodern Warfare

    Directory of Open Access Journals (Sweden)

    Valuch Jozef

    2017-06-01

    Full Text Available The aim of this paper is to evaluate and differentiate between the phenomena of cyberwarfare and information warfare, as manifestations of what we perceive as postmodern warfare. We describe and analyse the current examples of the use the postmodern warfare and the reactions of states and international bodies to these phenomena. The subject matter of this paper is the relationship between new types of postmodern conflicts and the law of armed conflicts (law of war. Based on ICJ case law, it is clear that under current legal rules of international law of war, cyber attacks as well as information attacks (often performed in the cyberspace as well can only be perceived as “war” if executed in addition to classical kinetic warfare, which is often not the case. In most cases perceived “only” as a non-linear warfare (postmodern conflict, this practice nevertheless must be condemned as conduct contrary to the principles of international law and (possibly a crime under national laws, unless this type of conduct will be recognized by the international community as a “war” proper, in its new, postmodern sense.

  11. False Positive and False Negative Effects on Network Attacks

    Science.gov (United States)

    Shang, Yilun

    2018-01-01

    Robustness against attacks serves as evidence for complex network structures and failure mechanisms that lie behind them. Most often, due to detection capability limitation or good disguises, attacks on networks are subject to false positives and false negatives, meaning that functional nodes may be falsely regarded as compromised by the attacker and vice versa. In this work, we initiate a study of false positive/negative effects on network robustness against three fundamental types of attack strategies, namely, random attacks (RA), localized attacks (LA), and targeted attack (TA). By developing a general mathematical framework based upon the percolation model, we investigate analytically and by numerical simulations of attack robustness with false positive/negative rate (FPR/FNR) on three benchmark models including Erdős-Rényi (ER) networks, random regular (RR) networks, and scale-free (SF) networks. We show that ER networks are equivalently robust against RA and LA only when FPR equals zero or the initial network is intact. We find several interesting crossovers in RR and SF networks when FPR is taken into consideration. By defining the cost of attack, we observe diminishing marginal attack efficiency for RA, LA, and TA. Our finding highlights the potential risk of underestimating or ignoring FPR in understanding attack robustness. The results may provide insights into ways of enhancing robustness of network architecture and improve the level of protection of critical infrastructures.

  12. Machine Learning Methods for Attack Detection in the Smart Grid.

    Science.gov (United States)

    Ozay, Mete; Esnaola, Inaki; Yarman Vural, Fatos Tunay; Kulkarni, Sanjeev R; Poor, H Vincent

    2016-08-01

    Attack detection problems in the smart grid are posed as statistical learning problems for different attack scenarios in which the measurements are observed in batch or online settings. In this approach, machine learning algorithms are used to classify measurements as being either secure or attacked. An attack detection framework is provided to exploit any available prior knowledge about the system and surmount constraints arising from the sparse structure of the problem in the proposed approach. Well-known batch and online learning algorithms (supervised and semisupervised) are employed with decision- and feature-level fusion to model the attack detection problem. The relationships between statistical and geometric properties of attack vectors employed in the attack scenarios and learning algorithms are analyzed to detect unobservable attacks using statistical learning methods. The proposed algorithms are examined on various IEEE test systems. Experimental analyses show that machine learning algorithms can detect attacks with performances higher than attack detection algorithms that employ state vector estimation methods in the proposed attack detection framework.

  13. Transient Ischemic Attack

    Medline Plus

    Full Text Available ... stroke symptoms. Popular Topics TIA Cardiac Catheter Cholesterol Heart Attack Stent © 2018, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. ...

  14. Application distribution model and related security attacks in VANET

    Science.gov (United States)

    Nikaein, Navid; Kanti Datta, Soumya; Marecar, Irshad; Bonnet, Christian

    2013-03-01

    In this paper, we present a model for application distribution and related security attacks in dense vehicular ad hoc networks (VANET) and sparse VANET which forms a delay tolerant network (DTN). We study the vulnerabilities of VANET to evaluate the attack scenarios and introduce a new attacker`s model as an extension to the work done in [6]. Then a VANET model has been proposed that supports the application distribution through proxy app stores on top of mobile platforms installed in vehicles. The steps of application distribution have been studied in detail. We have identified key attacks (e.g. malware, spamming and phishing, software attack and threat to location privacy) for dense VANET and two attack scenarios for sparse VANET. It has been shown that attacks can be launched by distributing malicious applications and injecting malicious codes to On Board Unit (OBU) by exploiting OBU software security holes. Consequences of such security attacks have been described. Finally, countermeasures including the concepts of sandbox have also been presented in depth.

  15. Nonepileptic attack disorder among married women.

    Science.gov (United States)

    Dhanaraj, M; Rangaraj, R; Arulmozhi, T; Vengatesan, A

    2005-06-01

    To study the clinical features, precipitating stressful life events and prognosis of nonepileptic attack disorder (NEAD) among married women. Prospective cohort study with 1-year follow-up. A tertiary care teaching hospital. Of the 1020 patients with epilepsy referred to the epilepsy clinic during 2002-2003, 30 were married women with NEAD. The diagnostic criteria for NEAD included normal EEG during ictal and post-ictal phase of the generalized 'attack.' The data collected included clinical characteristics, semiology of the attacks, precipitating stressful events, and co-morbid psychiatric disorders. The control group included 30 age-matched married women with generalized tonic-clonic seizures. The long-term outcome and factors influencing the outcomes were analyzed. The mean duration of illness was 18 months, and the pattern of the attack was 'fall and lying still' in 53% and 'fall with generalized motor movements' in 47%. The frequency was one or more per week in 57% and occasionally in 43%. The important stressful events were matrimonial discord following illegal relationship of the husband with another woman (chi2 = 9.02, P = 0.003) and constant quarrel with other family members (chi2 = 5.19, P = 0.02). The prevalence of sexual abuse was low (7%). Co-morbid psychiatric disorder was observed in 70%. At the end of 1 year, 39% were free from the attack. Resolution of the stressful life events (chi2 = 4.52, P = 0.03) and lower frequency of attack at the time of reporting (chi2 = 3.88, P = 0.05) correlated with good outcomes. Among patients with NEAD in India, the major precipitating factors were matrimonial discord following illegal relationship of the husband with another woman and constant quarrel with other family members and not sexual abuse. Women with low frequency of attack at the time of reporting and the remission of the stressful events had better outcomes.

  16. Subclinical endophthalmitis following a rooster attack.

    Science.gov (United States)

    Lekse Kovach, Jaclyn; Maguluri, Srilakshmi; Recchia, Franco M

    2006-12-01

    Ocular injury resulting from rooster attacks is rarely reported in the literature. Sadly, the target of these attacks is most often children younger than 3 years old, whose naiveté of the aggressive, territorial behavior of birds can place them at risk. Acute sequelae of these attacks can result in a lifetime of visual impairment. The possibility of a subacute or occult infection is an unusual occurrence that must always be considered. In an effort to prevent future attacks and ocular casualties, we present a case of a 12-month-old boy who suffered an open globe following a rooster attack. The open globe was emergently repaired. One week later, a white cataract was noticed on examination in the absence of systemic or ocular signs of inflammation. Traumatic endophthalmitis and lenticular abscess were suspected during examination under anesthesia. Vitrectomy, lensectomy, and injection of intravitreal antibiotics were performed. Culture of lenticular and vitreous aspirates grew alpha-streptococcus. Alpha-streptococcal endophthalmitis can result from ocular injuries caused by rooster pecking. The infection may present insidiously and without typical ocular or systemic symptoms or signs. Management is challenging and may require surgery.

  17. Robustness analysis of interdependent networks under multiple-attacking strategies

    Science.gov (United States)

    Gao, Yan-Li; Chen, Shi-Ming; Nie, Sen; Ma, Fei; Guan, Jun-Jie

    2018-04-01

    The robustness of complex networks under attacks largely depends on the structure of a network and the nature of the attacks. Previous research on interdependent networks has focused on two types of initial attack: random attack and degree-based targeted attack. In this paper, a deliberate attack function is proposed, where six kinds of deliberate attacking strategies can be derived by adjusting the tunable parameters. Moreover, the robustness of four types of interdependent networks (BA-BA, ER-ER, BA-ER and ER-BA) with different coupling modes (random, positive and negative correlation) is evaluated under different attacking strategies. Interesting conclusions could be obtained. It can be found that the positive coupling mode can make the vulnerability of the interdependent network to be absolutely dependent on the most vulnerable sub-network under deliberate attacks, whereas random and negative coupling modes make the vulnerability of interdependent network to be mainly dependent on the being attacked sub-network. The robustness of interdependent network will be enhanced with the degree-degree correlation coefficient varying from positive to negative. Therefore, The negative coupling mode is relatively more optimal than others, which can substantially improve the robustness of the ER-ER network and ER-BA network. In terms of the attacking strategies on interdependent networks, the degree information of node is more valuable than the betweenness. In addition, we found a more efficient attacking strategy for each coupled interdependent network and proposed the corresponding protection strategy for suppressing cascading failure. Our results can be very useful for safety design and protection of interdependent networks.

  18. Optimizing power system investments and resilience against attacks

    International Nuclear Information System (INIS)

    Fang, Yiping; Sansavini, Giovanni

    2017-01-01

    This paper studies the combination of capacity expansion and switch installation in electric systems that ensures optimum performance under nominal operations and attacks. The planner–attacker–defender model is adopted to develop decisions that minimize investment and operating costs, and functionality loss after attacks. The model bridges long-term system planning for transmission expansion and short-term switching operations in reaction to attacks. The mixed-integer optimization is solved by decomposition via two-layer cutting plane algorithm. Numerical results on an IEEE system shows that small investments in transmission line switching enhance resilience by responding to disruptions via system reconfiguration. Sensitivity analyses show that transmission planning under the assumption of small-scale attacks provides the most robust strategy, i.e. the minimum-regret planning, if many constraints and limited investment budget affect the planning. On the other hand, the assumption of large-scale attacks provides the most robust strategy if the planning process involves large flexibility and budget. - Highlights: • Investment optimization in power systems under attacks is presented. • Capacity expansion and switch installation for system reconfiguration are combined. • The problem is solved by decomposition via two-layer cutting plane algorithm. • Small investments in switch installation enhance resilience by response to attacks. • Sensitivity analyses identify robust planning against different attack scenarios.

  19. Attacker Modelling in Ubiquitous Computing Systems

    DEFF Research Database (Denmark)

    Papini, Davide

    in with our everyday life. This future is visible to everyone nowadays: terms like smartphone, cloud, sensor, network etc. are widely known and used in our everyday life. But what about the security of such systems. Ubiquitous computing devices can be limited in terms of energy, computing power and memory...... attacker remain somehow undened and still under extensive investigation. This Thesis explores the nature of the ubiquitous attacker with a focus on how she interacts with the physical world and it denes a model that captures the abilities of the attacker. Furthermore a quantitative implementation...

  20. Peacetime Use of Computer Network Attack

    National Research Council Canada - National Science Library

    Busby, Daniel

    2000-01-01

    .... PDD-63 alerts the nation to prepare for impending cyber attacks. This paper examines the nature, scale, and likelihood of cyber attacks posited in PDD-63 and finds that the country does not face an imminent "electronic Pearl Harbor...

  1. Denial of Service Attack Techniques: Analysis, Implementation and Comparison

    Directory of Open Access Journals (Sweden)

    Khaled Elleithy

    2005-02-01

    Full Text Available A denial of service attack (DOS is any type of attack on a networking structure to disable a server from servicing its clients. Attacks range from sending millions of requests to a server in an attempt to slow it down, flooding a server with large packets of invalid data, to sending requests with an invalid or spoofed IP address. In this paper we show the implementation and analysis of three main types of attack: Ping of Death, TCP SYN Flood, and Distributed DOS. The Ping of Death attack will be simulated against a Microsoft Windows 95 computer. The TCP SYN Flood attack will be simulated against a Microsoft Windows 2000 IIS FTP Server. Distributed DOS will be demonstrated by simulating a distribution zombie program that will carry the Ping of Death attack. This paper will demonstrate the potential damage from DOS attacks and analyze the ramifications of the damage.

  2. Genetic associations with asthma and virus-induced wheezing: a systematic review Associação genética da asma e da sibilância induzida por vírus: uma revisão sistemática

    Directory of Open Access Journals (Sweden)

    Leonardo Araujo Pinto

    2009-12-01

    Full Text Available Various wheezing phenotypes can be identified based on differences in natural histories, risk factors and responses to treatment. In epidemiologic studies, atopic asthma or virus-induced wheezing can be discriminated by the presence or the absence of sensitization to allergens. Children with asthma have been shown to present lower levels of lung function. Patients with viral respiratory infections evolve from normal lung function to enhanced airway reactivity. The objective of this study was to identify genes and polymorphisms associated with different wheezing phenotypes. Using data obtained from the Genetic Association Database, we systematically reviewed studies on genes and polymorphisms that have been associated with virus-induced wheezing or atopic asthma. The research was carried out in February of 2009. Genes associated with the studied outcomes in more than three studies were included in the analysis. We found that different genes and loci have been associated with virus-induced wheezing or atopic asthma. Virus-induced wheezing has frequently been associated with IL-8 polymorphisms, whereas atopic asthma and atopy have frequently been associated with Th2 cytokine gene (CD14 and IL-13 polymorphisms on chromosome 5. This review provides evidence that different wheezing disorders in childhood can be differently affected by genetic variations, considering their role on airway inflammation and atopy. Future studies of genetic associations should consider the different wheezing phenotypes in infancy. In addition, stratified analyses for atopy can be useful for elucidating the mechanisms of the disease.Diversos fenótipos de sibilância têm sido identificados com base em diferenças na história natural, fatores de risco e resposta ao tratamento. Em estudos epidemiológicos, a asma atópica ou sibilância induzida por vírus pode ser discriminada pela presença ou ausência de sensibilização a alérgenos. As crianças com asma apresentam n

  3. Attacks on IEEE 802.11 wireless networks

    Directory of Open Access Journals (Sweden)

    Dejan Milan Tepšić

    2013-06-01

    Full Text Available Security of wireless computer networks was initially secured with the WEP security protocol, which relies on the RC4 encryption algorithm and the CRC algorithm to check the integrity. The basic problems of the WEP are a short initialization vector, unsafe data integrity checking, using a common key, the lack of mechanisms for management and exchange of keys, the lack of protection from the endless insertion of the same package into the network, the lack of authentication of access points and the like. The consequences of these failures are easy attacks against the WEP network, namely their complete insecurity. Therefore, the work began on the IEEE 802.11i protocol, which should radically improve the security of wireless networks. Since the development of a protocol lasted, the WPA standard was released to offset the security gap caused by the WEP. The WPA also relies on RC4 and CRC algorithms, but brings temporary keys and the MIC algorithm for data integrity. The 802.1X authentication was introduced and common keys are no longer needed, since it is possible to use an authentication server. The length of the initialization vector was increased and the vector is obtained based on the packet serial number, in order to prevent the insertion of the same packet into the network. The weakness of the WPA security mechanism is the use of a common key. WPA2 (802.11i later appeared. Unlike the WPA mechanism that worked on old devices with the replacement of software, WPA2 requires new network devices that can perform AES encryption. AES replaces the RC4 algorithm and delivers much greater security. Data integrity is protected by encryption. Despite progress, there are still weaknesses in wireless networks. Attacks for denial of service are possible as well as spoofing package headers attacks. For now, it is not advisable to use wireless networks in environments where unreliability and unavailability are not tolerated. Introduction In the entire history of

  4. Temporal Cyber Attack Detection.

    Energy Technology Data Exchange (ETDEWEB)

    Ingram, Joey Burton [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Draelos, Timothy J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Galiardi, Meghan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Doak, Justin E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-11-01

    Rigorous characterization of the performance and generalization ability of cyber defense systems is extremely difficult, making it hard to gauge uncertainty, and thus, confidence. This difficulty largely stems from a lack of labeled attack data that fully explores the potential adversarial space. Currently, performance of cyber defense systems is typically evaluated in a qualitative manner by manually inspecting the results of the system on live data and adjusting as needed. Additionally, machine learning has shown promise in deriving models that automatically learn indicators of compromise that are more robust than analyst-derived detectors. However, to generate these models, most algorithms require large amounts of labeled data (i.e., examples of attacks). Algorithms that do not require annotated data to derive models are similarly at a disadvantage, because labeled data is still necessary when evaluating performance. In this work, we explore the use of temporal generative models to learn cyber attack graph representations and automatically generate data for experimentation and evaluation. Training and evaluating cyber systems and machine learning models requires significant, annotated data, which is typically collected and labeled by hand for one-off experiments. Automatically generating such data helps derive/evaluate detection models and ensures reproducibility of results. Experimentally, we demonstrate the efficacy of generative sequence analysis techniques on learning the structure of attack graphs, based on a realistic example. These derived models can then be used to generate more data. Additionally, we provide a roadmap for future research efforts in this area.

  5. 12 CFR 263.17 - Collateral attacks on adjudicatory proceeding.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Collateral attacks on adjudicatory proceeding... Collateral attacks on adjudicatory proceeding. If an interlocutory appeal or collateral attack is brought in... shall be excused based on the pendency before any court of any interlocutory appeal or collateral attack. ...

  6. 12 CFR 509.17 - Collateral attacks on adjudicatory proceeding.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Collateral attacks on adjudicatory proceeding....17 Collateral attacks on adjudicatory proceeding. If an interlocutory appeal or collateral attack is... shall be excused based on the pendency before any court of any interlocutory appeal or collateral attack. ...

  7. Detection of complex cyber attacks

    Science.gov (United States)

    Gregorio-de Souza, Ian; Berk, Vincent H.; Giani, Annarita; Bakos, George; Bates, Marion; Cybenko, George; Madory, Doug

    2006-05-01

    One significant drawback to currently available security products is their inabilty to correlate diverse sensor input. For instance, by only using network intrusion detection data, a root kit installed through a weak username-password combination may go unnoticed. Similarly, an administrator may never make the link between deteriorating response times from the database server and an attacker exfiltrating trusted data, if these facts aren't presented together. Current Security Information Management Systems (SIMS) can collect and represent diverse data but lack sufficient correlation algorithms. By using a Process Query System, we were able to quickly bring together data flowing from many sources, including NIDS, HIDS, server logs, CPU load and memory usage, etc. We constructed PQS models that describe dynamic behavior of complicated attacks and failures, allowing us to detect and differentiate simultaneous sophisticated attacks on a target network. In this paper, we discuss the benefits of implementing such a multistage cyber attack detection system using PQS. We focus on how data from multiple sources can be combined and used to detect and track comprehensive network security events that go unnoticed using conventional tools.

  8. Vulnerability Assessment by Learning Attack Specifications in Graphs

    NARCIS (Netherlands)

    Nunes Leal Franqueira, V.; Lopes, Raul H.C.

    This paper presents an evolutionary approach for learning attack specifications that describe attack scenarios. The objective is to find vulnerabilities in computer networks which minimise the cost of an attack with maximum impact. Although we focus on Insider Threat, the proposed approach applies

  9. Respiratory health and lung function in Chinese restaurant kitchen workers.

    Science.gov (United States)

    Wong, Tze Wai; Wong, Andromeda H S; Lee, Frank S C; Qiu, Hong

    2011-10-01

    To measure air pollutant concentrations in Chinese restaurant kitchens using different stove types and assess their influence on workers' respiratory health. 393 kitchen workers from 53 Chinese restaurants were surveyed over 16 months: 115 workers from 21 restaurants using only electric stoves and 278 workers from 32 restaurants using only gas stoves. Workers were interviewed about their respiratory symptoms and had their lung function tested. Concentrations of nitric oxide (NO), nitrogen dioxide (NO(2)), carbon monoxide (CO), carbon dioxide (CO(2)), methane (CH(4)), non-methane hydrocarbons (NMHC), total volatile organic compounds (TVOC) and fine particulate matter (PM(2.5)) were measured using portable monitors and air-bag sampling. Temperature and noise levels were assessed. Median concentrations of NO, NO(2) and CO were 7.4, 1.5 and 1.6 times higher in gas-fuelled kitchens than in electric ones and average concentrations of PM(2.5) and TVOC were 81% and 78% higher, respectively. Differences were smaller for CH(4) and NMHC. Electricity-run kitchens were 4.5°C cooler and 9 dBA less noisy than gas-fuelled ones. Workers using electric cookers had significantly better lung function than their gas-using counterparts and their mean FEV(1) and FVC values were 5.4% and 3.8% higher, respectively, after adjustment for confounders. Wheeze, phlegm, cough and sore throat were more prevalent in workers using gas. The adjusted OR for having phlegm regularly was significantly higher. The poorer lung function and higher prevalence of respiratory symptoms among workers in gas-fuelled kitchens compared to those in electricity-powered kitchens may be associated with exposure to higher concentrations of toxic air pollutants generated during gas cooking.

  10. Attack Tree Generation by Policy Invalidation

    NARCIS (Netherlands)

    Ivanova, Marieta Georgieva; Probst, Christian W.; Hansen, René Rydhof; Kammüller, Florian; Naeem Akram, R.; Jajodia, S.

    2015-01-01

    Attacks on systems and organisations increasingly exploit human actors, for example through social engineering, complicating their formal treatment and automatic identi﬿cation. Formalisation of human behaviour is difficult at best, and attacks on socio-technical systems are still mostly identi﬿ed

  11. Neural network classifier of attacks in IP telephony

    Science.gov (United States)

    Safarik, Jakub; Voznak, Miroslav; Mehic, Miralem; Partila, Pavol; Mikulec, Martin

    2014-05-01

    Various types of monitoring mechanism allow us to detect and monitor behavior of attackers in VoIP networks. Analysis of detected malicious traffic is crucial for further investigation and hardening the network. This analysis is typically based on statistical methods and the article brings a solution based on neural network. The proposed algorithm is used as a classifier of attacks in a distributed monitoring network of independent honeypot probes. Information about attacks on these honeypots is collected on a centralized server and then classified. This classification is based on different mechanisms. One of them is based on the multilayer perceptron neural network. The article describes inner structure of used neural network and also information about implementation of this network. The learning set for this neural network is based on real attack data collected from IP telephony honeypot called Dionaea. We prepare the learning set from real attack data after collecting, cleaning and aggregation of this information. After proper learning is the neural network capable to classify 6 types of most commonly used VoIP attacks. Using neural network classifier brings more accurate attack classification in a distributed system of honeypots. With this approach is possible to detect malicious behavior in a different part of networks, which are logically or geographically divided and use the information from one network to harden security in other networks. Centralized server for distributed set of nodes serves not only as a collector and classifier of attack data, but also as a mechanism for generating a precaution steps against attacks.

  12. SCADA system vulnerabilities to cyber attack

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, W. T. [Cyber Security Consulting (Canada)

    2004-10-01

    The susceptibility to terrorist attacks of computer-based supervisory control (SCADA) systems that are used to monitor and control water distribution systems, oil and gas pipelines and the electrical grid, is discussed. The discussion includes ways in which SCADA systems may be attacked and remedial actions that may be taken to reduce or eliminate the possibility of such attacks. Attacks may take the form of causing the system to generate false data to divert attention from impending system disasters, or commandeer the system to seriously disable it, or cause damage to the process or equipment being controlled by sending improper control commands. SCADA systems are also vulnerable to internal threats, either from an accidental action that results in damage, or an intentional action, as for example by a disgruntled employee, or ex-employee, usually by way of reprogramming an RTU or PLC by accessing the polling/communications circuit. Recent SCADA systems are much more susceptible to concerted cyber attacks because of the adoption of IT technologies and standards into the design of such systems. (Older systems are more likely to be unique designs, hence less susceptible to attack). As far as protection of SCADA systems is concerned, there are no technologies that would prevent a technologically sophisticated terrorist or disgruntled employee from doing major damage to the system, however, the IT world has developed a range of technologies for the protection of IT assets, and many of these same technologies can also be used to safeguard modern SCADA systems.

  13. Combating Memory Corruption Attacks On Scada Devices

    Science.gov (United States)

    Bellettini, Carlo; Rrushi, Julian

    Memory corruption attacks on SCADA devices can cause significant disruptions to control systems and the industrial processes they operate. However, despite the presence of numerous memory corruption vulnerabilities, few, if any, techniques have been proposed for addressing the vulnerabilities or for combating memory corruption attacks. This paper describes a technique for defending against memory corruption attacks by enforcing logical boundaries between potentially hostile data and safe data in protected processes. The technique encrypts all input data using random keys; the encrypted data is stored in main memory and is decrypted according to the principle of least privilege just before it is processed by the CPU. The defensive technique affects the precision with which attackers can corrupt control data and pure data, protecting against code injection and arc injection attacks, and alleviating problems posed by the incomparability of mitigation techniques. An experimental evaluation involving the popular Modbus protocol demonstrates the feasibility and efficiency of the defensive technique.

  14. Attack Methodology Analysis: Emerging Trends in Computer-Based Attack Methodologies and Their Applicability to Control System Networks

    Energy Technology Data Exchange (ETDEWEB)

    Bri Rolston

    2005-06-01

    Threat characterization is a key component in evaluating the threat faced by control systems. Without a thorough understanding of the threat faced by critical infrastructure networks, adequate resources cannot be allocated or directed effectively to the defense of these systems. Traditional methods of threat analysis focus on identifying the capabilities and motivations of a specific attacker, assessing the value the adversary would place on targeted systems, and deploying defenses according to the threat posed by the potential adversary. Too many effective exploits and tools exist and are easily accessible to anyone with access to an Internet connection, minimal technical skills, and a significantly reduced motivational threshold to be able to narrow the field of potential adversaries effectively. Understanding how hackers evaluate new IT security research and incorporate significant new ideas into their own tools provides a means of anticipating how IT systems are most likely to be attacked in the future. This research, Attack Methodology Analysis (AMA), could supply pertinent information on how to detect and stop new types of attacks. Since the exploit methodologies and attack vectors developed in the general Information Technology (IT) arena can be converted for use against control system environments, assessing areas in which cutting edge exploit development and remediation techniques are occurring can provide significance intelligence for control system network exploitation, defense, and a means of assessing threat without identifying specific capabilities of individual opponents. Attack Methodology Analysis begins with the study of what exploit technology and attack methodologies are being developed in the Information Technology (IT) security research community within the black and white hat community. Once a solid understanding of the cutting edge security research is established, emerging trends in attack methodology can be identified and the gap between

  15. Trace Attack against Biometric Mobile Applications

    Directory of Open Access Journals (Sweden)

    Sanaa Ghouzali

    2016-01-01

    Full Text Available With the exponential increase in the dependence on mobile devices in everyday life, there is a growing concern related to privacy and security issues in the Gulf countries; therefore, it is imperative that security threats should be analyzed in detail. Mobile devices store enormous amounts of personal and financial information, unfortunately without any security. In order to secure mobile devices against different threats, biometrics has been applied and shown to be effective. However, biometric mobile applications are also vulnerable to several types of attacks that can decrease their security. Biometric information itself is considered sensitive data; for example, fingerprints can leave traces in touched objects and facial images can be captured everywhere or accessed by the attacker if the facial image is stored in the mobile device (lost or stolen. Hence, an attacker can easily forge the identity of a legitimate user and access data on a device. In this paper, the effects of a trace attack on the sensitivity of biometric mobile applications are investigated in terms of security and user privacy. Experimental results carried out on facial and fingerprint mobile authentication applications using different databases have shown that these mobile applications are vulnerable to the proposed attack, which poses a serious threat to the overall system security and user privacy.

  16. Quantitative Attack Tree Analysis via Priced Timed Automata

    NARCIS (Netherlands)

    Kumar, Rajesh; Ruijters, Enno Jozef Johannes; Stoelinga, Mariëlle Ida Antoinette; Sankaranarayanan, Sriram; Vicario, Enrico

    The success of a security attack crucially depends on the resources available to an attacker: time, budget, skill level, and risk appetite. Insight in these dependencies and the most vulnerable system parts is key to providing effective counter measures. This paper considers attack trees, one of the

  17. Finite Energy and Bounded Actuator Attacks on Cyber-Physical Systems

    Energy Technology Data Exchange (ETDEWEB)

    Djouadi, Seddik M [ORNL; Melin, Alexander M [ORNL; Ferragut, Erik M [ORNL; Laska, Jason A [ORNL; Dong, Jin [ORNL; Drira, Anis [ORNL

    2015-01-01

    As control system networks are being connected to enterprise level networks for remote monitoring, operation, and system-wide performance optimization, these same connections are providing vulnerabilities that can be exploited by malicious actors for attack, financial gain, and theft of intellectual property. Much effort in cyber-physical system (CPS) protection has focused on protecting the borders of the system through traditional information security techniques. Less effort has been applied to the protection of cyber-physical systems from intelligent attacks launched after an attacker has defeated the information security protections to gain access to the control system. In this paper, attacks on actuator signals are analyzed from a system theoretic context. The threat surface is classified into finite energy and bounded attacks. These two broad classes encompass a large range of potential attacks. The effect of theses attacks on a linear quadratic (LQ) control are analyzed, and the optimal actuator attacks for both finite and infinite horizon LQ control are derived, therefore the worst case attack signals are obtained. The closed-loop system under the optimal attack signals is given and a numerical example illustrating the effect of an optimal bounded attack is provided.

  18. Predictors of bronchodilator responsiveness in infants with wheezing associated respiratory tract infection.

    Science.gov (United States)

    Deerojanawong, J; Prapphal, N

    1994-07-01

    The responsiveness to bronchodilator is variable in infants with wheezing associated respiratory illness (WARI). Factors for prediction of the response will lead to more rational use of the bronchodilator in these infants. We examined the possible predictive factors in 44 children under 2 years of age who had their first episode of WARI. All of them were treated with 0.15 mg/kg of nebulized salbutamol. Thirty patients (68%) with decreasing clinical score > or = 3 after treatment were considered as the responders while the remainder (14 infants) were non responders. By using Chi-square test, Fisher exact test and Mann-Whitney U test to compare the data of the 2 groups, the significant factors for the responders were older than 6 months and history of previous LRI (p < 0.01). The significant factors for the non-responders included concurrent diarrhea, patchy pulmonary infiltration and positive RSV in the nasopharyngeal secretion (p < 0.01). These results suggested effective bronchodilator therapy in infants older than 6 months or having a history of previous LRI. Those who had acute RSV infection or patchy infiltration in chest X-ray and associated diarrhea were less likely to respond.

  19. Modeling attacker-defender interactions in information networks.

    Energy Technology Data Exchange (ETDEWEB)

    Collins, Michael Joseph

    2010-09-01

    The simplest conceptual model of cybersecurity implicitly views attackers and defenders as acting in isolation from one another: an attacker seeks to penetrate or disrupt a system that has been protected to a given level, while a defender attempts to thwart particular attacks. Such a model also views all non-malicious parties as having the same goal of preventing all attacks. But in fact, attackers and defenders are interacting parts of the same system, and different defenders have their own individual interests: defenders may be willing to accept some risk of successful attack if the cost of defense is too high. We have used game theory to develop models of how non-cooperative but non-malicious players in a network interact when there is a substantial cost associated with effective defensive measures. Although game theory has been applied in this area before, we have introduced some novel aspects of player behavior in our work, including: (1) A model of how players attempt to avoid the costs of defense and force others to assume these costs; (2) A model of how players interact when the cost of defending one node can be shared by other nodes; and (3) A model of the incentives for a defender to choose less expensive, but less effective, defensive actions.

  20. Activity Modelling and Comparative Evaluation of WSN MAC Security Attacks

    DEFF Research Database (Denmark)

    Pawar, Pranav M.; Nielsen, Rasmus Hjorth; Prasad, Neeli R.

    2012-01-01

    and initiate security attacks that disturb the normal functioning of the network in a severe manner. Such attacks affect the performance of the network by increasing the energy consumption, by reducing throughput and by inducing long delays. Of all existing WSN attacks, MAC layer attacks are considered...... the most harmful as they directly affect the available resources and thus the nodes’ energy consumption. The first endeavour of this paper is to model the activities of MAC layer security attacks to understand the flow of activities taking place when mounting the attack and when actually executing it....... The second aim of the paper is to simulate these attacks on hybrid MAC mechanisms, which shows the performance degradation of aWSN under the considered attacks. The modelling and implementation of the security attacks give an actual view of the network which can be useful in further investigating secure...

  1. Algebraic Side-Channel Attack on Twofish

    Directory of Open Access Journals (Sweden)

    Chujiao Ma

    2017-05-01

    Full Text Available While algebraic side-channel attack (ASCA has been successful in breaking simple cryptographic algorithms, it has never been done on larger or more complex algorithms such as Twofish. Compared to other algorithms that ASCA has been used on, Twofish is more difficult to attack due to the key-dependent S-boxes as well as the complex key scheduling. In this paper, we propose the first algebraic side-channel attack on Twofish, and examine the importance of side-channel information in getting past the key-dependent S-boxes and the complex key scheduling. The cryptographic algorithm and side-channel information are both expressed as boolean equations and a SAT solver is used to recover the key. While algebraic attack by itself is not sufficient to break the algorithm, with the help of side-channel information such as Hamming weights, we are able to correctly solve for 96 bits of the 128 bits key in under 2 hours with known plaintext/ciphertext.

  2. On localization attacks against cloud infrastructure

    Science.gov (United States)

    Ge, Linqiang; Yu, Wei; Sistani, Mohammad Ali

    2013-05-01

    One of the key characteristics of cloud computing is the device and location independence that enables the user to access systems regardless of their location. Because cloud computing is heavily based on sharing resource, it is vulnerable to cyber attacks. In this paper, we investigate a localization attack that enables the adversary to leverage central processing unit (CPU) resources to localize the physical location of server used by victims. By increasing and reducing CPU usage through the malicious virtual machine (VM), the response time from the victim VM will increase and decrease correspondingly. In this way, by embedding the probing signal into the CPU usage and correlating the same pattern in the response time from the victim VM, the adversary can find the location of victim VM. To determine attack accuracy, we investigate features in both the time and frequency domains. We conduct both theoretical and experimental study to demonstrate the effectiveness of such an attack.

  3. Network attacks and defenses a hands-on approach

    CERN Document Server

    Trabelsi, Zouheir; Al Braiki, Arwa; Mathew, Sujith Samuel

    2012-01-01

    The attacks on computers and business networks are growing daily, and the need for security professionals who understand how malfeasants perform attacks and compromise networks is a growing requirement to counter the threat. Network security education generally lacks appropriate textbooks with detailed, hands-on exercises that include both offensive and defensive techniques. Using step-by-step processes to build and generate attacks using offensive techniques, Network Attacks and Defenses: A Hands-on Approach enables students to implement appropriate network security solutions within a laborat

  4. SDN-Based Double Hopping Communication against Sniffer Attack

    Directory of Open Access Journals (Sweden)

    Zheng Zhao

    2016-01-01

    Full Text Available Sniffer attack has been a severe threat to network communication security. Traditional network usually uses static network configuration, which provides convenience to sniffer attack. In this paper, an SDN-based double hopping communication (DHC approach is proposed to solve this problem. In DHC, ends in communication packets as well as the routing paths are changed dynamically. Therefore, the traffic will be distributed to multiple flows and transmitted along different paths. Moreover, the data from multiple users will be mixed, bringing difficulty for attackers in obtaining and recovering the communication data, so that sniffer attack will be prevented effectively. It is concluded that DHC is able to increase the overhead of sniffer attack, as well as the difficulty of communication data recovery.

  5. Attacks on Bluetooth Security Architecture and Its Countermeasures

    Science.gov (United States)

    Iqbal, Mian Muhammad Waseem; Kausar, Firdous; Wahla, Muhammad Arif

    WPANs compliment the traditional IEEE 802.11 wireless networks by facilitating the clients with flexibility in network topologies, higher mobility and relaxed configuration/hardware requirements. Bluetooth, a WPAN technology, is an open standard for short-range radio frequency (RF) communication. However, it is also susceptible to typical security threats found in wireless LANs. This paper discuses some of the attack scenarios against the bluetooth network such as hostile intrusion, active Man-in-the-Middle (MITM) attack using unit key and various forms of denial of service (DoS) attacks. These threats and attacks compromise the confidentiality and availability of bluetooth data and services. This paper proposes an improved security architecture for bluetooth device which provides protection against the above mentioned attacks.

  6. An SDN-Based Fingerprint Hopping Method to Prevent Fingerprinting Attacks

    Directory of Open Access Journals (Sweden)

    Zheng Zhao

    2017-01-01

    Full Text Available Fingerprinting attacks are one of the most severe threats to the security of networks. Fingerprinting attack aims to obtain the operating system information of target hosts to make preparations for future attacks. In this paper, a fingerprint hopping method (FPH is proposed based on software-defined networks to defend against fingerprinting attacks. FPH introduces the idea of moving target defense to show a hopping fingerprint toward the fingerprinting attackers. The interaction of the fingerprinting attack and its defense is modeled as a signal game, and the equilibriums of the game are analyzed to develop an optimal defense strategy. Experiments show that FPH can resist fingerprinting attacks effectively.

  7. [Diagnostics of broncho-obstructive states in children with wheezing syndrome and who live in ecologically non-friendly regions].

    Science.gov (United States)

    Antypkin, Iu H; Velychko, M I; Arabs'ka, L P; Barteniev, S H; Pavlovs'kyĭ, V S; Dardyns'ka, I V

    2008-01-01

    Disorders found by Spirography have been analysed. These data were obtained from 137 children with bronchial asthma and with wheezing syndrome and who live in ecologically not unfavorable regions of Ukraine. Decrease in patency of airways of small and big caliber was detected in patients with bronchial asthma from Dneprodzerzhinsk and the middle and Decrease in patency of airways of middle and small caliber small caliber of patients from Mariupol. The pharmacological test with salbuthamol demonstrated considerable changes in the reactivity of bronchial apparatus that shows necessity of administration of drugs correction in children with bronchial asthma and necessity to detail indications for this correction to patients with an isolated decreased patency of airways of big caliber.

  8. Data-plane Defenses against Routing Attacks on Tor

    Directory of Open Access Journals (Sweden)

    Tan Henry

    2016-10-01

    Full Text Available Tor is susceptible to traffic correlation attacks in which an adversary who observes flows entering and leaving the anonymity network can apply statistical techniques to correlate flows and de-anonymize their endpoints. While an adversary may not be naturally positioned to conduct such attacks, a recent study shows that the Internet’s control-plane can be manipulated to increase an adversary’s view of the network, and consequently, improve its ability to perform traffic correlation. This paper explores, in-depth, the effects of control-plane attacks on the security of the Tor network. Using accurate models of the live Tor network, we quantify Tor’s susceptibility to these attacks by measuring the fraction of the Tor network that is vulnerable and the advantage to the adversary of performing the attacks. We further propose defense mechanisms that protect Tor users from manipulations at the control-plane. Perhaps surprisingly, we show that by leveraging existing trust anchors in Tor, defenses deployed only in the data-plane are sufficient to detect most control-plane attacks. Our defenses do not assume the active participation of Internet Service Providers, and require only very small changes to Tor. We show that our defenses result in a more than tenfold decrease in the effectiveness of certain control-plane attacks.

  9. Rotational Rebound Attacks on Reduced Skein

    DEFF Research Database (Denmark)

    Khovratovich, Dmitry; Nikolic, Ivica; Rechberger, Christian

    2010-01-01

    In this paper we combine a recent rotational cryptanalysis with the rebound attack, which results in the best cryptanalysis of Skein, a candidate for the SHA-3 competition. The rebound attack approach was so far only applied to AES-like constructions. For the first time, we show that this approach...

  10. Step to improve neural cryptography against flipping attacks.

    Science.gov (United States)

    Zhou, Jiantao; Xu, Qinzhen; Pei, Wenjiang; He, Zhenya; Szu, Harold

    2004-12-01

    Synchronization of neural networks by mutual learning has been demonstrated to be possible for constructing key exchange protocol over public channel. However, the neural cryptography schemes presented so far are not the securest under regular flipping attack (RFA) and are completely insecure under majority flipping attack (MFA). We propose a scheme by splitting the mutual information and the training process to improve the security of neural cryptosystem against flipping attacks. Both analytical and simulation results show that the success probability of RFA on the proposed scheme can be decreased to the level of brute force attack (BFA) and the success probability of MFA still decays exponentially with the weights' level L. The synchronization time of the parties also remains polynomial with L. Moreover, we analyze the security under an advanced flipping attack.

  11. Improved Impossible Differential Attacks on Large-Block Rijndael

    DEFF Research Database (Denmark)

    Wang, Qingju; Gu, Dawu; Rijmen, Vincent

    2012-01-01

    . The improvement can lead to 10-round attack on Rijndael-256 as well. With 2198.1 chosen plaintexts, an attack is demonstrated on 9-round Rijndael-224 with 2 195.2 encryptions and 2140.4 bytes memory. Increasing the data complexity to 2216 plaintexts, the time complexity can be reduced to 2130 encryptions...... and the memory requirements to 2 93.6 bytes. For 9-round Rijndael-256, we provide an attack requiring 2229.3 chosen plaintexts, 2194 encryptions, and 2 139.6 bytes memory. Alternatively, with 2245.3 plaintexts, an attack with a reduced time of 2127.1 encryptions and a memory complexity of 290.9 bytes can...... be mounted. With 2244.2 chosen plaintexts, we can attack 10-round Rijndael-256 with 2253.9 encryptions and 2186.8 bytes of memory....

  12. RAPTOR: Ransomware Attack PredicTOR

    OpenAIRE

    Quinkert, Florian; Holz, Thorsten; Hossain, KSM Tozammel; Ferrara, Emilio; Lerman, Kristina

    2018-01-01

    Ransomware, a type of malicious software that encrypts a victim's files and only releases the cryptographic key once a ransom is paid, has emerged as a potentially devastating class of cybercrimes in the past few years. In this paper, we present RAPTOR, a promising line of defense against ransomware attacks. RAPTOR fingerprints attackers' operations to forecast ransomware activity. More specifically, our method learns features of malicious domains by looking at examples of domains involved in...

  13. Shark attack-related injuries: Epidemiology and implications for plastic surgeons.

    Science.gov (United States)

    Ricci, Joseph A; Vargas, Christina R; Singhal, Dhruv; Lee, Bernard T

    2016-01-01

    The increased media attention to shark attacks has led to a heightened fear and public awareness. Although few sharks are considered dangerous, attacks on humans can result in large soft tissue defects necessitating the intervention of reconstructive surgeons. This study aims to evaluate and describe the characteristics of shark-related injuries in order to improve treatment. The Global Shark Accident File, maintained by the Shark Research Institute (Princeton, NJ, USA), is a compilation of all known worldwide shark attacks. Database records since the 1900s were reviewed to identify differences between fatal and nonfatal attacks, including: geography, injury pattern, shark species, and victim activity. Since the 1900s, there have been 5034 reported shark attacks, of which 1205 (22.7%) were fatal. Although the incidence of attacks per decade has increased, the percentage of fatalities has decreased. Characteristics of fatal attacks included swimming (p = 0.001), boating (p = 0.001), three or more bite sites (p = 0.03), limb loss (p = 0.001), or tiger shark attack (p = 0.002). The most common attacks were bites to the legs (41.8%) or arms (18.4%), with limb loss occurring in 7% of attacks. Geographically, the majority of attacks occurred in North America (36.7%) and Australia (26.5%). Most attacks in the USA occurred in Florida (49.1%) and California (13.6%). Although rare, shark attacks result in devastating injuries to patients. As these injuries often involve multiple sites and limb loss, this creates a significant challenge for reconstructive surgeons. Proper identification of the characteristics of the attack can aid in providing optimal care for those affected. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Privacy Leaks through Data Hijacking Attack on Mobile Systems

    Directory of Open Access Journals (Sweden)

    Zhang Daojuan

    2017-01-01

    Full Text Available To persistently eavesdrop on the mobile devices, attackers may obtain the elevated privilege and inject malicious modules into the user devices. Unfortunately, the attackers may not be able to obtain the privilege for a long period of time since the exploitable vulnerabilities may be fixed or the malware may be removed. In this paper, we propose a new data hijacking attack for the mobile apps. By employing the proposed method, the attackers are only required to obtain the root privilege of the user devices once, and they can persistently eavesdrop without any change to the original device. Specifically, we design a new approach to construct a shadow system by hijacking user data files. In the shadow system, attackers possess the identical abilities to the victims. For instance, if a victim has logged into the email app, the attacker can also access the email server in the shadow system without authentication in a long period of time. Without reauthentication of the app, it is difficult for victims to notice the intrusion since the whole eavesdropping is performed on other devices (rather than the user devices. In our experiments, we evaluate the effectiveness of the proposed attack and the result demonstrates that even the Android apps released by the top developers cannot resist this attack. Finally, we discuss some approaches to defend the proposed attack.

  15. What Can We Learn?--The Algonquin Bear Attack.

    Science.gov (United States)

    Strickland, Dan

    1992-01-01

    Describes a bear attack in Algonquin Park in Lake Opeongo (Canada) in which a man and woman were killed. Hypothesizes that the bear deliberately preyed on its victims and concludes that the bear was physically normal. Despite this isolated attack, the chance of being attacked by a black bear when camping is virtually nonexistent. (KS)

  16. Combined Heuristic Attack Strategy on Complex Networks

    Directory of Open Access Journals (Sweden)

    Marek Šimon

    2017-01-01

    Full Text Available Usually, the existence of a complex network is considered an advantage feature and efforts are made to increase its robustness against an attack. However, there exist also harmful and/or malicious networks, from social ones like spreading hoax, corruption, phishing, extremist ideology, and terrorist support up to computer networks spreading computer viruses or DDoS attack software or even biological networks of carriers or transport centers spreading disease among the population. New attack strategy can be therefore used against malicious networks, as well as in a worst-case scenario test for robustness of a useful network. A common measure of robustness of networks is their disintegration level after removal of a fraction of nodes. This robustness can be calculated as a ratio of the number of nodes of the greatest remaining network component against the number of nodes in the original network. Our paper presents a combination of heuristics optimized for an attack on a complex network to achieve its greatest disintegration. Nodes are deleted sequentially based on a heuristic criterion. Efficiency of classical attack approaches is compared to the proposed approach on Barabási-Albert, scale-free with tunable power-law exponent, and Erdős-Rényi models of complex networks and on real-world networks. Our attack strategy results in a faster disintegration, which is counterbalanced by its slightly increased computational demands.

  17. Studies on sulfate attack: Mechanisms, test methods, and modeling

    Science.gov (United States)

    Santhanam, Manu

    The objective of this research study was to investigate various issues pertaining to the mechanism, testing methods, and modeling of sulfate attack in concrete. The study was divided into the following segments: (1) effect of gypsum formation on the expansion of mortars, (2) attack by the magnesium ion, (3) sulfate attack in the presence of chloride ions---differentiating seawater and groundwater attack, (4) use of admixtures to mitigate sulfate attack---entrained air, sodium citrate, silica fume, and metakaolin, (5) effects of temperature and concentration of the attack solution, (6) development of new test methods using concrete specimens, and (7) modeling of the sulfate attack phenomenon. Mortar specimens using portland cement (PC) and tricalcium silicate (C 3S), with or without mineral admixtures, were prepared and immersed in different sulfate solutions. In addition to this, portland cement concrete specimens were also prepared and subjected to complete and partial immersion in sulfate solutions. Physical measurements, chemical analyses and microstructural studies were performed periodically on the specimens. Gypsum formation was seen to cause expansion of the C3S mortar specimens. Statistical analyses of the data also indicated that the quantity of gypsum was the most significant factor controlling the expansion of mortar bars. The attack by magnesium ion was found to drive the reaction towards the formation of brucite. Decalcification of the C-S-H and its subsequent conversion to the non-cementitious M-S-H was identified as the mechanism of destruction in magnesium sulfate attack. Mineral admixtures were beneficial in combating sodium sulfate attack, while reducing the resistance to magnesium sulfate attack. Air entrainment did not change the measured physical properties, but reduced the visible distress of the mortars. Sodium citrate caused a substantial reduction in the rate of damage of the mortars due to its retarding effect. Temperature and

  18. Impact of Cyber Attacks on High Voltage DC Transmission Damping Control

    Directory of Open Access Journals (Sweden)

    Rui Fan

    2018-04-01

    Full Text Available Hybrid AC/HVDC (AC-HVDC grids have evolved to become huge cyber-physical systems that are vulnerable to cyber attacks because of the wide attack surface and increasing dependence on intelligent electronic devices, computing resources and communication networks. This paper, for the first time, studies the impact of cyber attacks on HVDC transmission oscillation damping control.Three kinds of cyber attack models are considered: timing attack, replay attack and false data injection attack. Followed by a brief introduction of the HVDC model and conventional oscillation damping control method, the design of three attack models is described in the paper. These attacks are tested on a modified IEEE New England 39-Bus AC-HVDC system. Simulation results have shown that all three kinds of attacks are capable of driving the AC-HVDC system into large oscillations or even unstable conditions.

  19. OPERATION COBRA. Deliberate Attack, Exploitation

    Science.gov (United States)

    1984-05-25

    to attack Sens, then continue to Troyes , on the Seine River. CCA was in the north, crossing the Loing River at Souppes against light resistance and...advanced from Troyes and prepared positions close to Sens. Under strong artillery support, a task force from CCA (TF Oden) attacked the enemy frontally...movement towards the Seine River on 24 August with an advance toward Troyes . Facing the combat command were what remained of the 51st SS Brigade, light

  20. Robustness of non-interdependent and interdependent networks against dependent and adaptive attacks

    Science.gov (United States)

    Tyra, Adam; Li, Jingtao; Shang, Yilun; Jiang, Shuo; Zhao, Yanjun; Xu, Shouhuai

    2017-09-01

    Robustness of complex networks has been extensively studied via the notion of site percolation, which typically models independent and non-adaptive attacks (or disruptions). However, real-life attacks are often dependent and/or adaptive. This motivates us to characterize the robustness of complex networks, including non-interdependent and interdependent ones, against dependent and adaptive attacks. For this purpose, dependent attacks are accommodated by L-hop percolation where the nodes within some L-hop (L ≥ 0) distance of a chosen node are all deleted during one attack (with L = 0 degenerating to site percolation). Whereas, adaptive attacks are launched by attackers who can make node-selection decisions based on the network state in the beginning of each attack. The resulting characterization enriches the body of knowledge with new insights, such as: (i) the Achilles' Heel phenomenon is only valid for independent attacks, but not for dependent attacks; (ii) powerful attack strategies (e.g., targeted attacks and dependent attacks, dependent attacks and adaptive attacks) are not compatible and cannot help the attacker when used collectively. Our results shed some light on the design of robust complex networks.

  1. Command Disaggregation Attack and Mitigation in Industrial Internet of Things

    Directory of Open Access Journals (Sweden)

    Peng Xun

    2017-10-01

    Full Text Available A cyber-physical attack in the industrial Internet of Things can cause severe damage to physical system. In this paper, we focus on the command disaggregation attack, wherein attackers modify disaggregated commands by intruding command aggregators like programmable logic controllers, and then maliciously manipulate the physical process. It is necessary to investigate these attacks, analyze their impact on the physical process, and seek effective detection mechanisms. We depict two different types of command disaggregation attack modes: (1 the command sequence is disordered and (2 disaggregated sub-commands are allocated to wrong actuators. We describe three attack models to implement these modes with going undetected by existing detection methods. A novel and effective framework is provided to detect command disaggregation attacks. The framework utilizes the correlations among two-tier command sequences, including commands from the output of central controller and sub-commands from the input of actuators, to detect attacks before disruptions occur. We have designed components of the framework and explain how to mine and use these correlations to detect attacks. We present two case studies to validate different levels of impact from various attack models and the effectiveness of the detection framework. Finally, we discuss how to enhance the detection framework.

  2. Command Disaggregation Attack and Mitigation in Industrial Internet of Things.

    Science.gov (United States)

    Xun, Peng; Zhu, Pei-Dong; Hu, Yi-Fan; Cui, Peng-Shuai; Zhang, Yan

    2017-10-21

    A cyber-physical attack in the industrial Internet of Things can cause severe damage to physical system. In this paper, we focus on the command disaggregation attack, wherein attackers modify disaggregated commands by intruding command aggregators like programmable logic controllers, and then maliciously manipulate the physical process. It is necessary to investigate these attacks, analyze their impact on the physical process, and seek effective detection mechanisms. We depict two different types of command disaggregation attack modes: (1) the command sequence is disordered and (2) disaggregated sub-commands are allocated to wrong actuators. We describe three attack models to implement these modes with going undetected by existing detection methods. A novel and effective framework is provided to detect command disaggregation attacks. The framework utilizes the correlations among two-tier command sequences, including commands from the output of central controller and sub-commands from the input of actuators, to detect attacks before disruptions occur. We have designed components of the framework and explain how to mine and use these correlations to detect attacks. We present two case studies to validate different levels of impact from various attack models and the effectiveness of the detection framework. Finally, we discuss how to enhance the detection framework.

  3. Counteracting Power Analysis Attacks by Masking

    Science.gov (United States)

    Oswald, Elisabeth; Mangard, Stefan

    The publication of power analysis attacks [12] has triggered a lot of research activities. On the one hand these activities have been dedicated toward the development of secure and efficient countermeasures. On the other hand also new and improved attacks have been developed. In fact, there has been a continuous arms race between designers of countermeasures and attackers. This chapter provides a brief overview of the state-of-the art in the arms race in the context of a countermeasure called masking. Masking is a popular countermeasure that has been extensively discussed in the scientific community. Numerous articles have been published that explain different types of masking and that analyze weaknesses of this countermeasure.

  4. Metrics for Assessment of Smart Grid Data Integrity Attacks

    Energy Technology Data Exchange (ETDEWEB)

    Annarita Giani; Miles McQueen; Russell Bent; Kameshwar Poolla; Mark Hinrichs

    2012-07-01

    There is an emerging consensus that the nation’s electricity grid is vulnerable to cyber attacks. This vulnerability arises from the increasing reliance on using remote measurements, transmitting them over legacy data networks to system operators who make critical decisions based on available data. Data integrity attacks are a class of cyber attacks that involve a compromise of information that is processed by the grid operator. This information can include meter readings of injected power at remote generators, power flows on transmission lines, and relay states. These data integrity attacks have consequences only when the system operator responds to compromised data by redispatching generation under normal or contingency protocols. These consequences include (a) financial losses from sub-optimal economic dispatch to service loads, (b) robustness/resiliency losses from placing the grid at operating points that are at greater risk from contingencies, and (c) systemic losses resulting from cascading failures induced by poor operational choices. This paper is focused on understanding the connections between grid operational procedures and cyber attacks. We first offer two examples to illustrate how data integrity attacks can cause economic and physical damage by misleading operators into taking inappropriate decisions. We then focus on unobservable data integrity attacks involving power meter data. These are coordinated attacks where the compromised data are consistent with the physics of power flow, and are therefore passed by any bad data detection algorithm. We develop metrics to assess the economic impact of these attacks under re-dispatch decisions using optimal power flow methods. These metrics can be use to prioritize the adoption of appropriate countermeasures including PMU placement, encryption, hardware upgrades, and advance attack detection algorithms.

  5. Risk factors for persistence of lower respiratory symptoms among community members exposed to the 2001 World Trade Center terrorist attacks

    Science.gov (United States)

    Jordan, Hannah T; Friedman, Stephen M; Reibman, Joan; Goldring, Roberta M; Miller Archie, Sara A; Ortega, Felix; Alper, Howard; Shao, Yongzhao; Maslow, Carey B; Cone, James E; Farfel, Mark R; Berger, Kenneth I

    2017-01-01

    Objectives We studied the course of lower respiratory symptoms (LRS; cough, wheeze or dyspnoea) among community members exposed to the 9/11/2001 World Trade Center (WTC) attacks during a period of 12–13 years following the attacks, and evaluated risk factors for LRS persistence, including peripheral airway dysfunction and post-traumatic stress disorder (PTSD). Methods Non-smoking adult participants in a case-control study of post-9/11-onset LRS (exam 1, 2008–2010) were recruited for follow-up (exam 2, 2013–2014). Peripheral airway function was assessed with impulse oscillometry measures of R5 and R5-20. Probable PTSD was a PTSD checklist score ≥44 on a 2006–2007 questionnaire. Results Of 785 exam 1 participants, 545 (69%) completed exam 2. Most (321, 59%) were asymptomatic at all assessments. Among 192 participants with initial LRS, symptoms resolved for 110 (57%) by exam 2, 55 (29%) had persistent LRS and 27 (14%) had other patterns. The proportion with normal spirometry increased from 65% at exam 1 to 85% at exam 2 in the persistent LRS group (p<0.01) and was stable among asymptomatic participants and those with resolved LRS. By exam 2, spirometry results did not differ across symptom groups; however, R5 and R5-20 abnormalities were more common among participants with persistent LRS (56% and 46%, respectively) than among participants with resolved LRS (30%, p<0.01; 27%, p=0.03) or asymptomatic participants (20%, p<0.001; 8.2%, p<0.001). PTSD, R5 at exam 1, and R5-20 at exam 1 were each independently associated with persistent LRS. Conclusions Peripheral airway dysfunction and PTSD may contribute to LRS persistence. Assessment of peripheral airway function detected pulmonary damage not evident on spirometry. Mental and physical healthcare for survivors of complex environmental disasters should be coordinated carefully. PMID:28341697

  6. A taxonomy of distributed denial of service attacks

    DEFF Research Database (Denmark)

    De Donno, Michele; Giaretta, Alberto; Dragoni, Nicola

    2017-01-01

    Distributed Denial of Service (DDoS) attacks which are now even more powerful and easier to achieve than the past. Understanding how these attacks work, in all their different forms, represents a first crucial step to tackle this urgent issue. To this end, in this paper we propose a new up-to-date taxonomy...... and a comprehensive classification of current DDoS attacks....

  7. An Explanation of Nakamoto's Analysis of Double-spend Attacks

    OpenAIRE

    Ozisik, A. Pinar; Levine, Brian Neil

    2017-01-01

    The fundamental attack against blockchain systems is the double-spend attack. In this tutorial, we provide a very detailed explanation of just one section of Satoshi Nakamoto's original paper where the attack's probability of success is stated. We show the derivation of the mathematics relied upon by Nakamoto to create a model of the attack. We also validate the model with a Monte Carlo simulation, and we determine which model component is not perfect.

  8. Modeling and Analysis of Information Attack in Computer Networks

    National Research Council Canada - National Science Library

    Pepyne, David

    2003-01-01

    ... (as opposed to physical and other forms of attack) . Information based attacks are attacks that can be carried out from anywhere in the world, while sipping cappuccino at an Internet cafe' or while enjoying the comfort of a living room armchair...

  9. Using an ontology for network attack planning

    CSIR Research Space (South Africa)

    Van Heerden, R

    2016-09-01

    Full Text Available The modern complexity of network attacks and their counter-measures (cyber operations) requires detailed planning. This paper presents a Network Attack Planning ontology which is aimed at providing support for planning such network operations within...

  10. Protecting infrastructure networks from cost-based attacks

    International Nuclear Information System (INIS)

    Wang Xingang; Guan Shuguang; Lai, Choy Heng

    2009-01-01

    It is well known that heterogeneous networks are vulnerable to the intentional removal of a small fraction of highly connected or loaded nodes, implying that to protect the network effectively, the important nodes should be allocated more defense resource than the others. However, if too much resource is allocated to the few important nodes, the numerous less-important nodes will be less protected, which if attacked together can still lead to devastating damage. A natural question is therefore how to efficiently distribute the limited defense resource among the network nodes such that the network damage is minimized against any attack strategy. In this paper, taking into account the factor of attack cost, the problem of network security is reconsidered in terms of efficient network defense against cost-based attacks. The results show that, for a general complex network, there exists an optimal distribution of the defense resource with which the network is best protected from cost-based attacks. Furthermore, it is found that the configuration of the optimal defense is dependent on the network parameters. Specifically, networks of larger size, sparser connection and more heterogeneous structure will more likely benefit from the defense optimization.

  11. Constructing APT Attack Scenarios Based on Intrusion Kill Chain and Fuzzy Clustering

    Directory of Open Access Journals (Sweden)

    Ru Zhang

    2017-01-01

    Full Text Available The APT attack on the Internet is becoming more serious, and most of intrusion detection systems can only generate alarms to some steps of APT attack and cannot identify the pattern of the APT attack. To detect APT attack, many researchers established attack models and then correlated IDS logs with the attack models. However, the accuracy of detection deeply relied on the integrity of models. In this paper, we propose a new method to construct APT attack scenarios by mining IDS security logs. These APT attack scenarios can be further used for the APT detection. First, we classify all the attack events by purpose of phase of the intrusion kill chain. Then we add the attack event dimension to fuzzy clustering, correlate IDS alarm logs with fuzzy clustering, and generate the attack sequence set. Next, we delete the bug attack sequences to clean the set. Finally, we use the nonaftereffect property of probability transfer matrix to construct attack scenarios by mining the attack sequence set. Experiments show that the proposed method can construct the APT attack scenarios by mining IDS alarm logs, and the constructed scenarios match the actual situation so that they can be used for APT attack detection.

  12. On node replication attack in wireless sensor networks

    International Nuclear Information System (INIS)

    Qabulio, M.; Malkani, Y.A.

    2015-01-01

    WSNs (Wireless Sensor Networks) comprise a large number of small, inexpensive, low power and memory constrained sensing devices (called sensor nodes) that are densely deployed to measure a given physical phenomenon. Since WSNs are commonly deployed in a hostile and unattended environment, it is easy for an adversary to physically capture one or more legitimate sensor nodes, re-program and redeploy them in the network. As a result, the adversary becomes able to deploy several identical copies of physically captured nodes in the network in order to perform illegitimate activities. This type of attack is referred to as Node Replication Attack or Clone Node Attack. By launching node replication attack, an adversary can easily get control on the network which consequently is the biggest threat to confidentiality, integrity and availability of data and services. Thus, detection and prevention of node replication attack in WSNs has become an active area of research and to date more than two dozen schemes have been proposed, which address this issue. In this paper, we present a comprehensive review, classification and comparative analysis of twenty five of these schemes which help to detect and/or prevent node replication attack in WSNs. (author)

  13. On Node Replication Attack in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Mumtaz Qabulio

    2016-04-01

    Full Text Available WSNs (Wireless Sensor Networks comprise a large number of small, inexpensive, low power and memory constrained sensing devices (called sensor nodes that are densely deployed to measure a given physical phenomenon. Since WSNs are commonly deployed in a hostile and unattended environment, it is easy for an adversary to physically capture one or more legitimate sensor nodes, re-program and redeploy them in the network. As a result, the adversary becomes able to deploy several identical copies of physically captured nodes in the network in order to perform illegitimate activities. This type of attack is referred to as Node Replication Attack or Clone Node Attack. By launching node replication attack, an adversary can easily get control on the network which consequently is the biggest threat to confidentiality, integrity and availability of data and services. Thus, detection and prevention of node replication attack in WSNs has become an active area of research and to date more than two dozen schemes have been proposed, which address this issue. In this paper, we present a comprehensive review, classification and comparative analysis of twenty five of these schemes which help to detect and/or prevent node replication attack in WSNs

  14. Attacker-defender game from a network science perspective

    Science.gov (United States)

    Li, Ya-Peng; Tan, Suo-Yi; Deng, Ye; Wu, Jun

    2018-05-01

    Dealing with the protection of critical infrastructures, many game-theoretic methods have been developed to study the strategic interactions between defenders and attackers. However, most game models ignore the interrelationship between different components within a certain system. In this paper, we propose a simultaneous-move attacker-defender game model, which is a two-player zero-sum static game with complete information. The strategies and payoffs of this game are defined on the basis of the topology structure of the infrastructure system, which is represented by a complex network. Due to the complexity of strategies, the attack and defense strategies are confined by two typical strategies, namely, targeted strategy and random strategy. The simulation results indicate that in a scale-free network, the attacker virtually always attacks randomly in the Nash equilibrium. With a small cost-sensitive parameter, representing the degree to which costs increase with the importance of a target, the defender protects the hub targets with large degrees preferentially. When the cost-sensitive parameter exceeds a threshold, the defender switches to protecting nodes randomly. Our work provides a new theoretical framework to analyze the confrontations between the attacker and the defender on critical infrastructures and deserves further study.

  15. Are the rules for the right to self-defense outdated to address current conflicts like attacks from non-state actors and cyber-attacks?

    Directory of Open Access Journals (Sweden)

    Gonzalo J. Arias

    2017-06-01

    Full Text Available The latest US-led coalition’s attacks against ISIS in Syria raised the question whether states can use defensive force against non-state actors. Two critical incidents had previously triggered the discussion on the importance and consequences of cyber-attacks as a new form armed attacks. The first one occurred in Estonia in 2007, when the country experienced extensive computer hacking attacks that lasted several weeks. The second incident happened in 2008, during the Georgia–Russia conflict over South Ossetia, when Georgia experienced cyber-attacks similar to those suffered by Estonia in the previous year. Furthermore, on June 21, 2016, the central banks of Indonesia and South Korea were hit by cyber-attacks on their public websites since activist hacking group Anonymous pledged last month to target banks across the world. The previous incidents have created, once again, public questioning if the rules on the use of force and the right of self-defense established in the United Nations Charter are sufficient and efficient to address these new forms of attacks.

  16. After-gate attack on a quantum cryptosystem

    International Nuclear Information System (INIS)

    Wiechers, C; Wittmann, C; Elser, D; Marquardt, Ch; Leuchs, G; Lydersen, L; Skaar, J; Makarov, V

    2011-01-01

    We present a method to control the detection events in quantum key distribution systems that use gated single-photon detectors. We employ bright pulses as faked states, timed to arrive at the avalanche photodiodes outside the activation time. The attack can remain unnoticed, since the faked states do not increase the error rate per se. This allows for an intercept-resend attack, where an eavesdropper transfers her detection events to the legitimate receiver without causing any errors. As a side effect, afterpulses, originating from accumulated charge carriers in the detectors, increase the error rate. We have experimentally tested detectors of the system id3110 (Clavis2) from ID Quantique. We identify the parameter regime in which the attack is feasible despite the side effect. Furthermore, we outline how simple modifications in the implementation can make the device immune to this attack.

  17. Compiling symbolic attacks to protocol implementation tests

    Directory of Open Access Journals (Sweden)

    Michael Rusinowitch

    2013-07-01

    Full Text Available Recently efficient model-checking tools have been developed to find flaws in security protocols specifications. These flaws can be interpreted as potential attacks scenarios but the feasability of these scenarios need to be confirmed at the implementation level. However, bridging the gap between an abstract attack scenario derived from a specification and a penetration test on real implementations of a protocol is still an open issue. This work investigates an architecture for automatically generating abstract attacks and converting them to concrete tests on protocol implementations. In particular we aim to improve previously proposed blackbox testing methods in order to discover automatically new attacks and vulnerabilities. As a proof of concept we have experimented our proposed architecture to detect a renegotiation vulnerability on some implementations of SSL/TLS, a protocol widely used for securing electronic transactions.

  18. An Analysis of Cyber-Attack on NPP Considering Physical Impact

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Hyo; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Son, Han Seong [Joonbu University, Geumsan (Korea, Republic of)

    2016-05-15

    Some research teams performed related works on cyber-physical system which is a system that cyber-attack can lead to serious consequences including product loss, damage, injury and death when it is attacked. They investigated the physical impact on cyber-physical system due to the cyber-attack. But it is hard to find the research about NPP cyber security considering the physical impact or safety. In this paper, to investigate the relationship between physical impact and cyber-attack, level 1 PSA results are utilized in chapter 2 and cyber-attack analysis is performed in chapter 3. The cyber security issue on NPP is inevitable issue. Unlike general cyber security, cyber-physical system like NPP can induce serious consequences such as core damage by cyber-attack. So in this paper, to find how hacker can attack the NPP, (1) PSA results were utilized to find the relationship between physical system and cyber-attack and (2) vulnerabilities on digital control systems were investigated to find how hacker can implement the possible attack. It is expected that these steps are utilized when establishing penetration test plans or cyber security drill plans.

  19. An Analysis of Cyber-Attack on NPP Considering Physical Impact

    International Nuclear Information System (INIS)

    Lee, In Hyo; Kang, Hyun Gook; Son, Han Seong

    2016-01-01

    Some research teams performed related works on cyber-physical system which is a system that cyber-attack can lead to serious consequences including product loss, damage, injury and death when it is attacked. They investigated the physical impact on cyber-physical system due to the cyber-attack. But it is hard to find the research about NPP cyber security considering the physical impact or safety. In this paper, to investigate the relationship between physical impact and cyber-attack, level 1 PSA results are utilized in chapter 2 and cyber-attack analysis is performed in chapter 3. The cyber security issue on NPP is inevitable issue. Unlike general cyber security, cyber-physical system like NPP can induce serious consequences such as core damage by cyber-attack. So in this paper, to find how hacker can attack the NPP, (1) PSA results were utilized to find the relationship between physical system and cyber-attack and (2) vulnerabilities on digital control systems were investigated to find how hacker can implement the possible attack. It is expected that these steps are utilized when establishing penetration test plans or cyber security drill plans

  20. Classification of cyber attacks in South Africa

    CSIR Research Space (South Africa)

    Van Heerden, R

    2016-05-01

    Full Text Available various ATM's throughout South Africa. Two criminals, Motsoane and Masoleng, were arrested in February 2012 and both sentenced to 15 years in jail [36, 37]. 3.10 2013: IOL DDoS Anonymous Africa claimed responsibility for launching a Distributed Denial... of Service (DDoS) attack on the Independent Newspaper web site iol.co.za. The attack was in response to claims that the IOL group supports Zimbabwean president Robert Mugabe. The following taunt was sent to boast about the attack: “IOL bad boys bad boys...

  1. A Review Of Recent Cyber-Attacks In Fiji

    Directory of Open Access Journals (Sweden)

    Neeraj A. Sharma

    2015-08-01

    Full Text Available Computing technology has evolved in such dramatic ways that a child can use such technology and their features. Internet is one such technology which allows peripheral devices to be connected to each other creating a network to share information. In the same way information can be attacked. In this paper we will be discussing the different types of cyber-attack that recently took place in Fiji. Common attacks discussed in this review paper are phishing email scams website defacement and skimming. Apart from common preventative methods some novel recommendations have been made. We believe the Fiji experiences and recommendations will assist technology users prepare better against such attacks.

  2. Research on high power intra-channel crosstalk attack in optical networks

    Science.gov (United States)

    Ren, Shuai; Zhang, Yinfa; Wang, Jingyu; Zhang, Jumei; Rao, Xuejun; Fang, Yuanyuan

    2017-02-01

    The mechanism of high power intra-channel crosstalk attack is analyzed theoretically and the conclusion that power of attack signal and crosstalk coefficient of optical switch are the main factors for which high power intra-channel have destructive effect on quality of legitimate signals is drawn. Effects of high power intra-channel crosstalk attack on quality of legitimate signals and its capability of attack propagation are investigated quantitatively by building the simulation system in VPI software. The results show that legitimate signals through the first and the second stage optical switch are affected by attack and legitimate signal through the third stage optical switch is almost unaffected by attack when power of original attack signal (OAS) is above 20dB more than that of legitimate signals and crosstalk coefficient of optical switch is -20dB at optical cross connect 1 (OXC1). High power intra-channel crosstalk attack has a certain capability of attack propagation. Attack capability of OAS can be propagated to OXC3 when power of OAS is 27dB more than that of legitimate signals and crosstalk coefficient of optical switch is -20dB. We also find that the secondary attack signal (SAS) does not have capability of attack propagation.

  3. Evaluation of Crosstalk Attacks in Access Networks

    DEFF Research Database (Denmark)

    Wagner, Christoph; Eiselt, Michael; Grobe, Klaus

    2016-01-01

    WDM-PON systems regained interest as low-cost solution for metro and access networks. We present a comparative analysis of resilience of wavelength-selective and wavelength-routed architectures against crosstalk attackers. We compare the vulnerability of these architectures against attacks...

  4. Optimal counterterrorism and the recruitment effect of large terrorist attacks

    DEFF Research Database (Denmark)

    Jensen, Thomas

    2011-01-01

    We analyze a simple dynamic model of the interaction between terrorists and authorities. Our primary aim is to study optimal counterterrorism and its consequences when large terrorist attacks lead to a temporary increase in terrorist recruitment. First, we show that an increase in counterterrorism...... makes it more likely that terrorist cells plan small rather than large attacks and therefore may increase the probability of a successful attack. Analyzing optimal counterterrorism we see that the recruitment effect makes authorities increase the level of counterterrorism after large attacks. Therefore......, in periods following large attacks a new attack is more likely to be small compared to other periods. Finally, we analyze the long-run consequences of the recruitment effect. We show that it leads to more counterterrorism, more small attacks, and a higher sum of terrorism damage and counterterrorism costs...

  5. Quantitative Verification and Synthesis of Attack-Defence Scenarios Conference

    NARCIS (Netherlands)

    Aslanyan, Zaruhi; Nielson, Flemming; Parker, David

    Attack-defence trees are a powerful technique for formally evaluating attack-defence scenarios. They represent in an intuitive, graphical way the interaction between an attacker and a defender who compete in order to achieve conflicting objectives. We propose a novel framework for the formal

  6. 'Cryptogenic Drop Attacks' revisited: evidence of overlap with functional neurological disorder.

    Science.gov (United States)

    Hoeritzauer, Ingrid; Carson, Alan J; Stone, Jon

    2018-02-07

    In their 1973 BMJ paper 'Cryptogenic Drop Attacks', Stevens and Matthews described 40, mostly middle-aged, female patients with drop attacks of unknown cause. Although clinically common, there has been little on this topic since. We aimed to determine clinical features, comorbidity and outcome of patients with drop attacks. We carried out a retrospective review of patients with cryptogenic drop attacks seen consecutively by one clinician (JS) between 2006 and 2016. Demographics, phenomenology, duration and frequency of attacks, attack description and comorbid diagnoses were recorded. Patients were followed up with a notes review. 83 patients with cryptogenic drop attacks were predominantly female (89%, n=79), mean age 44  years. The majority (93%, n=77) could not remember the fall itself and almost half (43%, n=36) experienced prodromal dissociative symptoms. Mechanical trips or syncope preceded drop attacks, historically, in 24% (n=20) of cases. Persistent fatigue (73%, n=61), chronic pain (40%, n=33), functional limb weakness (31%,n=26) and dissociative (non-epileptic) attacks 28% (n=23) were common, with the latter usually preceding or emerging from drop attacks. At follow-up (88%, mean 38 months), 28% (n=23) had resolution of their drop attacks. Predisposing (but non-causative) disease comorbidity was found at baseline (n=12) and follow-up (n=5). Cryptogenic drop attacks are associated with high frequency of comorbid functional somatic and functional neurological disorders. Patients commonly have prodromal dissociative symptoms and in some there was a clear relationship with prior or subsequent dissociative (non-epileptic) attacks. Some cryptogenic drop attacks may be best understood as phenomena on the spectrum of dissociative attacks. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Optimal Patrol to Detect Attacks at Dispersed Heterogeneous Locations

    Science.gov (United States)

    2013-12-01

    solution RALP Random-attacker linear program SALP Strategic-attacker linear program SMDP Semi-Markov decision process SP Shortest path SPR1 Shortest...average cost per attack among all vertices, which we refer to as the strategic-attacker linear program ( SALP ): min x zOPT (3.1a) subject to ∑ (k,l)∈A c...the SALP is indicated by zOPT. The lower bound that is obtained from using the LBLP is indicated by zLB. Solutions obtained from using a heuristic

  8. Detecting Distributed SQL Injection Attacks in a Eucalyptus Cloud Environment

    Science.gov (United States)

    Kebert, Alan; Barnejee, Bikramjit; Solano, Juan; Solano, Wanda

    2013-01-01

    The cloud computing environment offers malicious users the ability to spawn multiple instances of cloud nodes that are similar to virtual machines, except that they can have separate external IP addresses. In this paper we demonstrate how this ability can be exploited by an attacker to distribute his/her attack, in particular SQL injection attacks, in such a way that an intrusion detection system (IDS) could fail to identify this attack. To demonstrate this, we set up a small private cloud, established a vulnerable website in one instance, and placed an IDS within the cloud to monitor the network traffic. We found that an attacker could quite easily defeat the IDS by periodically altering its IP address. To detect such an attacker, we propose to use multi-agent plan recognition, where the multiple source IPs are considered as different agents who are mounting a collaborative attack. We show that such a formulation of this problem yields a more sophisticated approach to detecting SQL injection attacks within a cloud computing environment.

  9. Can a Copycat Effect be Observed in Terrorist Suicide Attacks?

    Directory of Open Access Journals (Sweden)

    Nicholas Farnham

    2017-03-01

    Full Text Available The purpose of this paper is to explore how a copycat effect – established within the field of suicide studies – may manifest itself in terrorist suicide attacks, and takes an exploratory approach in evaluating the prospect of incorporating open-data resources in future counter-terrorism research. This paper explores a possible ‘copycat effect’ in cases of suicide terrorism, which entails a perpetrator being inspired by a preceding attack to carry out a similar attack not long after the original. In the wake of mounting risks of lone wolf terrorist attacks today and due to the general difficulties faced in preventing such attacks, in this paper we explore a potential area of future prevention in media reporting, security and anti-terrorism policies today. Using the START Global Terrorism Database (GTD, this paper investigates terrorist suicide-attack clusters and analyses the relationship between attacks found within the same cluster. Using a mixed-method approach, our analyses did not uncover clear evidence supporting a copycat effect among the studied attacks. These and other findings have numerous policy and future research implications.

  10. Transient Ischemic Attack

    Medline Plus

    Full Text Available ... major stroke. It's important to call 9-1-1 immediately for any stroke symptoms. Popular Topics TIA Cardiac Catheter Cholesterol Heart Attack Stent © 2018, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. The content in this ...

  11. THE REPRISAL ATTACKS BY AL-SHABAAB AGAINST KENYA

    Directory of Open Access Journals (Sweden)

    E.O.S.ODHIAMBO

    2013-10-01

    Full Text Available The incursion of Kenya Defence Forces (KDF into Somalia was met by a series of threats from the Al-Shabaab that it would increase the attacks against Kenya if the troops were not withdrawn. The capture of Kismayu by KDF has weakened the nerve of Al-Shabaab but has not eliminated the imminent danger of a substantive terror attack. Since the incursion by KDF, Kenya has succumbed to a sequence of grenade and Improvised Explosive Devices attacks, roadside bombs, landmines and raids by fighters using small arms and light weapons and Rocket Propelled Grenades against Kenyans mostly in North Eastern, Coastal and Nairobi counties, marking the resurgence of terrorism in the country. We argue that Kenya is more vulnerable to Al-Shabaab terrorists attack than before the KDF incursion by citing the frequencies of reprisal attacks from October 2011 to January 2013. Hence, our troops should be withdrawn and deployed within our boundary.

  12. Thwarting Nonintrusive Occupancy Detection Attacks from Smart Meters

    Directory of Open Access Journals (Sweden)

    Dapeng Man

    2017-01-01

    Full Text Available Occupancy information is one of the most important privacy issues of a home. Unfortunately, an attacker is able to detect occupancy from smart meter data. The current battery-based load hiding (BLH methods cannot solve this problem. To thwart occupancy detection attacks, we propose a framework of battery-based schemes to prevent occupancy detection (BPOD. BPOD monitors the power consumption of a home and detects the occupancy in real time. According to the detection result, BPOD modifies those statistical metrics of power consumption, which highly correlate with the occupancy by charging or discharging a battery, creating a delusion that the home is always occupied. We evaluate BPOD in a simulation using several real-world smart meter datasets. Our experiment results show that BPOD effectively prevents the threshold-based and classifier-based occupancy detection attacks. Furthermore, BPOD is also able to prevent nonintrusive appliance load monitoring attacks (NILM as a side-effect of thwarting detection attacks.

  13. Detecting peripheral-based attacks on the host memory

    CERN Document Server

    Stewin, Patrick

    2015-01-01

    This work addresses stealthy peripheral-based attacks on host computers and presents a new approach to detecting them. Peripherals can be regarded as separate systems that have a dedicated processor and dedicated runtime memory to handle their tasks. The book addresses the problem that peripherals generally communicate with the host via the host’s main memory, storing cryptographic keys, passwords, opened files and other sensitive data in the process – an aspect attackers are quick to exploit.  Here, stealthy malicious software based on isolated micro-controllers is implemented to conduct an attack analysis, the results of which provide the basis for developing a novel runtime detector. The detector reveals stealthy peripheral-based attacks on the host’s main memory by exploiting certain hardware properties, while a permanent and resource-efficient measurement strategy ensures that the detector is also capable of detecting transient attacks, which can otherwise succeed when the applied strategy only me...

  14. Why cryptography should not rely on physical attack complexity

    CERN Document Server

    Krämer, Juliane

    2015-01-01

    This book presents two practical physical attacks. It shows how attackers can reveal the secret key of symmetric as well as asymmetric cryptographic algorithms based on these attacks, and presents countermeasures on the software and the hardware level that can help to prevent them in the future. Though their theory has been known for several years now, since neither attack has yet been successfully implemented in practice, they have generally not been considered a serious threat. In short, their physical attack complexity has been overestimated and the implied security threat has been underestimated. First, the book introduces the photonic side channel, which offers not only temporal resolution, but also the highest possible spatial resolution. Due to the high cost of its initial implementation, it has not been taken seriously. The work shows both simple and differential photonic side channel analyses. Then, it presents a fault attack against pairing-based cryptography. Due to the need for at least two indepe...

  15. Multi-Layer Approach for the Detection of Selective Forwarding Attacks.

    Science.gov (United States)

    Alajmi, Naser; Elleithy, Khaled

    2015-11-19

    Security breaches are a major threat in wireless sensor networks (WSNs). WSNs are increasingly used due to their broad range of important applications in both military and civilian domains. WSNs are prone to several types of security attacks. Sensor nodes have limited capacities and are often deployed in dangerous locations; therefore, they are vulnerable to different types of attacks, including wormhole, sinkhole, and selective forwarding attacks. Security attacks are classified as data traffic and routing attacks. These security attacks could affect the most significant applications of WSNs, namely, military surveillance, traffic monitoring, and healthcare. Therefore, there are different approaches to detecting security attacks on the network layer in WSNs. Reliability, energy efficiency, and scalability are strong constraints on sensor nodes that affect the security of WSNs. Because sensor nodes have limited capabilities in most of these areas, selective forwarding attacks cannot be easily detected in networks. In this paper, we propose an approach to selective forwarding detection (SFD). The approach has three layers: MAC pool IDs, rule-based processing, and anomaly detection. It maintains the safety of data transmission between a source node and base station while detecting selective forwarding attacks. Furthermore, the approach is reliable, energy efficient, and scalable.

  16. Multi-Layer Approach for the Detection of Selective Forwarding Attacks

    Directory of Open Access Journals (Sweden)

    Naser Alajmi

    2015-11-01

    Full Text Available Security breaches are a major threat in wireless sensor networks (WSNs. WSNs are increasingly used due to their broad range of important applications in both military and civilian domains. WSNs are prone to several types of security attacks. Sensor nodes have limited capacities and are often deployed in dangerous locations; therefore, they are vulnerable to different types of attacks, including wormhole, sinkhole, and selective forwarding attacks. Security attacks are classified as data traffic and routing attacks. These security attacks could affect the most significant applications of WSNs, namely, military surveillance, traffic monitoring, and healthcare. Therefore, there are different approaches to detecting security attacks on the network layer in WSNs. Reliability, energy efficiency, and scalability are strong constraints on sensor nodes that affect the security of WSNs. Because sensor nodes have limited capabilities in most of these areas, selective forwarding attacks cannot be easily detected in networks. In this paper, we propose an approach to selective forwarding detection (SFD. The approach has three layers: MAC pool IDs, rule-based processing, and anomaly detection. It maintains the safety of data transmission between a source node and base station while detecting selective forwarding attacks. Furthermore, the approach is reliable, energy efficient, and scalable.

  17. Adversarial Feature Selection Against Evasion Attacks.

    Science.gov (United States)

    Zhang, Fei; Chan, Patrick P K; Biggio, Battista; Yeung, Daniel S; Roli, Fabio

    2016-03-01

    Pattern recognition and machine learning techniques have been increasingly adopted in adversarial settings such as spam, intrusion, and malware detection, although their security against well-crafted attacks that aim to evade detection by manipulating data at test time has not yet been thoroughly assessed. While previous work has been mainly focused on devising adversary-aware classification algorithms to counter evasion attempts, only few authors have considered the impact of using reduced feature sets on classifier security against the same attacks. An interesting, preliminary result is that classifier security to evasion may be even worsened by the application of feature selection. In this paper, we provide a more detailed investigation of this aspect, shedding some light on the security properties of feature selection against evasion attacks. Inspired by previous work on adversary-aware classifiers, we propose a novel adversary-aware feature selection model that can improve classifier security against evasion attacks, by incorporating specific assumptions on the adversary's data manipulation strategy. We focus on an efficient, wrapper-based implementation of our approach, and experimentally validate its soundness on different application examples, including spam and malware detection.

  18. Trojan-horse attacks on quantum-key-distribution systems

    International Nuclear Information System (INIS)

    Gisin, N.; Fasel, S.; Kraus, B.; Zbinden, H.; Ribordy, G.

    2006-01-01

    General Trojan-horse attacks on quantum-key-distribution systems, i.e., attacks on Alice or Bob's system via the quantum channel, are analyzed. We illustrate the power of such attacks with today's technology and conclude that all systems must implement active counter measures. In particular, all systems must include an auxiliary detector that monitors any incoming light. We show that such counter measures can be efficient, provided that enough additional privacy amplification is applied to the data. We present a practical way to reduce the maximal information gain that an adversary can gain using Trojan-horse attacks. This does reduce the security analysis of the two-way plug-and-play implementation to those of the standard one-way systems

  19. 12 CFR 308.17 - Collateral attacks on adjudicatory proceeding.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Collateral attacks on adjudicatory proceeding... PRACTICE RULES OF PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.17 Collateral attacks on adjudicatory proceeding. If an interlocutory appeal or collateral attack is brought in any...

  20. 12 CFR 19.17 - Collateral attacks on adjudicatory proceeding.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Collateral attacks on adjudicatory proceeding... OF PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 19.17 Collateral attacks on adjudicatory proceeding. If an interlocutory appeal or collateral attack is brought in any court concerning all...

  1. Drammer : Deterministic Rowhammer attacks on mobile platforms

    NARCIS (Netherlands)

    Van Der Veen, Victor; Fratantonio, Yanick; Lindorfer, Martina; Gruss, Daniel; Maurice, Clémentine; Vigna, Giovanni; Bos, Herbert; Razavi, Kaveh; Giuffrida, Cristiano

    2016-01-01

    Recent work shows that the Rowhammer hardware bug can be used to craft powerful attacks and completely subvert a system. However, existing efforts either describe probabilistic (and thus unreliable) attacks or rely on special (and often unavailable) memory management features to place victim objects

  2. A Comprehensive Taxonomy and Analysis of IEEE 802.15.4 Attacks

    Directory of Open Access Journals (Sweden)

    Yasmin M. Amin

    2016-01-01

    Full Text Available The IEEE 802.15.4 standard has been established as the dominant enabling technology for Wireless Sensor Networks (WSNs. With the proliferation of security-sensitive applications involving WSNs, WSN security has become a topic of great significance. In comparison with traditional wired and wireless networks, WSNs possess additional vulnerabilities which present opportunities for attackers to launch novel and more complicated attacks against such networks. For this reason, a thorough investigation of attacks against WSNs is required. This paper provides a single unified survey that dissects all IEEE 802.15.4 PHY and MAC layer attacks known to date. While the majority of existing references investigate the motive and behavior of each attack separately, this survey classifies the attacks according to clear metrics within the paper and addresses the interrelationships and differences between the attacks following their classification. The authors’ opinions and comments regarding the placement of the attacks within the defined classifications are also provided. A comparative analysis between the classified attacks is then performed with respect to a set of defined evaluation criteria. The first half of this paper addresses attacks on the IEEE 802.15.4 PHY layer, whereas the second half of the paper addresses IEEE 802.15.4 MAC layer attacks.

  3. The accountability problem of flooding attacks in service-oriented architectures

    DEFF Research Database (Denmark)

    Jensen, Meiko; Schwenk, Jörg

    2009-01-01

    The threat of Denial of Service attacks poses a serious problem to the security of network-based services in general. For flooding attacks against service-oriented applications, this threat is dramatically amplified with potentially much higher impact and very little effort on the attacker's side....... Additionally, due to the high distribution of a SOA application's components, fending such attacks becomes a far more complex task. In this paper, we present the problem of accountability, referring to the issue of resolving the attacker in a highly distributed service-oriented application. Using a general...

  4. Attack Helicopter Operations: Art or Science

    Science.gov (United States)

    1991-05-13

    ATTACK HELICOPTER OPERATIONS: ART OR SCIENCE ? BY LIEUTENANT COLONEL JAN CALLEN United States Army DISTRIBUTION STATEMENT A: Approved for public release...TASK IWORK UNIT ELEMENT NO. NO. NO. ACCESSION NC 11. TITLE (Include Socurity Classification) Attack Helicopter Operations: Art or Science ? 12. PERSONAL...OPERATIONS: ART OR SCIENCE ? AN INDIVIDUAL STUDY PROJECT by Lieutenant Colonel Jan Callen United States Army Colonel Greg Snelgrove Project Adviser U.S

  5. Attacker Model Lab

    OpenAIRE

    2006-01-01

    tut quiz present Tutorial Quiz Presentation Interactive Media Element This interactive tutorial the two sub-classes of computer attackers: amateurs and professionals. It provides valuable insight into the nature of necessary protection measure for information assets. CS3600 Information Assurance: Introduction to Computer Security Course

  6. A Secure Localization Approach against Wormhole Attacks Using Distance Consistency

    Directory of Open Access Journals (Sweden)

    Lou Wei

    2010-01-01

    Full Text Available Wormhole attacks can negatively affect the localization in wireless sensor networks. A typical wormhole attack can be launched by two colluding attackers, one of which sniffs packets at one point in the network and tunnels them through a wired or wireless link to another point, and the other relays them within its vicinity. In this paper, we investigate the impact of the wormhole attack on the localization and propose a novel distance-consistency-based secure localization scheme against wormhole attacks, which includes three phases of wormhole attack detection, valid locators identification and self-localization. The theoretical model is further formulated to analyze the proposed secure localization scheme. The simulation results validate the theoretical results and also demonstrate the effectiveness of our proposed scheme.

  7. Extended Password Recovery Attacks against APOP, SIP, and Digest Authentication

    Science.gov (United States)

    Sasaki, Yu; Wang, Lei; Ohta, Kazuo; Kunihiro, Noboru

    In this paper, we propose password recovery attacks against challenge-response authentication protocols. Our attacks use a message difference for a MD5 collision attack proposed in IEICE 2008. First, we show how to efficiently find a message pair that collides with the above message difference. Second, we show that a password used in authenticated post office protocol (APOP) can be recovered practically. We also show that the password recovery attack can be applied to a session initiation protocol (SIP) and digest authentication. Our attack can recover up to the first 31 password characters in a short time and up to the first 60 characters faster than the naive search method. We have implemented our attack and confirmed that 31 characters can be successfully recovered.

  8. 12 CFR 747.17 - Collateral attacks on adjudicatory proceeding.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Collateral attacks on adjudicatory proceeding... INVESTIGATIONS Uniform Rules of Practice and Procedure § 747.17 Collateral attacks on adjudicatory proceeding. If an interlocutory appeal or collateral attack is brought in any court concerning all or any part of an...

  9. Phase-remapping attack in practical quantum-key-distribution systems

    International Nuclear Information System (INIS)

    Fung, Chi-Hang Fred; Qi, Bing; Lo, Hoi-Kwong; Tamaki, Kiyoshi

    2007-01-01

    Quantum key distribution (QKD) can be used to generate secret keys between two distant parties. Even though QKD has been proven unconditionally secure against eavesdroppers with unlimited computation power, practical implementations of QKD may contain loopholes that may lead to the generated secret keys being compromised. In this paper, we propose a phase-remapping attack targeting two practical bidirectional QKD systems (the 'plug-and-play' system and the Sagnac system). We showed that if the users of the systems are unaware of our attack, the final key shared between them can be compromised in some situations. Specifically, we showed that, in the case of the Bennett-Brassard 1984 (BB84) protocol with ideal single-photon sources, when the quantum bit error rate (QBER) is between 14.6% and 20%, our attack renders the final key insecure, whereas the same range of QBER values has been proved secure if the two users are unaware of our attack; also, we demonstrated three situations with realistic devices where positive key rates are obtained without the consideration of Trojan horse attacks but in fact no key can be distilled. We remark that our attack is feasible with only current technology. Therefore, it is very important to be aware of our attack in order to ensure absolute security. In finding our attack, we minimize the QBER over individual measurements described by a general POVM, which has some similarity with the standard quantum state discrimination problem

  10. Effectiveness of the Call in Beach Volleyball Attacking Play

    Directory of Open Access Journals (Sweden)

    Künzell Stefan

    2014-12-01

    Full Text Available In beach volleyball the setter has the opportunity to give her or his hitter a “call”. The call intends that the setter suggests to her or his partner where to place the attack in the opponent’s court. The effectiveness of a call is still unknown. We investigated the women’s and men’s Swiss National Beach Volleyball Championships in 2011 and analyzed 2185 attacks. We found large differences between female and male players. While men called in only 38.4% of attacks, women used calls in 85.5% of attacks. If the male players followed a given call, 63% of the attacks were successful. The success rate of attacks without any call was 55.8% and 47.6% when the call was ignored. These differences were not significant (χ2(2 = 4.55, p = 0.103. In women’s beach volleyball, the rate of successful attacks was 61.5% when a call was followed, 35% for attacks without a call, and 42.6% when a call was ignored. The differences were highly significant (χ2(2 = 23.42, p < 0.0005. Taking into account the findings of the present study, we suggested that the call was effective in women’s beach volleyball, while its effect in men’s game was unclear. Considering the quality of calls we indicate that there is a significant potential to increase the effectiveness of a call.

  11. Shilling Attacks Detection in Recommender Systems Based on Target Item Analysis.

    Science.gov (United States)

    Zhou, Wei; Wen, Junhao; Koh, Yun Sing; Xiong, Qingyu; Gao, Min; Dobbie, Gillian; Alam, Shafiq

    2015-01-01

    Recommender systems are highly vulnerable to shilling attacks, both by individuals and groups. Attackers who introduce biased ratings in order to affect recommendations, have been shown to negatively affect collaborative filtering (CF) algorithms. Previous research focuses only on the differences between genuine profiles and attack profiles, ignoring the group characteristics in attack profiles. In this paper, we study the use of statistical metrics to detect rating patterns of attackers and group characteristics in attack profiles. Another question is that most existing detecting methods are model specific. Two metrics, Rating Deviation from Mean Agreement (RDMA) and Degree of Similarity with Top Neighbors (DegSim), are used for analyzing rating patterns between malicious profiles and genuine profiles in attack models. Building upon this, we also propose and evaluate a detection structure called RD-TIA for detecting shilling attacks in recommender systems using a statistical approach. In order to detect more complicated attack models, we propose a novel metric called DegSim' based on DegSim. The experimental results show that our detection model based on target item analysis is an effective approach for detecting shilling attacks.

  12. Shilling Attacks Detection in Recommender Systems Based on Target Item Analysis

    Science.gov (United States)

    Zhou, Wei; Wen, Junhao; Koh, Yun Sing; Xiong, Qingyu; Gao, Min; Dobbie, Gillian; Alam, Shafiq

    2015-01-01

    Recommender systems are highly vulnerable to shilling attacks, both by individuals and groups. Attackers who introduce biased ratings in order to affect recommendations, have been shown to negatively affect collaborative filtering (CF) algorithms. Previous research focuses only on the differences between genuine profiles and attack profiles, ignoring the group characteristics in attack profiles. In this paper, we study the use of statistical metrics to detect rating patterns of attackers and group characteristics in attack profiles. Another question is that most existing detecting methods are model specific. Two metrics, Rating Deviation from Mean Agreement (RDMA) and Degree of Similarity with Top Neighbors (DegSim), are used for analyzing rating patterns between malicious profiles and genuine profiles in attack models. Building upon this, we also propose and evaluate a detection structure called RD-TIA for detecting shilling attacks in recommender systems using a statistical approach. In order to detect more complicated attack models, we propose a novel metric called DegSim’ based on DegSim. The experimental results show that our detection model based on target item analysis is an effective approach for detecting shilling attacks. PMID:26222882

  13. Collaborative Attack Mitigation and Response: A survey

    NARCIS (Netherlands)

    Steinberger, Jessica; Sperotto, Anna; Baier, Harald; Pras, Aiko

    2015-01-01

    Over recent years, network-based attacks have become to one of the top causes of network infrastructure and service outages. To counteract a network-based attack, an approach is to move mitigation from the target network to the networks of Internet Service Providers (ISP). However, it remains

  14. A Unique Fatal Moose Attack Mimicking Homicide.

    Science.gov (United States)

    Gudmannsson, Petur; Berge, Johan; Druid, Henrik; Ericsson, Göran; Eriksson, Anders

    2018-03-01

    Fatalities caused by animal attacks are rare, but have the potential to mimic homicide. We present a case in which a moose attacked and killed a woman who was walking her dog in a forest. Autopsy showed widespread blunt trauma with a large laceration on one leg in which blades of grass were embedded. Flail chest was the cause of death. The case was initially conceived as homicide by means of a riding lawn mower. A review of the case by moose experts and analyses of biological trace material that proved to originate from moose, established the true source of injury. The dog probably provoked a moose, which, in response, stomped and gored the victim to death. The injuries resembled those previously reported from attacks by cattle and water buffalo. Fatal moose attacks constitute an extremely rare threat in boreal areas, but can be considered in traumatic deaths of unknown cause. © 2017 American Academy of Forensic Sciences.

  15. The role of sleep in migraine attacks

    Directory of Open Access Journals (Sweden)

    Elaine Inamorato

    1993-11-01

    Full Text Available Migraine attacks may be precipitated by sleep deprivation or excessive sleep and sleep is also associated with relief of migraine attacks. In view of this variable relationship we studied the records of 159 consecutive outpatients of our Headache Unit. In 121 records there was reference to sleep involvement, in 55% by a single form and in 45% by more than one form. When only one form was related, relief was most common (70%. 30% of that group of patients had the migraine attack precipitated by sleep, 24% by deprivation and 6% by sleep excess. When the effects of sleep were multiple, these effects were as expected logically in 65%: «in accordance» group (e.g attack precipitated by sleep deprivation and relieved by sleep onset. In a second group, («conflicting» where the involvement was not logical, there were three different combinations of sleep involvement, possibly due to more than one pathophysiological mechanism.

  16. Changes in vestibular evoked myogenic potentials after Meniere attacks.

    Science.gov (United States)

    Kuo, Shih-Wei; Yang, Ting-Hua; Young, Yi-Ho

    2005-09-01

    The aim of this study was to apply videonystagmography (VNG) and vestibular evoked myogenic potential (VEMP) tests to patients with Meniere attacks, to explore the mechanics of where saccular disorders may affect the semicircular canals. From January 2001 to December 2003, 12 consecutive patients with unilateral definite Meniere's disease with vertiginous attacks underwent VNG for recording spontaneous nystagmus, as well as VEMP tests. At the very beginning of the Meniere attack, the spontaneous nystagmus beat toward the lesion side in 5 patients (42%) and toward the healthy side in 7 patients (58%). Twenty-four hours later, only 6 patients (50%) showed spontaneous nystagmus beating toward the healthy side. Nevertheless, spontaneous nystagmus subsided in all patients within 48 hours. The VEMP test was performed within 24 hours of a Meniere attack; the VEMPs were normal in 4 patients and abnormal in 8 patients (67%). After 48 hours, 4 patients with initially abnormal VEMPs had resolution and return to normal VEMPs, and the other 4 patients still had absent VEMPs. Most patients (67%) with Meniere attacks revealed abnormal VEMPs, indicating that the saccule participates in a Meniere attack. This is an important idea that stimulates consideration of the mechanism of Meniere attacks.

  17. Messaging Attacks on Android: Vulnerabilities and Intrusion Detection

    Directory of Open Access Journals (Sweden)

    Khodor Hamandi

    2015-01-01

    Full Text Available Currently, Android is the leading mobile operating system in number of users worldwide. On the security side, Android has had significant challenges despite the efforts of the Android designers to provide a secure environment for apps. In this paper, we present numerous attacks targeting the messaging framework of the Android system. Our focus is on SMS, USSD, and the evolution of their associated security in Android and accordingly the development of related attacks. Also, we shed light on the Android elements that are responsible for these attacks. Furthermore, we present the architecture of an intrusion detection system (IDS that promises to thwart SMS messaging attacks. Our IDS shows a detection rate of 87.50% with zero false positives.

  18. Prodromal features of asthma.

    OpenAIRE

    Beer, S; Laver, J; Karpuch, J; Chabut, S; Aladjem, M

    1987-01-01

    One hundred and thirty four ambulatory children with bronchial asthma were investigated in the Pediatric Pulmonary-Allergic Service. In 95 patients an interval characterised by prodromal respiratory symptoms (cough, rhinorrhoea, and wheezing), behavioural changes (irritability, apathy, anxiety, and sleep disorders), gastrointestinal symptoms (abdominal pain and anorexia), fever, itching, skin eruptions, and toothache preceded the onset of the attack of asthma. Each child had his own constant ...

  19. Defending networks against denial-of-service attacks

    Science.gov (United States)

    Gelenbe, Erol; Gellman, Michael; Loukas, George

    2004-11-01

    Denial of service attacks, viruses and worms are common tools for malicious adversarial behavior in networks. Experience shows that over the last few years several of these techniques have probably been used by governments to impair the Internet communications of various entities, and we can expect that these and other information warfare tools will be used increasingly as part of hostile behavior either independently, or in conjunction with other forms of attack in conventional or asymmetric warfare, as well as in other forms of malicious behavior. In this paper we concentrate on Distributed Denial of Service Attacks (DDoS) where one or more attackers generate flooding traffic and direct it from multiple sources towards a set of selected nodes or IP addresses in the Internet. We first briefly survey the literature on the subject, and discuss some examples of DDoS incidents. We then present a technique that can be used for DDoS protection based on creating islands of protection around a critical information infrastructure. This technique, that we call the CPN-DoS-DT (Cognitive Packet Networks DoS Defence Technique), creates a self-monitoring sub-network surrounding each critical infrastructure node. CPN-DoS-DT is triggered by a DDoS detection scheme, and generates control traffic from the objects of the DDoS attack to the islands of protection where DDOS packet flows are destroyed before they reach the critical infrastructure. We use mathematical modelling, simulation and experiments on our test-bed to show the positive and negative outcomes that may result from both the attack, and the CPN-DoS-DT protection mechanism, due to imperfect detection and false alarms.

  20. Integrated Modules Analysis to Explore the Molecular Mechanisms of Phlegm-Stasis Cementation Syndrome with Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Wei-Ming Xu

    2018-01-01

    Full Text Available Background: Ischemic heart disease (IHD has been the leading cause of death for several decades globally, IHD patients usually hold the symptoms of phlegm-stasis cementation syndrome (PSCS as significant complications. However, the underlying molecular mechanisms of PSCS complicated with IHD have not yet been fully elucidated.Materials and Methods: Network medicine methods were utilized to elucidate the underlying molecular mechanisms of IHD phenotypes. Firstly, high-quality IHD-associated genes from both human curated disease-gene association database and biomedical literatures were integrated. Secondly, the IHD disease modules were obtained by dissecting the protein-protein interaction (PPI topological modules in the String V9.1 database and the mapping of IHD-associated genes to the PPI topological modules. After that, molecular functional analyses (e.g., Gene Ontology and pathway enrichment analyses for these IHD disease modules were conducted. Finally, the PSCS syndrome modules were identified by mapping the PSCS related symptom-genes to the IHD disease modules, which were further validated by both pharmacological and physiological evidences derived from published literatures.Results: The total of 1,056 high-quality IHD-associated genes were integrated and evaluated. In addition, eight IHD disease modules (the PPI sub-networks significantly relevant to IHD were identified, in which two disease modules were relevant to PSCS syndrome (i.e., two PSCS syndrome modules. These two modules had enriched pathways on Toll-like receptor signaling pathway (hsa04620 and Renin-angiotensin system (hsa04614, with the molecular functions of angiotensin maturation (GO:0002003 and response to bacterium (GO:0009617, which had been validated by classical Chinese herbal formulas-related targets, IHD-related drug targets, and the phenotype features derived from human phenotype ontology (HPO and published biomedical literatures.Conclusion: A network medicine

  1. Integrated Modules Analysis to Explore the Molecular Mechanisms of Phlegm-Stasis Cementation Syndrome with Ischemic Heart Disease.

    Science.gov (United States)

    Xu, Wei-Ming; Yang, Kuo; Jiang, Li-Jie; Hu, Jing-Qing; Zhou, Xue-Zhong

    2018-01-01

    Background: Ischemic heart disease (IHD) has been the leading cause of death for several decades globally, IHD patients usually hold the symptoms of phlegm-stasis cementation syndrome (PSCS) as significant complications. However, the underlying molecular mechanisms of PSCS complicated with IHD have not yet been fully elucidated. Materials and Methods: Network medicine methods were utilized to elucidate the underlying molecular mechanisms of IHD phenotypes. Firstly, high-quality IHD-associated genes from both human curated disease-gene association database and biomedical literatures were integrated. Secondly, the IHD disease modules were obtained by dissecting the protein-protein interaction (PPI) topological modules in the String V9.1 database and the mapping of IHD-associated genes to the PPI topological modules. After that, molecular functional analyses (e.g., Gene Ontology and pathway enrichment analyses) for these IHD disease modules were conducted. Finally, the PSCS syndrome modules were identified by mapping the PSCS related symptom-genes to the IHD disease modules, which were further validated by both pharmacological and physiological evidences derived from published literatures. Results: The total of 1,056 high-quality IHD-associated genes were integrated and evaluated. In addition, eight IHD disease modules (the PPI sub-networks significantly relevant to IHD) were identified, in which two disease modules were relevant to PSCS syndrome (i.e., two PSCS syndrome modules). These two modules had enriched pathways on Toll-like receptor signaling pathway (hsa04620) and Renin-angiotensin system (hsa04614), with the molecular functions of angiotensin maturation (GO:0002003) and response to bacterium (GO:0009617), which had been validated by classical Chinese herbal formulas-related targets, IHD-related drug targets, and the phenotype features derived from human phenotype ontology (HPO) and published biomedical literatures. Conclusion: A network medicine

  2. Integrated Modules Analysis to Explore the Molecular Mechanisms of Phlegm-Stasis Cementation Syndrome with Ischemic Heart Disease

    Science.gov (United States)

    Xu, Wei-Ming; Yang, Kuo; Jiang, Li-Jie; Hu, Jing-Qing; Zhou, Xue-Zhong

    2018-01-01

    Background: Ischemic heart disease (IHD) has been the leading cause of death for several decades globally, IHD patients usually hold the symptoms of phlegm-stasis cementation syndrome (PSCS) as significant complications. However, the underlying molecular mechanisms of PSCS complicated with IHD have not yet been fully elucidated. Materials and Methods: Network medicine methods were utilized to elucidate the underlying molecular mechanisms of IHD phenotypes. Firstly, high-quality IHD-associated genes from both human curated disease-gene association database and biomedical literatures were integrated. Secondly, the IHD disease modules were obtained by dissecting the protein-protein interaction (PPI) topological modules in the String V9.1 database and the mapping of IHD-associated genes to the PPI topological modules. After that, molecular functional analyses (e.g., Gene Ontology and pathway enrichment analyses) for these IHD disease modules were conducted. Finally, the PSCS syndrome modules were identified by mapping the PSCS related symptom-genes to the IHD disease modules, which were further validated by both pharmacological and physiological evidences derived from published literatures. Results: The total of 1,056 high-quality IHD-associated genes were integrated and evaluated. In addition, eight IHD disease modules (the PPI sub-networks significantly relevant to IHD) were identified, in which two disease modules were relevant to PSCS syndrome (i.e., two PSCS syndrome modules). These two modules had enriched pathways on Toll-like receptor signaling pathway (hsa04620) and Renin-angiotensin system (hsa04614), with the molecular functions of angiotensin maturation (GO:0002003) and response to bacterium (GO:0009617), which had been validated by classical Chinese herbal formulas-related targets, IHD-related drug targets, and the phenotype features derived from human phenotype ontology (HPO) and published biomedical literatures. Conclusion: A network medicine

  3. Performance Improvement of Power Analysis Attacks on AES with Encryption-Related Signals

    Science.gov (United States)

    Lee, You-Seok; Lee, Young-Jun; Han, Dong-Guk; Kim, Ho-Won; Kim, Hyoung-Nam

    A power analysis attack is a well-known side-channel attack but the efficiency of the attack is frequently degraded by the existence of power components, irrelative to the encryption included in signals used for the attack. To enhance the performance of the power analysis attack, we propose a preprocessing method based on extracting encryption-related parts from the measured power signals. Experimental results show that the attacks with the preprocessed signals detect correct keys with much fewer signals, compared to the conventional power analysis attacks.

  4. Mass casualty response in the 2008 Mumbai terrorist attacks.

    Science.gov (United States)

    Roy, Nobhojit; Kapil, Vikas; Subbarao, Italo; Ashkenazi, Isaac

    2011-12-01

    The November 26-29, 2008, terrorist attacks on Mumbai were unique in its international media attention, multiple strategies of attack, and the disproportionate national fear they triggered. Everyone was a target: random members of the general population, iconic targets, and foreigners alike were under attack by the terrorists. A retrospective, descriptive study of the distribution of terror victims to various city hospitals, critical radius, surge capacity, and the nature of specialized medical interventions was gathered through police, legal reports, and interviews with key informants. Among the 172 killed and 304 injured people, about four-fifths were men (average age, 33 years) and 12% were foreign nationals. The case-fatality ratio for this event was 2.75:1, and the mortality rate among those who were critically injured was 12%. A total of 38.5% of patients arriving at the hospitals required major surgical intervention. Emergency surgical operations were mainly orthopedic (external fixation for compound fractures) and general surgical interventions (abdominal explorations for penetrating bullet/shrapnel injuries). The use of heavy-duty automatic weapons, explosives, hostages, and arson in these terrorist attacks alerts us to new challenges to medical counterterrorism response. The need for building central medical control for a coordinated response and for strengthening public hospital capacity are lessons learned for future attacks. These particular terrorist attacks had global consequences, in terms of increased security checks and alerts for and fears of further similar "Mumbai-style" attacks. The resilience of the citizens of Mumbai is a critical measure of the long-term effects of terror attacks.

  5. 1994 Attack Team Workshop: Phase II - Full-Scale Offensive Fog Attack Tests

    National Research Council Canada - National Science Library

    Scheffey, Joseph

    1997-01-01

    .... This report demonstrates the benefits of using a medium angle fog stream to control the overhead fire threat when conducting a direct attack on a growing/steady state fire where the sea of the fire is obstructed...

  6. Network overload due to massive attacks

    Science.gov (United States)

    Kornbluth, Yosef; Barach, Gilad; Tuchman, Yaakov; Kadish, Benjamin; Cwilich, Gabriel; Buldyrev, Sergey V.

    2018-05-01

    We study the cascading failure of networks due to overload, using the betweenness centrality of a node as the measure of its load following the Motter and Lai model. We study the fraction of survived nodes at the end of the cascade pf as a function of the strength of the initial attack, measured by the fraction of nodes p that survive the initial attack for different values of tolerance α in random regular and Erdös-Renyi graphs. We find the existence of a first-order phase-transition line pt(α ) on a p -α plane, such that if p pt , pf is large and the giant component of the network is still present. Exactly at pt, the function pf(p ) undergoes a first-order discontinuity. We find that the line pt(α ) ends at a critical point (pc,αc) , in which the cascading failures are replaced by a second-order percolation transition. We find analytically the average betweenness of nodes with different degrees before and after the initial attack, we investigate their roles in the cascading failures, and we find a lower bound for pt(α ) . We also study the difference between localized and random attacks.

  7. Novel mechanism of network protection against the new generation of cyber attacks

    Science.gov (United States)

    Milovanov, Alexander; Bukshpun, Leonid; Pradhan, Ranjit

    2012-06-01

    A new intelligent mechanism is presented to protect networks against the new generation of cyber attacks. This mechanism integrates TCP/UDP/IP protocol stack protection and attacker/intruder deception to eliminate existing TCP/UDP/IP protocol stack vulnerabilities. It allows to detect currently undetectable, highly distributed, low-frequency attacks such as distributed denial-of-service (DDoS) attacks, coordinated attacks, botnet, and stealth network reconnaissance. The mechanism also allows insulating attacker/intruder from the network and redirecting the attack to a simulated network acting as a decoy. As a result, network security personnel gain sufficient time to defend the network and collect the attack information. The presented approach can be incorporated into wireless or wired networks that require protection against known and the new generation of cyber attacks.

  8. Software test attacks to break mobile and embedded devices

    CERN Document Server

    Hagar, Jon Duncan

    2013-01-01

    Address Errors before Users Find Them Using a mix-and-match approach, Software Test Attacks to Break Mobile and Embedded Devices presents an attack basis for testing mobile and embedded systems. Designed for testers working in the ever-expanding world of ""smart"" devices driven by software, the book focuses on attack-based testing that can be used by individuals and teams. The numerous test attacks show you when a software product does not work (i.e., has bugs) and provide you with information about the software product under test. The book guides you step by step starting with the basics. It

  9. Modeling attacking of high skills volleyball players

    Directory of Open Access Journals (Sweden)

    Vladimir Gamaliy

    2014-12-01

    Full Text Available Purpose: to determine the model indicators of technical and tactical actions in the attack highly skilled volleyball players. Material and Methods: the study used statistical data of major international competitions: Olympic Games – 2012 World Championships – 2010, World League – 2010–2014 European Championship – 2010–2014. A total of 130 analyzed games. Methods were used: analysis and generalization of scientific and methodological literature, analysis of competitive activity highly skilled volleyball players, teacher observation, modeling technical and tactical actions in attacking highly skilled volleyball players. Results: it was found that the largest volume application of technical and tactical actions in the attack belongs to the group tactics «supple movement», whose indicator is 21,3%. The smallest amount of application belongs to the group tactics «flight level» model whose indicators is 5,4%, the efficiency of 3,4%, respectively. It is found that the power service in the jump from model parameters used in 51,6% of cases, the planning targets – 21,7% and 4,4% planning to reduce. Attacks performed with the back line, on model parameters used in the amount of 20,8% efficiency –13,7%. Conclusions: we prove that the performance of technical and tactical actions in the attack can be used as model in the control system of training and competitive process highly skilled volleyball players

  10. Sleep Deprivation Attack Detection in Wireless Sensor Network

    OpenAIRE

    Bhattasali, Tapalina; Chaki, Rituparna; Sanyal, Sugata

    2012-01-01

    Deployment of sensor network in hostile environment makes it mainly vulnerable to battery drainage attacks because it is impossible to recharge or replace the battery power of sensor nodes. Among different types of security threats, low power sensor nodes are immensely affected by the attacks which cause random drainage of the energy level of sensors, leading to death of the nodes. The most dangerous type of attack in this category is sleep deprivation, where target of the intruder is to maxi...

  11. Calcium Supplements: A Risk Factor for Heart Attack?

    Science.gov (United States)

    ... factor for heart attack? I've read that calcium supplements may increase the risk of heart attack. ... D. Some doctors think it's possible that taking calcium supplements may increase your risk of a heart ...

  12. Using the Domain Name System to Thwart Automated Client-Based Attacks

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Curtis R [ORNL; Shue, Craig A [ORNL

    2011-09-01

    On the Internet, attackers can compromise systems owned by other people and then use these systems to launch attacks automatically. When attacks such as phishing or SQL injections are successful, they can have negative consequences including server downtime and the loss of sensitive information. Current methods to prevent such attacks are limited in that they are application-specific, or fail to block attackers. Phishing attempts can be stopped with email filters, but if the attacker manages to successfully bypass these filters, then the user must determine if the email is legitimate or not. Unfortunately, they often are unable to do so. Since attackers have a low success rate, they attempt to compensate for it in volume. In order to have this high throughput, attackers take shortcuts and break protocols. We use this knowledge to address these issues by implementing a system that can detect malicious activity and use it to block attacks. If the client fails to follow proper procedure, they can be classified as an attacker. Once an attacker has been discovered, they will be isolated and monitored. This can be accomplished using existing software in Ubuntu Linux applications, along with our custom wrapper application. After running the system and seeing its performance on three popular Web browsers Chromium, Firefox and Internet Explorer as well as two popular email clients, Thunderbird and Evolution, we found that not only is this system conceivable, it is effective and has low overhead.

  13. Multilevel Modeling of Distributed Denial of Service Attacks in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Katarzyna Mazur

    2016-01-01

    Full Text Available The growing popularity of wireless sensor networks increases the risk of security attacks. One of the most common and dangerous types of attack that takes place these days in any electronic society is a distributed denial of service attack. Due to the resource constraint nature of mobile sensors, DDoS attacks have become a major threat to its stability. In this paper, we established a model of a structural health monitoring network, being disturbed by one of the most common types of DDoS attacks, the flooding attack. Through a set of simulations, we explore the scope of flood-based DDoS attack problem, assessing the performance and the lifetime of the network under the attack condition. To conduct our research, we utilized the Quality of Protection Modeling Language. With the proposed approach, it was possible to examine numerous network configurations, parameters, attack options, and scenarios. The results of the carefully performed multilevel analysis allowed us to identify a new kind of DDoS attack, the delayed distributed denial of service, by the authors, referred to as DDDoS attack. Multilevel approach to DDoS attack analysis confirmed that, examining endangered environments, it is significant to take into account many characteristics at once, just to not overlook any important aspect.

  14. Exploiting Small Leakages in Masks to Turn a Second-Order Attack into a First-Order Attack and Improved Rotating Substitution Box Masking with Linear Code Cosets

    Science.gov (United States)

    DeTrano, Alexander; Karimi, Naghmeh; Karri, Ramesh; Guo, Xiaofei; Carlet, Claude; Guilley, Sylvain

    2015-01-01

    Masking countermeasures, used to thwart side-channel attacks, have been shown to be vulnerable to mask-extraction attacks. State-of-the-art mask-extraction attacks on the Advanced Encryption Standard (AES) algorithm target S-Box recomputation schemes but have not been applied to scenarios where S-Boxes are precomputed offline. We propose an attack targeting precomputed S-Boxes stored in nonvolatile memory. Our attack targets AES implemented in software protected by a low entropy masking scheme and recovers the masks with 91% success rate. Recovering the secret key requires fewer power traces (in fact, by at least two orders of magnitude) compared to a classical second-order attack. Moreover, we show that this attack remains viable in a noisy environment or with a reduced number of leakage points. Eventually, we specify a method to enhance the countermeasure by selecting a suitable coset of the masks set. PMID:26491717

  15. Quick Reference: Cyber Attacks Awareness and Prevention Method for Home Users

    OpenAIRE

    Haydar Teymourlouei

    2015-01-01

    It is important to take security measures to protect your computer information, reduce identify theft, and prevent from malicious cyber-attacks. With cyber-attacks on the continuous rise, people need to understand and learn ways to prevent from these attacks. Cyber-attack is an important factor to be considered if one is to be able to protect oneself from malicious attacks. Without proper security measures, most computer technology would hinder home users more than such t...

  16. A Strategic Analysis of Information Sharing Among Cyber Attackers

    Directory of Open Access Journals (Sweden)

    Kjell Hausken

    2015-10-01

    Full Text Available We build a game theory model where the market design is such that one firm invests in security to defend against cyber attacks by two hackers. The firm has an asset, which is allocated between the three market participants dependent on their contest success. Each hacker chooses an optimal attack, and they share information with each other about the firm’s vulnerabilities. Each hacker prefers to receive information, but delivering information gives competitive advantage to the other hacker. We find that each hacker’s attack and information sharing are strategic complements while one hacker’s attack and the other hacker’s information sharing are strategic substitutes. As the firm’s unit defense cost increases, the attack is inverse U-shaped and reaches zero, while the firm’s defense and profit decrease, and the hackers’ information sharing and profit increase. The firm’s profit increases in the hackers’ unit cost of attack, while the hackers’ information sharing and profit decrease. Our analysis also reveals the interesting result that the cumulative attack level of the hackers is not affected by the effectiveness of information sharing between them and moreover, is also unaffected by the intensity of joint information sharing. We also find that as the effectiveness of information sharing between hackers increases relative to the investment in attack, the firm’s investment in cyber security defense and profit are constant, the hackers’ investments in attacks decrease, and information sharing levels and hacker profits increase. In contrast, as the intensity of joint information sharing increases, while the firm’s investment in cyber security defense and profit remain constant, the hackers’ investments in attacks increase, and the hackers’ information sharing levels and profits decrease. Increasing the firm’s asset causes all the variables to increase linearly, except information sharing which is constant. We extend

  17. Strengthening Crypto-1 Cipher Against Algebraic Attacks

    Directory of Open Access Journals (Sweden)

    Farah Afianti

    2015-08-01

    Full Text Available In the last few years, several studies addressed the problem of data security in Mifare Classic. One of its weaknesses is the low random number quality. This causes SAT solver attacks to have lower complexity. In order to strengthen Crypto-1 against SAT solver attacks, a modification of the feedback function with better cryptographic properties is proposed. It applies a primitive polynomial companion matrix. SAT solvers cannot directly attack the feedback shift register that uses the modified Boolean feedback function, the register has to be split into smaller groups. Experimental testing showed that the amount of memory and CPU time needed were highest when attacking the modified Crypto-1 using the modified feedback function and the original filter function. In addition, another modified Crypto-1, using the modified feedback function and a modified filter function, had the lowest percentage of revealed variables. It can be concluded that the security strength and performance of the modified Crypto-1 using the modified feedback function and the modified filter function are better than those of the original Crypto-1.

  18. Recurrent wheezing in relation to environmental risk factors in infancy. A prospective study of 276 infants

    DEFF Research Database (Denmark)

    Halken, S; Høst, A; Husby, S

    1991-01-01

    Clinical course and environmental factors were recorded in a prospective study of 276 unselected infants followed from birth to the age of 18 months. The study was performed with a questionnaire at the age of 6 and 12 months and a physical examination at 18 months. Fifty-nine (21%) of the children...... had greater than or equal to 2 episodes of wheezing before they were 18 months old. A total of 58 (21%) of the children belonged to the lowest social class V, 182 (66%) were daily exposed to passive tobacco smoking at home and/or in daycare, 164 (59%) were breastfed greater than or equal to 3 months......, 192 (70%) were in daycare, 62 (22%) lived in flats and 167 (61%) were in daily contact with furred pets at home and/or in daycare. In social class V a preponderance of children were exposed to passive tobacco smoking, a majority were living in flats and a minority were breastfed greater than or equal...

  19. A Stochastic Framework for Quantitative Analysis of Attack-Defense Trees

    NARCIS (Netherlands)

    Jhawar, Ravi; Lounis, Karim; Mauw, Sjouke

    2016-01-01

    Cyber attacks are becoming increasingly complex, practically sophisticated and organized. Losses due to such attacks are important, varying from the loss of money to business reputation spoilage. Therefore, there is a great need for potential victims of cyber attacks to deploy security solutions

  20. Vulnerability of water supply systems to cyber-physical attacks

    Science.gov (United States)

    Galelli, Stefano; Taormina, Riccardo; Tippenhauer, Nils; Salomons, Elad; Ostfeld, Avi

    2016-04-01

    The adoption of smart meters, distributed sensor networks and industrial control systems has largely improved the level of service provided by modern water supply systems. Yet, the progressive computerization exposes these critical infrastructures to cyber-physical attacks, which are generally aimed at stealing critical information (cyber-espionage) or causing service disruption (denial-of-service). Recent statistics show that water and power utilities are undergoing frequent attacks - such as the December power outage in Ukraine - , attracting the interest of operators and security agencies. Taking the security of Water Distribution Networks (WDNs) as domain of study, our work seeks to characterize the vulnerability of WDNs to cyber-physical attacks, so as to conceive adequate defense mechanisms. We extend the functionality of EPANET, which models hydraulic and water quality processes in pressurized pipe networks, to include a cyber layer vulnerable to repeated attacks. Simulation results on a medium-scale network show that several hydraulic actuators (valves and pumps, for example) can be easily attacked, causing both service disruption - i.e., water spillage and loss of pressure - and structural damages - e.g., pipes burst. Our work highlights the need for adequate countermeasures, such as attacks detection and reactive control systems.

  1. Security Measurement for Unknown Threats Based on Attack Preferences

    Directory of Open Access Journals (Sweden)

    Lihua Yin

    2018-01-01

    Full Text Available Security measurement matters to every stakeholder in network security. It provides security practitioners the exact security awareness. However, most of the works are not applicable to the unknown threat. What is more, existing efforts on security metric mainly focus on the ease of certain attack from a theoretical point of view, ignoring the “likelihood of exploitation.” To help administrator have a better understanding, we analyze the behavior of attackers who exploit the zero-day vulnerabilities and predict their attack timing. Based on the prediction, we propose a method of security measurement. In detail, we compute the optimal attack timing from the perspective of attacker, using a long-term game to estimate the risk of being found and then choose the optimal timing based on the risk and profit. We design a learning strategy to model the information sharing mechanism among multiattackers and use spatial structure to model the long-term process. After calculating the Nash equilibrium for each subgame, we consider the likelihood of being attacked for each node as the security metric result. The experiment results show the efficiency of our approach.

  2. The Need for Situational Awareness in a CBRNE Attack

    Directory of Open Access Journals (Sweden)

    Jordan Nelms

    2011-02-01

    Full Text Available Six years before the terrorist attacks on the World Trade Center and the Pentagon, and eight years before the United States went to war with Saddam Hussein for his alleged concealment of chemical and biological weapons caches, Japan's Tokyo subway was struck by one of the most vicious terror attacks in modern history.  The 1995 Sarin terrorist attack represents an important case study for post-9/11 emergency managers because it highlights the key issues first responders and public health officials face when confronted with a CBRNE ('C'hemical, 'B'iological, 'R'adiological, 'N'uclear, 'E'xplosive mass-casualty attack.

  3. Cyber attack analysis on cyber-physical systems: Detectability, severity, and attenuation strategy

    Science.gov (United States)

    Kwon, Cheolhyeon

    Security of Cyber-Physical Systems (CPS) against malicious cyber attacks is an important yet challenging problem. Since most cyber attacks happen in erratic ways, it is usually intractable to describe and diagnose them systematically. Motivated by such difficulties, this thesis presents a set of theories and algorithms for a cyber-secure architecture of the CPS within the control theoretic perspective. Here, instead of identifying a specific cyber attack model, we are focused on analyzing the system's response during cyber attacks. Firstly, we investigate the detectability of the cyber attacks from the system's behavior under cyber attacks. Specifically, we conduct a study on the vulnerabilities in the CPS's monitoring system against the stealthy cyber attack that is carefully designed to avoid being detected by its detection scheme. After classifying three kinds of cyber attacks according to the attacker's ability to compromise the system, we derive the necessary and sufficient conditions under which such stealthy cyber attacks can be designed to cause the unbounded estimation error while not being detected. Then, the analytical design method of the optimal stealthy cyber attack that maximizes the estimation error is developed. The proposed stealthy cyber attack analysis is demonstrated with illustrative examples on Air Traffic Control (ATC) system and Unmanned Aerial Vehicle (UAV) navigation system applications. Secondly, in an attempt to study the CPSs' vulnerabilities in more detail, we further discuss a methodology to identify potential cyber threats inherent in the given CPSs and quantify the attack severity accordingly. We then develop an analytical algorithm to test the behavior of the CPS under various cyber attack combinations. Compared to a numerical approach, the analytical algorithm enables the prediction of the most effective cyber attack combinations without computing the severity of all possible attack combinations, thereby greatly reducing the

  4. Consciousness in Non-Epileptic Attack Disorder

    OpenAIRE

    Reuber, M.; Kurthen, M.

    2011-01-01

    Non-epileptic attack disorder (NEAD) is one of the most important differential diagnoses of epilepsy. Impairment of\\ud consciousness is the key feature of non-epileptic attacks (NEAs). The first half of this review summarises the clinical research\\ud literature featuring observations relating to consciousness in NEAD. The second half places this evidence in the wider context\\ud of the recent discourse on consciousness in neuroscience and the philosophy of mind. We argue that studies of consci...

  5. Gait biometrics under spoofing attacks: an experimental investigation

    Science.gov (United States)

    Hadid, Abdenour; Ghahramani, Mohammad; Kellokumpu, Vili; Feng, Xiaoyi; Bustard, John; Nixon, Mark

    2015-11-01

    Gait is a relatively biometric modality which has a precious advantage over other modalities, such as iris and voice, in that it can be easily captured from a distance. Although it has recently become a topic of great interest in biometric research, there has been little investigation into gait spoofing attacks where a person tries to imitate the clothing or walking style of someone else. We recently analyzed for the first time the effects of spoofing attacks on silhouette-based gait biometric systems and showed that it was indeed possible to spoof gait biometric systems by clothing impersonation and the deliberate selection of a target that has a similar build to the attacker. To gain deeper insight into the performance of current gait biometric systems under spoofing attacks, we provide a thorough investigation on how clothing can be used to spoof a target and evaluate the performance of two state-of-the-art recognition methods on a gait spoofing database recorded at the University of Southampton. Furthermore, we describe and evaluate an initial solution coping with gait spoofing attacks. The obtained results are very promising and point out interesting findings which can be used for future investigations.

  6. Learning from history: The Glasgow Airport terrorist attack.

    Science.gov (United States)

    Crichton, Gillies

    Glasgow Airport was the target of a terrorist attack on 30th June, 2007. Many people within Scotland had come to believe that Scotland was immune from terrorism. This perception was in large part informed by Scotland's experience during the protracted Troubles in Northern Ireland, during which the Provisional Irish Republican Army's mainland bombing campaign focused on targets in England, sparing both Scotland and Wales. While Glasgow Airport did not expect such an attack to take place, meticulous planning, organising and testing of plans had taken place to mitigate the unlikely event of such an attack. The attack stands up as a shining example of robust business continuity management, where the airport reopened for business as usual in less than 24 hours from the time of the attack. Little is known about how the airport handled the situation in conjunction with other responding agencies as people tend to want to focus on high-profile disasters only. Yet countless such incidents are happening worldwide on a daily basis, in which there are excellent learning opportunities, and, taken in the spirit of converting hindsight into foresight, the likelihood of similar incidents could potentially be reduced in the future.

  7. Heart Attack Payment - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – provider data. This data set includes provider data for payments associated with a 30-day episode of care for heart...

  8. Stability Analysis of an Advanced Persistent Distributed Denial-of-Service Attack Dynamical Model

    Directory of Open Access Journals (Sweden)

    Chunming Zhang

    2018-01-01

    Full Text Available The advanced persistent distributed denial-of-service (APDDoS attack is a fairly significant threat to cybersecurity. Formulating a mathematical model for accurate prediction of APDDoS attack is important. However, the dynamical model of APDDoS attack has barely been reported. This paper first proposes a novel dynamical model of APDDoS attack to understand the mechanisms of APDDoS attack. Then, the attacked threshold of this model is calculated. The global stability of attack-free and attacked equilibrium are both proved. The influences of the model’s parameters on attacked equilibrium are discussed. Eventually, the main conclusions of the theoretical analysis are examined through computer simulations.

  9. Inflammation and neuropathic attacks in hereditary brachial plexus neuropathy

    Science.gov (United States)

    Klein, C; Dyck, P; Friedenberg, S; Burns, T; Windebank, A; Dyck, P

    2002-01-01

    Objective: To study the role of mechanical, infectious, and inflammatory factors inducing neuropathic attacks in hereditary brachial plexus neuropathy (HBPN), an autosomal dominant disorder characterised by attacks of pain and weakness, atrophy, and sensory alterations of the shoulder girdle and upper limb muscles. Methods: Four patients from separate kindreds with HBPN were evaluated. Upper extremity nerve biopsies were obtained during attacks from a person of each kindred. In situ hybridisation for common viruses in nerve tissue and genetic testing for a hereditary tendency to pressure palsies (HNPP; tomaculous neuropathy) were undertaken. Two patients treated with intravenous methyl prednisolone had serial clinical and electrophysiological examinations. One patient was followed prospectively through pregnancy and during the development of a stereotypic attack after elective caesarean delivery. Results: Upper extremity nerve biopsies in two patients showed prominent perivascular inflammatory infiltrates with vessel wall disruption. Nerve in situ hybridisation for viruses was negative. There were no tomaculous nerve changes. In two patients intravenous methyl prednisolone ameliorated symptoms (largely pain), but with tapering of steroid dose, signs and symptoms worsened. Elective caesarean delivery did not prevent a typical postpartum attack. Conclusions: Inflammation, probably immune, appears pathogenic for some if not all attacks of HBPN. Immune modulation may be useful in preventing or reducing the neuropathic attacks, although controlled trials are needed to establish efficacy, as correction of the mutant gene is still not possible. The genes involved in immune regulation may be candidates for causing HBPN disorders. PMID:12082044

  10. Heart Attack Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for heart...

  11. Heart Attack Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – state data. This data set includes state-level data for payments associated with a 30-day episode of care for heart...

  12. Choosing What to Protect When Attacker Resources and Asset Valuations are Uncertain

    Directory of Open Access Journals (Sweden)

    Kjell Hausken

    2014-01-01

    Full Text Available The situation has been modelled where the attacker's resources are unknown to the defender. Protecting assets presupposes that the defender has some information on the attacker's resource capabilities. An attacker targets one of two assets. The attacker's resources and valuations of these assets are drawn probabilistically. We specify when the isoutility curves are upward sloping (the defender prefers to invest less in defense, thus leading to higher probabilities of success for attacks on both assets or downward sloping (e.g. when one asset has a low value or high unit defense cost. This stands in contrast to earlier research and results from the uncertainty regarding the level of the attacker's resources. We determine which asset the attacker targets depending on his type, unit attack costs, the contest intensity, and investment in defense. A two stage game is considered, where the defender moves first and the attacker moves second. When both assets are equivalent and are treated equivalently by both players, an interior equilibrium exists when the contest intensity is low, and a corner equilibrium with no defense exists when the contest intensity is large and the attacker holds large resources. Defense efforts are inverse U shaped in the attacker's resources. (original abstract

  13. Development of Cyber-attack Risk Assessment Model for Nuclear Power Plants

    International Nuclear Information System (INIS)

    Park, Jong Woo; Lee, Seung Jun

    2017-01-01

    In this work, a risk evaluation method to identify significant cyber-attack scenarios and important components which should be defensed was proposed based on the probabilistic safety assessment (PSA) method which is widely used for evaluating risk of NPPs. NPPs adopting digital systems have been facing the risk of cyber-attacks. To develop efficient and reasonable defense strategy, it is required to identify significant cyber-attack scenarios and important components because there are huge number of critical digital assets in an NPP. By evaluating the risk of cyber-attack, the risk-informed defense strategies against cyber-attack could be suggested. In this work, the method to identify important cyber-attack scenarios and to evaluate the quantitative risk caused by cyber-attacks was proposed. For a future study, more feasible scenarios will be analyzed and additional modifications will be made in the model if necessary.

  14. Analysis of Network Vulnerability Under Joint Node and Link Attacks

    Science.gov (United States)

    Li, Yongcheng; Liu, Shumei; Yu, Yao; Cao, Ting

    2018-03-01

    The security problem of computer network system is becoming more and more serious. The fundamental reason is that there are security vulnerabilities in the network system. Therefore, it’s very important to identify and reduce or eliminate these vulnerabilities before they are attacked. In this paper, we are interested in joint node and link attacks and propose a vulnerability evaluation method based on the overall connectivity of the network to defense this attack. Especially, we analyze the attack cost problem from the attackers’ perspective. The purpose is to find the set of least costs for joint links and nodes, and their deletion will lead to serious network connection damage. The simulation results show that the vulnerable elements obtained from the proposed method are more suitable for the attacking idea of the malicious persons in joint node and link attack. It is easy to find that the proposed method has more realistic protection significance.

  15. Semantic Identification Attacks on Web Browsing

    OpenAIRE

    Guha, Neel

    2016-01-01

    We introduce a Semantic Identification Attack, in which an adversary uses semantic signals about the pages visited in one browsing session to identify other browsing sessions launched by the same user. This attack allows an adver- sary to determine if two browsing sessions originate from the same user regardless of any measures taken by the user to disguise their browser or network. We use the MSNBC Anonymous Browsing data set, which contains a large set of user visits (labeled by category) t...

  16. Hereditary angioedema attacks resolve faster and are shorter after early icatibant treatment.

    Directory of Open Access Journals (Sweden)

    Marcus Maurer

    Full Text Available BACKGROUND: Attacks of hereditary angioedema (HAE are unpredictable and, if affecting the upper airway, can be lethal. Icatibant is used for physician- or patient self-administered symptomatic treatment of HAE attacks in adults. Its mode of action includes disruption of the bradykinin pathway via blockade of the bradykinin B(2 receptor. Early treatment is believed to shorten attack duration and prevent severe outcomes; however, evidence to support these benefits is lacking. OBJECTIVE: To examine the impact of timing of icatibant administration on the duration and resolution of HAE type I and II attacks. METHODS: The Icatibant Outcome Survey is an international, prospective, observational study for patients treated with icatibant. Data on timings and outcomes of icatibant treatment for HAE attacks were collected between July 2009-February 2012. A mixed-model of repeated measures was performed for 426 attacks in 136 HAE type I and II patients. RESULTS: Attack duration was significantly shorter in patients treated <1 hour of attack onset compared with those treated ≥ 1 hour (6.1 hours versus 16.8 hours [p<0.001]. Similar significant effects were observed for <2 hours versus ≥ 2 hours (7.2 hours versus 20.2 hours [p<0.001] and <5 hours versus ≥ 5 hours (8.0 hours versus 23.5 hours [p<0.001]. Treatment within 1 hour of attack onset also significantly reduced time to attack resolution (5.8 hours versus 8.8 hours [p<0.05]. Self-administrators were more likely to treat early and experience shorter attacks than those treated by a healthcare professional. CONCLUSION: Early blockade of the bradykinin B(2 receptor with icatibant, particularly within the first hour of attack onset, significantly reduced attack duration and time to attack resolution.

  17. Pre-attack signs and symptoms in cluster headache: Characteristics and time profile.

    Science.gov (United States)

    Snoer, Agneta; Lund, Nunu; Beske, Rasmus; Jensen, Rigmor; Barloese, Mads

    2018-05-01

    Introduction In contrast to the premonitory phase of migraine, little is known about the pre-attack (prodromal) phase of a cluster headache. We aimed to describe the nature, prevalence, and duration of pre-attack symptoms in cluster headache. Methods Eighty patients with episodic cluster headache or chronic cluster headache, according to ICHD-3 beta criteria, were invited to participate. In this observational study, patients underwent a semi-structured interview where they were asked about the presence of 31 symptoms/signs in relation to a typical cluster headache attack. Symptoms included previously reported cluster headache pre-attack symptoms, premonitory migraine symptoms and accompanying symptoms of migraine and cluster headache. Results Pre-attack symptoms were reported by 83.3% of patients, with an average of 4.25 (SD 3.9) per patient. Local and painful symptoms, occurring with a median of 10 minutes before attack, were reported by 70%. Local and painless symptoms and signs, occurring with a median of 10 minutes before attack, were reported by 43.8% and general symptoms, occurring with a median of 20 minutes before attack, were reported by 62.5% of patients. Apart from a dull/aching sensation in the attack area being significantly ( p cluster headache. Since the origin of cluster headache attacks is still unresolved, studies of pre-attack symptoms could contribute to the understanding of cluster headache pathophysiology. Furthermore, identification and recognition of pre-attack symptoms could potentially allow earlier abortive treatment.

  18. Variability of clinical features in attacks of migraine with aura

    DEFF Research Database (Denmark)

    Hansen, Jakob M; Goadsby, Peter J; Charles, Andrew C

    2016-01-01

    . CONCLUSION: These findings are consistent with variable involvement of different brain regions during a migraine attack. The variable occurrence of nausea, and phonophobia in conjunction with photophobia, both defining features of migraine, may be an important consideration in designing clinical studies......BACKGROUND: There is significant variability in the clinical presentation of migraine, both among patients, and between attacks in an individual patient. We examined clinical features of migraine with aura in a large group of patients enrolled in a clinical trial, and compared retrospective...... a detailed retrospective description of the clinical features of their attacks of migraine. During the trial, clinical symptoms in migraine attacks starting with aura were recorded prospectively in 861 attacks. RESULTS: Retrospectively reported visual aura symptoms were variable and often overlapping...

  19. "Dateline NBC"'s Persuasive Attack on Wal-Mart.

    Science.gov (United States)

    Benoit, William L.; Dorries, Bruce

    1996-01-01

    Develops a typology of persuasive attack strategies. Identifies two key components of persuasive attack: responsibility and offensiveness. Describes several strategies for intensifying each of these elements. Applies this analysis to "Dateline NBC"'s allegations that Wal-Mart's "Buy American" campaign was deceptive. Concludes…

  20. Transforming Graphical System Models To Graphical Attack Models

    NARCIS (Netherlands)

    Ivanova, Marieta Georgieva; Probst, Christian W.; Hansen, René Rydhof; Kammüller, Florian; Mauw, S.; Kordy, B.

    2015-01-01

    Manually identifying possible attacks on an organisation is a complex undertaking; many different factors must be considered, and the resulting attack scenarios can be complex and hard to maintain as the organisation changes. System models provide a systematic representation of organisations that