Open Access

Today’s medical IT is more and more connected and network or IT system outages may impact the quality of patient treatment. IT outages from cyberattacks are particularly worrisome if attackers focus on those medical IT devices that are critical for medical processes. However, medical processes are primarily documented for the hospital employees and not for analyzing the criticality of any given human or medical IT resource. This paper presents a generic model for realistic, patient-focused simulation of medical processes. The model allows the simulation of cyber incidents, focusing on device outages or overload situations like mass casualty incidents. Furthermore, we present a proof-of-concept tool that implements the described model, enabling end-users to simulate their processes. The tool offers the ability to run with low detailed data for overview purposes and highly detailed data for fine-grained simulation results. We perform different scenario simulations for a sample hospital, including the acute phase of a ransomware attack, negative performance impacts due to the implementation of cybersecurity measures, and emergency plans for mass casualty incidents. In each scenario, the respective simulation resulted in a quantitative statement of how these scenarios affect overall process performance and show possible key factors supporting decision-making. We use real-world data from a German trauma room to optimize and evaluate the process simulation.

Die sichere E-Mail-Infrastruktur für Ärzt*innen, Apotheker*innen, Krankenversicherungen und Kliniken in Deutschland, KIM - Kommunikation im Gesundheitswesen - ist mit über 200 Millionen E-Mails in den vergangenen zwei Jahren eine der am meisten genutzten Anwendungen in der Telematikinfrastruktur. Mit dem Ausgeben von S/MIME-Zertifikaten für alle medizinische Beteiligten in Deutschland verspricht KIM sichere Ende-zu-Ende-Verschlüsselung von E-Mails zwischen Heilberufler*innen in ganz Deutschland. In diesem Paper analysieren wir die KIM-Spezifikation sowie eine beispielhafte KIM-Installation in einer deutschen Zahnarztpraxis. Wir zeigen, dass KIM kryptografisch ein sehr hohes Sicherheitslevel erfüllt, doch in der Verarbeitung der E-Mails bei den Clients eine schwerwiegende Sicherheitslücke besteht. Weiterhin zeigen wir zwei Sicherheitslücken in dem KIM-Verarbeitungsmodul eines großen deutschen Unternehmens für medizinische Software. Diese Defizite zeigen außerdem Mängel in dem verpflichtenden Zulassungsprozess der KIM-Komponenten auf.

We investigate the magnetic field-dependent fluorescence lifetime of microdiamond powder containing a high density of nitrogen-vacancy centers. This constitutes a non-intensity quantity for robust, all-optical magnetic field sensing. We propose a fiber-based setup in which the excitation intensity is modulated in a frequency range up to 100MHz. The change in magnitude and phase of the fluorescence relative to 𝐵=0 is recorded where the phase shows a maximum in magnetic contrast of 5.8∘ at 13MHz. A lock-in amplifier-based setup utilizing the change in phase at this frequency shows a 100 times higher immunity to fluctuations in the optical path compared to the intensity-based approach. A noise floor of 20μT/Hz−−−√ and a shot-noise-limited sensitivity of 0.95μT/Hz−−−√ were determined. Keywords: nitrogen-vacancy center; quantum sensor; fluorescence lifetime; all-optical; magnetometr

The Lightweight Directory Access Protocol (LDAP) is the standard technology to query information stored in directories. These directories can contain sensitive personal data such as usernames, email addresses, and passwords. LDAP is also used as a central, organization-wide storage of configuration data for other services. Hence, it is important to the security posture of many organizations, not least because it is also at the core of Microsoft’s Active Directory, and other identity management and authentication services. We report on a large-scale security analysis of deployed LDAP servers on the Internet. We developed LanDscAPe, a scanning tool that analyzes security-relevant misconfigurations of LDAP servers and the security of their TLS configurations. Our Internet-wide analysis revealed more than 10k servers that appear susceptible to a range of threats, including insecure configurations, deprecated software with known vulnerabilities, and insecure TLS setups. 4.9k LDAP servers host personal data, and 1.8k even leak passwords. We document, classify, and discuss these and briefly describe our notification campaign to address these concerning issues.

A communication over an Internet Protocol (IP) based network fails if an endpoint sends packets that are too big to reach their destination and if the sender is unable to detect that. The node on the path that drops these packets should respond with a Packet Too Big (PTB) message. However, multiple scenarios exist in which the sender will not receive a PTB message. Even if it does, it refrains from using the information in case it suspects that a potential attacker forged the message. In particular, we are not aware of any implementation of the secure transport protocol QUIC (e.g., used by HTTP/3) that processes PTB messages. In this paper, we present a novel parameterizable PTB detection algorithm for reliable transport protocols that does not depend on PTB messages. We further describe how to integrate our algorithm into QUIC, present results from an evaluation using the algorithm within a QUIC simulation model and, based on these results, suggest concrete parameter values.