由于在数据库服务(Database as a Service,DaaS)模式下,数据库服务提供者是半可信的(Honest-But-Curious),因此,为了保证外包数据的机密性和安全可查询,数据拥有者通常采用特定的加密技术加密外包数据,如采用可搜索加密技术、同态加密...由于在数据库服务(Database as a Service,DaaS)模式下,数据库服务提供者是半可信的(Honest-But-Curious),因此,为了保证外包数据的机密性和安全可查询,数据拥有者通常采用特定的加密技术加密外包数据,如采用可搜索加密技术、同态加密技术等实现外包加密数据上的安全查询.然而,且当前提出的大多数方法都基于关键字精确匹配查询,即使存在少量针对加密数据上的模糊查询,也在查询效率、存储开销和安全性方面存在一定的局限性,不适用于DaaS数据库服务模式.文中首次提出了融合具有高编码效率的Huffman编码和具有数据存储优势的布鲁姆过滤器,并结合现有的安全加密方法,实现了DaaS模式下保护隐私的模糊关键字查询处理.一方面,基于Huffman编码的树型索引提供了较高的查找效率;另一方面,基于布鲁姆过滤器的模糊关键字集合实现了较小的存储开销.安全分析、性能分析以及真实论文集上的实验结果进一步验证了文中查询算法的安全性、存储开销和查询效率.展开更多
In the United States,the fight to eradicate hepatitis C virus (HCV) infection has been ongoing for many years,but the results have been less than ideal.Historically,patients with chronic hepatitis C (CHC) were treated...In the United States,the fight to eradicate hepatitis C virus (HCV) infection has been ongoing for many years,but the results have been less than ideal.Historically,patients with chronic hepatitis C (CHC) were treated with interferon-based regimens,which were associated with frequent adverse effects,suboptimal response rates,and long durations of treatment-of up to 48 weeks.Expertise from specialistphysicians,such as hepatologists and gastroenterologists,was needed to closely follow patients on these medications so as to monitor laboratory values and manage adverse effects.However,the emergence of direct-acting antiviral (DAA) agents against HCV infection have heralded outstanding progress in terms of safety,tolerability,lack of adverse effects,efficacy,and truncated duration of therapy-12 weeks or less-thereby making the need for close monitoring by specialist-physicians obsolete.With the recent approval of DAA agents by the Food and Drug Administration,the treatment model for CHC no longer relies on the limited number of specialist-physicians,which represented a major barrier to treatment access in the past,especially in underserved areas of the United States.We propose and share our experiences in adapting a task-shifting treatment model,one that utilizes a relatively larger pool of non-specialist healthcare providers,such as nursing staff (medical assistants,vocational licensed nurses,registered nurses,etc.) and advanced practice providers (nurse practitioners and physician assistants),to perform a variety of important clinical functions in an effort to make DAA-based antiviral therapy widely available against HCV infection.Most recently,task-shifting was implemented by the United States and World Health Organization in the fight against the human immunodeficiency virus and showed encouraging results.Based on our experiences in implementing this model at our outreach clinics,the majority of HCV-infected patients treated with DAA agents can be easily monitored by non-specialist healthcare providers and physici展开更多
Prevalence of hepatitis C virus (HCV) infection is high in patients with end-stage renal dysfunction,including patients undergoing hemodialysis (HD).The HCV infection itself can cause glomerulonephritis and puts indiv...Prevalence of hepatitis C virus (HCV) infection is high in patients with end-stage renal dysfunction,including patients undergoing hemodialysis (HD).The HCV infection itself can cause glomerulonephritis and puts individuals at increased risk of developing end-stage renal disease;fortunately,successful HCV eradication sometimes restore HCV-related renal dysfunction.Moreover,the prognosis of dialysis patients infected with HCV is significantly worse and the renal allograft survival in HCV-infected patients is also worse than in dialysis patients without HCV infection.If life prognosis is favorable,therefore,anti-HCV therapy is strongly recommended for HCV-infected patients with severe renal dysfunction.The standard therapy for HCV-infected patients with severe renal dysfunction has historically been interferon-based therapy.However,this therapy remains ineffective in achieving high,sustained viral response rates and the rate of adverse events and treatment discontinuation due to treatment-induced adverse events continues to be high in patients with severe renal dysfunction.Safe and effective anti-HCV therapies are urgently needed,and crucial,for patients with severe renal dysfunction.Recently,direct-acting antivirals (DAAs) that specifically target viral proteins have been developed,and these targets include the NS3,NS5A,and NS5B of HCV.Clinical trials have revealed high efficacy and safety of the DAA-based therapies,but patients with severe renal dysfunction were not included in the majority of these trials.However,several recent reports have shown high efficacy and safety for some regimens of DAA combination therapy for HCV-infected patients with severe renal dysfunction.In this review,we discuss novel treatments for HCV-infected patients with severe renal dysfunction and the pharmacokinetics of these drugs.展开更多
文摘由于在数据库服务(Database as a Service,DaaS)模式下,数据库服务提供者是半可信的(Honest-But-Curious),因此,为了保证外包数据的机密性和安全可查询,数据拥有者通常采用特定的加密技术加密外包数据,如采用可搜索加密技术、同态加密技术等实现外包加密数据上的安全查询.然而,且当前提出的大多数方法都基于关键字精确匹配查询,即使存在少量针对加密数据上的模糊查询,也在查询效率、存储开销和安全性方面存在一定的局限性,不适用于DaaS数据库服务模式.文中首次提出了融合具有高编码效率的Huffman编码和具有数据存储优势的布鲁姆过滤器,并结合现有的安全加密方法,实现了DaaS模式下保护隐私的模糊关键字查询处理.一方面,基于Huffman编码的树型索引提供了较高的查找效率;另一方面,基于布鲁姆过滤器的模糊关键字集合实现了较小的存储开销.安全分析、性能分析以及真实论文集上的实验结果进一步验证了文中查询算法的安全性、存储开销和查询效率.
文摘In the United States,the fight to eradicate hepatitis C virus (HCV) infection has been ongoing for many years,but the results have been less than ideal.Historically,patients with chronic hepatitis C (CHC) were treated with interferon-based regimens,which were associated with frequent adverse effects,suboptimal response rates,and long durations of treatment-of up to 48 weeks.Expertise from specialistphysicians,such as hepatologists and gastroenterologists,was needed to closely follow patients on these medications so as to monitor laboratory values and manage adverse effects.However,the emergence of direct-acting antiviral (DAA) agents against HCV infection have heralded outstanding progress in terms of safety,tolerability,lack of adverse effects,efficacy,and truncated duration of therapy-12 weeks or less-thereby making the need for close monitoring by specialist-physicians obsolete.With the recent approval of DAA agents by the Food and Drug Administration,the treatment model for CHC no longer relies on the limited number of specialist-physicians,which represented a major barrier to treatment access in the past,especially in underserved areas of the United States.We propose and share our experiences in adapting a task-shifting treatment model,one that utilizes a relatively larger pool of non-specialist healthcare providers,such as nursing staff (medical assistants,vocational licensed nurses,registered nurses,etc.) and advanced practice providers (nurse practitioners and physician assistants),to perform a variety of important clinical functions in an effort to make DAA-based antiviral therapy widely available against HCV infection.Most recently,task-shifting was implemented by the United States and World Health Organization in the fight against the human immunodeficiency virus and showed encouraging results.Based on our experiences in implementing this model at our outreach clinics,the majority of HCV-infected patients treated with DAA agents can be easily monitored by non-specialist healthcare providers and physici
文摘Prevalence of hepatitis C virus (HCV) infection is high in patients with end-stage renal dysfunction,including patients undergoing hemodialysis (HD).The HCV infection itself can cause glomerulonephritis and puts individuals at increased risk of developing end-stage renal disease;fortunately,successful HCV eradication sometimes restore HCV-related renal dysfunction.Moreover,the prognosis of dialysis patients infected with HCV is significantly worse and the renal allograft survival in HCV-infected patients is also worse than in dialysis patients without HCV infection.If life prognosis is favorable,therefore,anti-HCV therapy is strongly recommended for HCV-infected patients with severe renal dysfunction.The standard therapy for HCV-infected patients with severe renal dysfunction has historically been interferon-based therapy.However,this therapy remains ineffective in achieving high,sustained viral response rates and the rate of adverse events and treatment discontinuation due to treatment-induced adverse events continues to be high in patients with severe renal dysfunction.Safe and effective anti-HCV therapies are urgently needed,and crucial,for patients with severe renal dysfunction.Recently,direct-acting antivirals (DAAs) that specifically target viral proteins have been developed,and these targets include the NS3,NS5A,and NS5B of HCV.Clinical trials have revealed high efficacy and safety of the DAA-based therapies,but patients with severe renal dysfunction were not included in the majority of these trials.However,several recent reports have shown high efficacy and safety for some regimens of DAA combination therapy for HCV-infected patients with severe renal dysfunction.In this review,we discuss novel treatments for HCV-infected patients with severe renal dysfunction and the pharmacokinetics of these drugs.
