304 research outputs found

    Role Based Secure Data Access Control for Cost Optimized Cloud Storage Using Data Fragmentation While Maintaining Data Confidentiality

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    The paper proposes a role-based secure data access control framework for cost-optimized cloud storage, addressing the challenge of maintaining data security, privacy, integrity, and availability at lower cost. The proposed framework incorporates a secure authenticity scheme to protect data during storage or transfer over the cloud. The framework leverages storage cost optimization by compressing high-resolution images and fragmenting them into multiple encrypted chunks using the owner's private key. The proposed approach offers two layers of security, ensuring that only authorized users can decrypt and reconstruct data into its original format. The implementation results depicts that the proposed scheme outperforms existing systems in various aspects, making it a reliable solution for cloud service providers to enhance data security while reducing storage costs

    The acute-to-chronic workload ratio:An inaccurate scaling index for an unnecessary normalisation process?

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    BACKGROUND: Problematic use of alcohol and other drugs (AOD) is highly prevalent among people living with the human immunodeficiency virus (PLWH), and untreated AOD use disorders have particularly detrimental effects on human immunodeficiency virus (HIV) outcomes. The Healthcare Effectiveness Data and Information Set (HEDIS) measures of treatment initiation and engagement are important benchmarks for access to AOD use disorder treatment. To inform improved patient care, we compared HEDIS measures of AOD use disorder treatment initiation and engagement and health care utilization among PLWH and patients without an HIV diagnosis. METHODS: Patients with a new AOD use disorder diagnosis documented between October 1, 2014, and August 15, 2015, were identified using electronic health records (EHR) and insurance claims data from 7 health care systems in the United States. Demographic characteristics, clinical diagnoses, and health care utilization data were also obtained. AOD use disorder treatment initiation and engagement rates were calculated using HEDIS measure criteria. Factors associated with treatment initiation and engagement were examined using multivariable logistic regression models. RESULTS: There were 469 PLWH (93% male) and 86,096 patients without an HIV diagnosis (60% male) in the study cohort. AOD use disorder treatment initiation was similar in PLWH and patients without an HIV diagnosis (10% vs. 11%, respectively). Among those who initiated treatment, few engaged in treatment in both groups (9% PLWH vs. 12% patients without an HIV diagnosis). In multivariable analysis, HIV status was not significantly associated with either AOD use disorder treatment initiation or engagement. CONCLUSIONS: AOD use disorder treatment initiation and engagement rates were low in both PLWH and patients without an HIV diagnosis. Future studies need to focus on developing strategies to efficiently integrate AOD use disorder treatment with medical care for HIV

    Hazardous drinking among young adults seeking outpatient mental health services

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    BACKGROUND: Alcohol use can have a significant negative impact on young adults in mental health treatment. This cross-sectional study examined prevalence and factors associated with hazardous drinking among young adults seeking outpatient mental health services, rate of alcohol use disorders (AUDs), and the relationship between hazardous drinking and other types of substance use. METHODS: Participants were 487 young adults ages 18–25 who completed self-administered computerized screening questions for alcohol and drug use. Alcohol use patterns were assessed and predictors of hazardous drinking (≄5 drinks on one or more occasions in the past year) were identified using logistic regression. RESULTS: Of the 487 participants, 79.8 % endorsed prior-year alcohol use, 52.3 % reported one or more episodes of hazardous drinking in the prior year and 8.2 % were diagnosed with an AUD. Rates of recent and lifetime alcohol, tobacco and marijuana use were significantly greater in those with prior-year hazardous drinking. In logistic regression, prior-year hazardous drinking was associated with lifetime marijuana use (OR 3.30, p < 0.001; 95 % CI 2.05, 5.28), lifetime tobacco use (OR 1.88, p = 0.004; 95 % CI 1.22, 2.90) and older age (OR 1.18 per year, p < 0.001; 95 % CI 1.08, 1.29). CONCLUSIONS: In an outpatient mental health setting, high rates of hazardous drinking were identified, and drinking was associated with history of other substance use. Results highlight patient characteristics associated with hazardous drinking that mental health providers should be aware of in treating young adults, especially older age and greater use of tobacco and marijuana

    All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America: findings from the ART-CC cohort collaboration

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    BACKGROUND: Understanding demographic disparities in hospitalisation is crucial for the identification of vulnerable populations, interventions, and resource planning. METHODS: Data were from the Antiretroviral Therapy Cohort Collaboration (ART-CC) on people living with HIV in Europe and North America, followed up between January, 2007 and December, 2020. We investigated differences in all-cause hospitalisation according to gender and mode of HIV acquisition, ethnicity, and combined geographical origin and ethnicity, in people living with HIV on modern combination antiretroviral therapy (cART). Analyses were performed separately for European and North American cohorts. Hospitalisation rates were assessed using negative binomial multilevel regression, adjusted for age, time since cART intitiaion, and calendar year. FINDINGS: Among 23 594 people living with HIV in Europe and 9612 in North America, hospitalisation rates per 100 person-years were 16·2 (95% CI 16·0-16·4) and 13·1 (12·8-13·5). Compared with gay, bisexual, and other men who have sex with men, rates were higher for heterosexual men and women, and much higher for men and women who acquired HIV through injection drug use (adjusted incidence rate ratios ranged from 1·2 to 2·5 in Europe and from 1·2 to 3·3 in North America). In both regions, individuals with geographical origin other than the region of study generally had lower hospitalisation rates compared with those with geographical origin of the study country. In North America, Indigenous people and Black or African American individuals had higher rates than White individuals (adjusted incidence rate ratios 1·9 and 1·2), whereas Asian and Hispanic people living with HIV had somewhat lower rates. In Europe there was a lower rate in Asian individuals compared with White individuals. INTERPRETATION: Substantial disparities exist in all-cause hospitalisation between demographic groups of people living with HIV in the current cART era in high-income settings, highlighting the need for targeted support. FUNDING: Royal Free Charity and the National Institute on Alcohol Abuse and Alcoholism

    The relationship of smoking and unhealthy alcohol use to the HIV care continuum among people with HIV in an integrated health care system

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    INTRODUCTION: Smoking tobacco and unhealthy alcohol use may negatively influence HIV care continuum outcomes but have not been examined in combination. METHODS: Participants were people with HIV (PWH) in Kaiser Permanente Northern California. Predictors included smoking status and unhealthy alcohol use (exceeding daily and/or weekly limits) reported by patients during primary care screening (index date). Outcomes were based on not achieving the following steps in the care continuum: linkage to HIV care (≄1 visit within 90 days of newly identified HIV diagnosis), retention (2+ in-person visits, 60+ days apart) and HIV RNA control (<75 copies/mL). Adjusted odds ratios (ORs) were obtained from separate logistic regression models for each outcome associated with smoking and unhealthy alcohol use independently and combined. RESULTS: The overall sample (N=8,958) had a mean age of 48.0 years; was 91.3% male; 54.0% white, 17.6% Latino, 15.1% black, and 9.6% other race/ethnicity. Smoking was associated with higher odds of not being linked to HIV care (OR=1.60 [95% CI 1.03–2.48]), not retained (OR=1.30 [95% CI 1.13–1.50]), and HIV RNA not in control (OR=1.91 [95% CI 1.60–2.27]). Alcohol measures were not independently associated with outcomes. The combination of unhealthy alcohol use and smoking (versus neither) was associated with higher odds of not being linked to care (OR=2.83 [95% CI 1.40–5.71]), although the interaction did not reach significance (p=0.18). CONCLUSIONS: In this large sample of PWH in an integrated health care system, smoking, both independently and in combination with unhealthy alcohol use, was associated with worse HIV care continuum outcomes

    Fundamentos e aplicaçÔes da metodologia de ensaios não destrutivos com células bacterianas

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    Os Ensaios NĂŁo Destrutivos (END) sĂŁo determinantes para a fiabilidade de materiais cuja integridade Ă© de extrema importĂąncia. A tĂ©cnica de Ensaios NĂŁo Destrutivos com cĂ©lulas bacterianas (CB) tem demonstrado viabilidade para deteção de defeitos superficiais, com espessuras e profundidades inferiores a 5 ÎŒm em vĂĄrios materiais de engenharia. O conhecimento adquirido sobre esta tĂ©cnica jĂĄ Ă© significativo mas alguns aspetos necessitam de mais desenvolvimentos, como a interação bactĂ©ria-defeito e a viabilidade da tĂ©cnica para condiçÔes de superfĂ­cie diferentes das jĂĄ ensaiadas. O objetivo deste trabalho Ă© alargar a tĂ©cnica a uma maior gama de materiais de engenharia com condiçÔes de superfĂ­cie diferentes, assim como, desenvolver o conhecimento sobre a interação bactĂ©ria-defeito. A bactĂ©ria Rhodococcus erythropolis foi usada na inspeção de vĂĄrios materiais como AlumĂ­nio Liga 1100, Estanho, Ouro, Prata, INCONEL 9095, Aço revestido com Nickel, Cobre revestido com Ouro, AlumĂ­nio revestido com Cobre, PolĂ­mero com nano tubos de carbono, entre outros, e com condiçÔes de superfĂ­cie diferentes como superfĂ­cies anodizadas e revestidas. Foram tambĂ©m caracterizados os campos magnĂ©ticos de dois equipamentos desenvolvidos para esta tĂ©cnica de Ensaios NĂŁo Destrutivos. Os resultados experimentais mostraram que a utilização de campos magnĂ©ticos contribui positivamente para a deteção de defeitos e que provetes com revestimentos superficiais diferentes revelam resultados diferentes apesar de terem o mesmo material base
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