Confidentiality Guarantees Research Articles

On the Anonymization of Workflow Provenance without Compromising the Transparency of Lineage

Workflows have been adopted in several scientific fields as a tool for the specification and execution of scientific experiments. In addition to automating the execution of experiments, workflow systems often include capabilities to record provenance information, which contains, among other things, data records used and generated by the workflow as a whole but also by its component modules. It is widely recognized that provenance information can be useful for the interpretation, verification, and re-use of workflow results, justifying its sharing and publication among scientists. However, workflow execution in some branches of science can manipulate sensitive datasets that contain information about individuals. To address this problem, we investigate, in this article, the problem of anonymizing the provenance of workflows. In doing so, we consider a popular class of workflows in which component modules use and generate collections of data records as a result of their invocation, as opposed to a single data record. The solution we propose offers guarantees of confidentiality without compromising lineage information, which provides transparency as to the relationships between the data records used and generated by the workflow modules. We provide algorithmic solutions that show how the provenance of a single module and an entire workflow can be anonymized and present the results of experiments that we conducted for their evaluation.

Monitoring for COVID-19 by universal testing in a homeless shelter in Germany: a prospective feasibility cohort study

BackgroundLiving conditions in homeless shelters facilitate the transmission of COVID-19. Social determinants and pre-existing health conditions place homeless people at increased risk of severe disease. Described outbreaks in homeless shelters resulted in high proportions of infected residents and staff members. In addition to other infection prevention strategies, regular shelter-wide (universal) testing for COVID-19 may be valuable, depending on the level of community transmission and when resources permit.MethodsThis was a prospective feasibility cohort study to evaluate universal testing for COVID-19 at a homeless shelter with 106 beds in Berlin, Germany. Co-researchers were recruited from the shelter staff. A PCR analysis of saliva or self-collected nasal/oral swab was performed weekly over a period of 3 weeks in July 2020. Acceptability and implementation barriers were analyzed by process evaluation using mixed methods including evaluation sheets, focus group discussion and a structured questionnaire.ResultsNinety-three out of 124 (75%) residents were approached to participate in the study. Fifty-one out of the 93 residents (54.8%) gave written informed consent; thus 41.1% (51 out of 124) of all residents were included in the study. Among these, high retention rates (88.9–93.6%) of a weekly respiratory specimen were reached, but repeated collection attempts, as well as assistance were required. Around 48 person-hours were necessary for the sample collection including the preparation of materials. A self-collected nasal/oral swab was considered easier and more hygienic to collect than a saliva specimen. No resident was tested positive by RT-PCR. Language barriers were the main reason for non-participation. Flexibility of sample collection schedules, the use of video and audio materials, and concise written information were the main recommendations of the co-researchers for future implementation.ConclusionsVoluntary universal testing for COVID-19 is feasible in homeless shelters. Universal testing of high-risk facilities will require flexible approaches, considering the level of the community transmission, the available resources, and the local recommendations. Lack of human resources and laboratory capacity may be a major barrier for implementation of universal testing, requiring adapted approaches compared to standard individual testing. Assisted self-collection of specimens and barrier free communication may facilitate implementation in homeless shelters. Program planning must consider homeless people’s needs and life situation, and guarantee confidentiality and autonomy.

Digital Technologies for Schizophrenia Management: A Descriptive Review

While the implementation of digital technology in psychiatry appears promising, there is an urgent need to address the implications of the absence of ethical design in the early development of such technologies. Some authors have noted the gap between technology development and ethical analysis and have called for an upstream examination of the ethical issues raised by digital technologies. In this paper, we address this suggestion, particularly in relation to digital healthcare technologies for patients with schizophrenia spectrum disorders. The introduction of digital technologies in psychiatry offers a broad spectrum of diagnostic and treatment options tailored to the health needs and goals of patients’ care. These technologies include wearable devices, smartphone applications for high-immersive virtual realities, smart homes, telepsychiatry and messaging systems for patients in rural areas. The availability of these technologies could increase access to mental health services and improve the diagnostics of mental disorders.Additional Instruction In this descriptive review, we systematize ethical concerns about digital technologies for mental health with a particular focus on individuals suffering from schizophrenia. There are many unsolved dilemmas and conflicts of interest in the implementation of these technologies, such as (1) the lack of evidence on efficacy and impact on self-perception; (2) the lack of clear standards for the safety of their daily implementation; (3) unclear roles of technology and a shift in the responsibilities of all parties; (4) no guarantee of data confidentiality; and (5) the lack of a user-centered design that meets the particular needs of patients with schizophrenia. mHealth can improve care in psychiatry and make mental healthcare services more efficient and personalized while destigmatizing mental health disorders. To ensure that these technologies will benefit people with mental health disorders, we need to heighten sensitivity to ethical issues among mental healthcare specialists, health policy makers, software developers, patients themselves and their proxies. Additionally, we need to develop frameworks for furthering sustainable development in the digital technologies industry and for the responsible usage of such technologies for patients with schizophrenia in the clinical setting. We suggest that digital technology in psychiatry, particularly for schizophrenia and other serious mental health disorders, should be integrated into treatment with professional supervision rather than as a self-treatment tool.

Enabling Secure and Space-Efficient Metadata Management in Encrypted Deduplication

Encrypted deduplication combines encryption and deduplication in a seamless way to provide confidentiality guarantees for the physical data in deduplicated storage, yet it incurs substantial metadata storage overhead due to the additional storage of keys. We present a new encrypted deduplication storage system called <inline-formula><tex-math notation="LaTeX">${\sf Metadedup}$</tex-math></inline-formula> , which suppresses metadata storage by also applying deduplication to metadata. Its idea builds on indirection, which adds another level of metadata chunks that record metadata information. We find that metadata chunks are highly redundant in real-world workloads and hence can be effectively deduplicated. We further extend <inline-formula><tex-math notation="LaTeX">${\sf Metadedup}$</tex-math></inline-formula> to incorporate multiple servers via a distributed key management approach, so as to provide both fault-tolerant storage and security guarantees. We extensively evaluate <inline-formula><tex-math notation="LaTeX">${\sf Metadedup}$</tex-math></inline-formula> from performance and storage efficiency perspectives. We show that <inline-formula><tex-math notation="LaTeX">${\sf Metadedup}$</tex-math></inline-formula> achieves high throughput in writing and restoring files, and saves the metadata storage by up to 93.94 percent for real-world backup workloads.

Implementation of a telemental health service for medical students during the COVID-19 pandemic

Abstract: Introduction: The COVID-19 pandemic can be considered a severely stressful event and trigger negative repercussions on the mental health of medical students, such as psychological distress and the development or worsening of mental disorders, harming the academic, social and professional life of these students. As a result of the interruption of classes and the social distancing measures advocated by health agencies during the pandemic, the mental health care sector for medical students at the Federal University of Rio de Janeiro (UFRJ) needed to cancel the face-to-face care at the Clementino Fraga Filho University Hospital in early March 2020 and think of other forms of mental health care for these students. Experience report: This is an experience report about the implementation of telemental health care for medical students at UFRJ during the pandemic, for the continuity of mental health care program using remote assistance, started in late March 2020. The service is being offered by a team of five psychiatrists, a psychologist and a social worker, all university employees. Discussion: The teleservice has served as an important space for listening and embracement in face of these students’ psychosocial demands, whose challenge consists in overcoming some barriers that hinder the availability of and access to mental health services on the university campus, including the preservation of the doctor-patient relationship, the guarantee of confidentiality and quality, and the offer of a space for mental health care when the physical presence is not possible. Conclusion: Despite the difficulties inherent in the rapid process of implementing this service, the potential of technology to help the population at this critical moment is perceived, especially regarding the attention to the mental health of specific groups, such as medical students. The telehealth represents a potential for learning and change in the ways how the access to care is offered, with the perspective of bringing benefits to the students’ mental health, even after the current period of the pandemic, with the goal of expanding these services to other courses of the UFRJ.

Implementation of a telemental health service for medical students during the COVID-19 pandemic

Abstract: Introduction: The COVID-19 pandemic can be considered a severely stressful event and trigger negative repercussions on the mental health of medical students, such as psychological distress and the development or worsening of mental disorders, harming the academic, social and professional life of these students. As a result of the interruption of classes and the social distancing measures advocated by health agencies during the pandemic, the mental health care sector for medical students at the Federal University of Rio de Janeiro (UFRJ) needed to cancel the face-to-face care at the Clementino Fraga Filho University Hospital in early March 2020 and think of other forms of mental health care for these students. Experience report: This is an experience report about the implementation of telemental health care for medical students at UFRJ during the pandemic, for the continuity of mental health care program using remote assistance, started in late March 2020. The service is being offered by a team of five psychiatrists, a psychologist and a social worker, all university employees. Discussion: The teleservice has served as an important space for listening and embracement in face of these students’ psychosocial demands, whose challenge consists in overcoming some barriers that hinder the availability of and access to mental health services on the university campus, including the preservation of the doctor-patient relationship, the guarantee of confidentiality and quality, and the offer of a space for mental health care when the physical presence is not possible. Conclusion: Despite the difficulties inherent in the rapid process of implementing this service, the potential of technology to help the population at this critical moment is perceived, especially regarding the attention to the mental health of specific groups, such as medical students. The telehealth represents a potential for learning and change in the ways how the access to care is offered, with the perspective of bringing benefits to the students’ mental health, even after the current period of the pandemic, with the goal of expanding these services to other courses of the UFRJ.

Blockchain-Based Fair and Secure Certified Electronic Mail Without a TTP

Certified mail is a special postal service that provides the sender with a proof that the mail was successfully received by the other party. However, when it comes to certified <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">electronic</i> mail (CEM), there has not been a widely accepted protocol yet. Most of the existing solutions rely on a Trusted Third Party (TTP) in order to achieve fairness, which can become a bottleneck and lead to more charges and computations. Other solutions that do not rely on a TTP have a relatively high computation and communication overhead. Blockchains have allowed the creation of TTP-free protocols for fair exchange; however, the existing Blockchain-based protocols are either too expensive or do not meet the necessary fairness and confidentiality guarantees. In this work, we have developed two TTP-free Blockchain-based protocols for certified electronic mail that achieve the required security properties of strong fairness, non-repudiation, timeliness, and confidentiality. The first protocol uses simple bitcoin transactions for a single receiver, whereas the second one implements smart contracts for one or multiple receivers. We have analyzed and compared both protocols to existing TTP-free Blockchain solutions and have demonstrated their superior properties and cost. Furthermore, we have implemented the two protocols in a realistic testbed, demonstrating the viability of our approach.

Efficient Revocable Multi-Authority Attribute-Based Encryption for Cloud Storage

As is known, attribute-based encryption (ABE) is usually adopted for cloud storage, both for its achievement of fine-grained access control over data, and for its guarantee of data confidentiality. Nevertheless, single-authority attribute-based encryption (SA-ABE) has its obvious drawback in that only one attribute authority can assign the users' attributes, enabling the data to be shared only within the management domain of the attribute authority, while rendering multiple attribute authorities unable to share the data. On the other hand, multi-authority attribute-based encryption (MA-ABE) has its advantages over SA-ABE. It can not only satisfy the need for the fine-grained access control and confidentiality of data, but also make the data shared among different multiple attribute authorities. However, existing MA-ABE schemes are unsuitable for the devices with resources-constraint, because these schemes are all based on expensive bilinear pairing. Moreover, the major challenge of MA-ABE scheme is attribute revocation. So far, many solutions in this respect are not efficient enough. In this paper, on the basis of the elliptic curves cryptography, we propose an efficient revocable multi-authority attribute-based encryption (RMA-ABE) scheme for cloud storage. The security analysis indicates that the proposed scheme satisfies indistinguishable under adaptive chosen plaintext attack assuming hardness of the decisional Diffie-Hellman problem. Compared with the other schemes, the proposed scheme gets its advantages in that it is more economical in computation and storage.

Data Security: A New Symmetric Cryptosystem based on Graph Theory

Sharing private data in an unsecured channel is extremely critical, as unauthorized entities can intercept it and could break its privacy. The design of a cryptosystem that fulfills the security requirements in terms of confidentiality, integrity and authenticity of transmitted data has therefore become an unavoidable imperative. Indeed, a lot of work has been carried out in this regard. Although many cryptosystems have been proposed in the published literature, it has been found that their robustness and performance vary relatively from one to another. Adopting this reflection, we address in this paper the concept of block cipher, which is a major cryptographic solution to guarantee confidentiality, by involving the properties of graph theory to represent the plaintext message. Our proposal is in fact a new symmetric encryption block cipher that proceeds by representing plaintext messages using disjoint Hamiltonian circuits and then dealing with them as an adjacency matrix in a pre-encryption phase. The proposed system relies on a particular sub-key generator that has been carefully designed to produce the encryption keys according to the specifications of the system. The obtained experimental results demonstrate that our proposed cryptosystem is robust against statistical attacks, particularly the DIEHARD test, and presents both good confusion and good diffusion.

Secure Transmission of Compressed Sampling Data Using Edge Clouds

Cloud capability is considered to be extended to the edge of the Internet for improving the security of data transmission. Compressive sensing (CS) has been widely studied as a built-in privacy-preserving layer to provide some cryptographic features while sampling and compressing, including data confidentiality guarantees and data integrity guarantees. Unfortunately, most existing CS-based ciphers are too lightweight or highly complex to meet the requirements of both high security of transmitting the captured data over the Internet and low energy consumption of sensing devices in the Internet of Things (IoT). In this article, a secure transmission framework for CS data by combining CS-based cipher and edge computing is proposed. From the perspective of security, the double-layer encryption mechanism and double-layer authentication mechanism are rooted in it by performing some privacy-preserving operations, including CS-based encryption, CS-based hash, information splitting, strong encryption, and feature extraction. Most significantly, the proposed framework is very useful for resource-limited IoT applications.

Barriers and facilitators for transitioning of young people from adolescent clinics to adult ART clinics in Uganda: unintended consequences of successful adolescent ART clinics

BackgroundThere is a growing number of adolescents and young adults living with HIV (YPLHIV) who require the transfer of care from pediatric/ adolescent clinics to adult Antiretroviral therapy (ART) clinics. A successful transition is critical for optimum health outcomes, yet facilities may lack infrastructure, human resources (with appropriate knowledge and skills), and a supportive environment, as only 3% of clinics in Uganda caring for YPLHIV have a process for supporting this critical transition from pediatric to adult care, and, facilitators and barriers of a successful transition are not well documented. The purpose of this study was to explore the facilitators and barriers of transitioning among adolescents from adolescent clinics to adult ART clinics.MethodEighteen focus group discussions were held in nine health facilities with 174 adolescents and YPLHIV to assess barriers and facilitators regarding transitioning to adult clinics. The focus group discussions were audio-recorded and transcribed. The Silences Framework using a thematic approach guided the analysis.ResultsThe key emerging issues were: Unfriendly adults in adult clinics, Care provided in the adolescent clinics, fear of stigma from health care providers, Congestion and long waiting time, fear to lose friends were barriers to transitioning. Transitioning preparation is key to a successful transition, moving as a cohort facilitates transition, and care in adult clinics offers new opportunities, could facilitate readiness and transition.ConclusionYPLHIV expressed fear to transition to adult clinics mainly because of the perceived better care provided in the adolescent clinic, thus constituting a barrier to smooth transition A range of individual, social and health system and services-related factors hindered transitioning. The expectation of transitioning as a group, assurance of similar care as in the adolescent clinic, and guarantees of confidentiality, privacy, and autonomy in decision-making for care was perceived as facilitators. Understanding barriers and facilitators can enable the Ministry of Health to improve the quality of life of YPLHIV through linkage to care, adherence, retention, and viral suppression. There is a need to better planning and preparation for clinical providers and YPLHIV with a focus on age-appropriate and individualized case management transition as well as focus on improving both clinical and psychosocial support throughout the process.

Which Subject Lines and Messages Improve Response to E-mail Invitations to Web Surveys?

What subject lines and messages in an e-mailed invitation maximize cooperation for a web survey? Answering this question is ever more important as survey researchers increasingly turn to web surveys to reduce costs. We test respondents’ preferences for subject lines and messages in an e-mailed invitation to participate in a Consumer Assessment of Healthcare Providers and Systems survey. Findings suggest that respondents prefer informative and straightforward subject lines that reference the purpose and the sponsor of the survey. Brief and uninformative subject lines should be avoided. In the body of the e-mail, respondents prefer messages that expand on the study’s purpose and usefulness and extend a guarantee of confidentiality. Messages that encourage participation for the sake of the study’s representativeness or accuracy are unpersuasive to potential respondents. Few differences emerged in preferences among demographic subgroups.

Evaluación de la infección por VIH en Chile: pronunciamiento del Comité VIH de la Academia Chilena de Medicina

The Chilean Academy of Medicine convened a commission to evaluate the status of HIV epidemic and the national response to it, regarding its achievements, gaps and challenges, aiming to recommend actions to optimize assessment quality and national response. This publication summarizes the agreed upon opinion of its members. The epidemic is overwhelmingly sexually transmitted, predominant in homo/bisexual men. Vertical transmission is very low. An increasing number of new diagnoses is occurring, with relative over representation of foreign people lately. There is a legal guarantee of confidentiality, nondiscrimination and treatment for those affected, both in the private and public sector. All public health services have active HIV care units. Modern antiviral drugs and monitoring tests are also available. Despite these clear achievements, insufficient, occasionally inadequate public policies and certain rigid regulations thwart optimal effectivity and efficiency of the programs, contributing to the slow and incomplete compliance with international commitments. Shortcomings worth highlighting are: suboptimal educational and preventive programs directed to youngsters, vulnerable and general population; persistent underdiagnosis of infected population; cumbersome requirements to request and inform diagnostic tests, thus discouraging testing; excessive centralization and long latency of diagnosis confirmation and monitoring tests; incomplete epidemiologic analysis and public reporting of findings; non flexibility and slow updating of therapeutic guidelines; insufficient adaptation of care and drug delivery modalities to patients' needs; excessive administrative requirements at care centers and restrictive legislation for outcome and interventional clinical research. Recommendations to deal with these issues were proposed.

Ethical aspects of taking and using photographs in pediatric medical practice

From the beginning of medicine, the reproduction of patients' images, initially as drawings, either for didactic purposes or to share experiences, were common in medical practice. Photography greatly facilitated and generalized this practice within health teams. The images of the affected patients need the same consents and guarantees of confidentiality as any other parts of the medical record, so the importance of obtaining informed consent is highlighted. Beyond ethical aspects, professionals have to take into account the legal responsibility involved in carrying out this act.

Managing confidentiality leaks through private algorithms on Software Guard eXtensions (SGX) enclaves

Many applications are built upon private algorithms, and executing them in untrusted, remote environments poses confidentiality issues. To some extent, these problems can be addressed by ensuring the use of secure hardware in the execution environment; however, an insecure software-stack can only provide limited algorithm secrecy.This paper aims to address this problem, by exploring the components of the Trusted Computing Base (TCB) in hardware-supported enclaves. First, we provide a taxonomy and give an extensive understanding of trade-offs during secure enclave development. Next, we present a case study on existing secret-code execution frameworks; which have bad TCB design due to processing secrets with commodity software in enclaves. This increased attack surface introduces additional footprints on memory that breaks the confidentiality guarantees; as a result, the private algorithms are leaked. Finally, we propose an alternative approach for remote secret-code execution of private algorithms. Our solution removes the potentially untrusted commodity software from the TCB and provides a minimal loader for secret-code execution. Based on our new enclave development paradigm, we demonstrate three industrial templates for cloud applications: ① computational power as a service, ② algorithm querying as a service, and ③ data querying as a service.

Being in a space of sharing decision-making for dignified mental care.

WHAT IS KNOWN ON THE SUBJECT?: Several studies describe barriers and facilitators for implementing shared decision-making in mental care, yet a deeper understanding of the meaning of shared decision-making in this context is lacking. Shared decision-making is aimed at facilitating patients' active participation in their care. Mental care is intended to empower the patients by increasing their responsibility and self-awareness and helping them to use their own resources. Too much focus on the patients' independence, responsibility and choice may hinder the patients getting the help they need. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The meaning of SDM can be understood as a continuous relational process between the patients and MHCPs in search of dignified care. Practising shared decision-making is a challenging process which requires the MHCPs to possess high professional competence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental healthcare professionals should be conscious of their own role in the asymmetrical power relationship in decision-making and use their professional competence for their patients' benefit. Clinical supervision can be a tool for developing professional competence and is considered important when assisting mental healthcare professionals practising shared decision-making for dignified care. Abstract Introduction Several studies describe barriers and facilitators for implementing shared decision-making in mental care. However, a deeper understanding of the meaning of shared decision-making in this context is lacking. Shared decision-making is aimed at facilitating patients' active participation in their care by placing them at the centre of care. Too much focus on the patients' autonomy may hinder them getting the help they need. A comprehensive understanding of shared decision-making is needed for its implementation. Aim/research question To interpret the meaning of shared decision-making in mental care as perceived by patients and mental healthcare professionals. The research question was: What is the meaning of shared decision-making in mental care? Method A hermeneutic inductive design with a thematic interpretative analysis of data was performed from in-depth interviews with 16 patients and multistage focus group interviews with eight mental healthcare professionals. Results The overall theme being in a space of sharing decision-making for dignified mental care was described by the three themes engaging in a mental room of values and knowledge, relating in a process of awareness and comprehension and responding anchored in acknowledgement. Discussion Balancing the patients' need for assistance with autonomy, while safeguarding their dignity, is a challenging process requiring mental healthcare professionals to possess professional competence. Implications for practice Organized professional development of the carers' professional competence is important to facilitate shared decision-making.

Can Attorneys Guarantee Confidentiality in the Era of Smartphones and Voice-Activated Devices?

Among a lawyer’s many obligations to clients is the duty of confidentiality found in Colorado Rules of Professional Conduct (Colo. RPC) 1.6. Recent news reports make it clear that voice activated devices are always listening and smartphones are always tracking. Confidentiality issues are always present for attorneys who choose to keep a voice activated device in their office potentially listening to conversations with clients. While the tracking apps in smartphones are more a risk to personal privacy, there are attorney-client confidentiality issues as well.

Enforcing globally dependent flow policies in message-passing systems

Abstract The flow of information in a computing system is a crucial indicator for the security of the system. In a system of multiple message-passing processes, the flow of information could depend on the states of different processes. We devise a type-based verification technique for flow policies with such multi-process (global) dependencies, to provide confidentiality guarantees. In this technique, the confidentiality requirements for the presence and content of messages are dealt with separately. We develop a pair of synergetic static analyses to over-approximate the potential sets of values of the variables depended upon by the flow policies – covering global value correspondence between the variables of different processes. We significantly improve the permissiveness of security typing by exploiting information about which variables are live, and by specializing the flow policies using the conditional expressions of branching and looping constructs. We prove the soundness of our verification technique, provide a proof-of-concept implementation of it, and illustrate its effectiveness at an example system where the flow of information depends on how the headers of the messages from different processes correlate.

Fog-based Secure Communications for Low-power IoT Devices

Designing secure, scalable, and resilient IoT networks is a challenging task because of resource-constrained devices and no guarantees of reliable network connectivity. Fog computing improves the resiliency of IoT, but its security model assumes that fog nodes are fully trusted. We relax this latter constraint by proposing a solution that guarantees confidentiality of messages exchanged through semi-honest fog nodes thanks to a lightweight proxy re-encryption scheme. We demonstrate the feasibility of the solution by applying it to IoT networks of low-power devices through experiments on microcontrollers and ARM-based architectures.

Per-session security: Password-based cryptography revisited

Cryptographic security is usually defined as a guarantee that holds except when a bad event with negligible probability occurs, and nothing is guaranteed in that bad case. However, in settings where such failure can happen with substantial probability, one needs to provide guarantees even for the bad case. A typical example is where a (possibly weak) password is used instead of a secure cryptographic key to protect a session, the bad event being that the adversary correctly guesses the password. In a situation with multiple such sessions, a per-session guarantee is desired: any session for which the password has not been guessed remains secure, independently of whether other sessions have been compromised. A new formalism for stating such gracefully degrading security guarantees is introduced and applied to analyze the examples of password-based message authentication and password-based encryption. While a natural per-message guarantee is achieved for authentication, the situation of password-based encryption is more delicate: a per-session confidentiality guarantee only holds against attackers for which the distribution of password-guessing effort over the sessions is known in advance. In contrast, for more general attackers without such a restriction, a strong, composable notion of security cannot be achieved.