Background A comprehensive assessment of the association of patients’ renal replacement therapy (RRT) modality on their participation in life activities (physical function, travel, recreation, freedom, work) is needed. Study Design Systematic review of peer-reviewed published studies. Setting & Population Adults undergoing RRT (hemodialysis, peritoneal dialysis, or transplantation). Selection Criteria for Studies We searched PubMed, Cochrane Library, and EMBASE from January 1980 through April 2012 for English-language articles that compared participation in life activities among patients receiving 1) hemodialysis compared with peritoneal dialysis, 2) hemodialysis compared with kidney transplantation, or 3) peritoneal dialysis compared with kidney transplantation. Predictor RRT modality. Outcomes Reported rates of physical function, travel, recreation, freedom, and work-related activities by RRT modality. Results A total of 46 studies (6 prospective cohort, 38 cross-sectional, and 2 pre-post transplantation) provided relevant comparisons of life participation activities among patients treated with hemodialysis, peritoneal dialysis, and kidney transplantation. Studies were conducted from 1985 to 2011 among diverse patient populations in 16 distinct locations. A majority of studies reported greater life participation rates among patients with kidney transplants compared to patients receiving either hemodialysis or peritoneal dialysis. In contrast, a majority of studies reported no differences in outcomes between patients receiving hemodialysis and patients receiving peritoneal dialysis. These results were consistent throughout the study period, across diverse populations, and among the subset of studies that performed appropriate adjustments for potential confounding factors. Limitations Many studies included in the review had significant design weaknesses. Conclusions Evidence suggests patients with kidney transplants may experience better rates of life participation compared to patients receiving dialysis, while patients receiving hemodialysis and patients receiving peritoneal dialysis may experience similar rates of life participation. Rigorously performed studies are needed to better inform patients about the association of RRT on these important patient reported outcomes.

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With progress toward a practical quantum computer has come an increasingly rapid search for quantum-safe, secure communication schemes that do not rely on discrete logarithm or factorization problems. One such encryption scheme, Multi-path Switching with Secret Sharing (MSSS), combines secret sharing with multi-path switching to achieve security as long as the adversary does not have global observability of all paths and thus cannot capture enough shares to reconstruct messages. MSSS assumes that sending a share on a path is an atomic operation and all paths have the same delay. We identify a side-channel vulnerability for MSSS, created by the fact that in real networks, sending a share is not an atomic operation as paths have multiple hops and different delays. This channel, referred to as Network Data Remanence (NDR), is present in all schemes like MSSS whose security relies on transfer atomicity and all paths having the same delay. We demonstrate the presence of NDR in a physical testbed. We then identify two new attacks that aim to exploit the side-channel, referred to as NDR Blind and NDR Planned, propose an analytical model to analyze the attacks, and demonstrate them using an implementation of MSSS based on the ONOS SDN controller. Finally, we present a countermeasure for the attacks and show its effectiveness in simulations and Mininet experiments. DISTRIBUTION STATEMENT A. Approved for public release. Distribution is unlimited.

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