Conditional Anonymous Remote Healthcare Data Sharing Over Blockchain.

As an important carrier of healthcare data, Electronic Medical Records (EMRs) generated from various sensors, i.e., wearable, implantable, are extremely valuable research materials for artificial intelligence and machine learning. The efficient circulation of EMRs can improve remote medical services and promote the development of the related healthcare industry. However, in traditional centralized data sharing architectures, the balance between privacy and traceability still cannot be well handled. To address the issue that malicious users cannot be locked in the fully anonymous sharing schemes, we propose a trackable anonymous remote healthcare data storing and sharing scheme over decentralized consortium blockchain. Through an "on-chain & off-chain" model, it relieves the massive data storage pressure of medical blockchain. By introducing an improved proxy re-encryption mechanism, the proposed scheme realizes the fine-gained access control of the outsourced data, and can also prevent the collusion between semi-trusted cloud servers and data requestors who try to reveal EMRs without authorization. Compared with the existing schemes, our solution can provide a lower computational overhead in repeated EMRs sharing, resulting in a more efficient overall performance.

Clinicopathologic study of mantle cell lymphoma with epstein-barr virus infection: A case series and literature review.

Background: Mantle cell lymphoma (MCL) with Epstein-Barr virus (EBV) infection is rarely reported. The objective of this study was to analyze the prevalence and clinicopathological features of MCL with EBV infection in the largest series thus far. Methods: After screening 138 cases of MCL, we identified eight cases of MCL with EBV infection. Results: Most of them (7/8) had non-neoplastic bystander cells with positivity for EBV and no expression of latent membrane protein 1 (LMP1) and EBV nuclear antigen 2 (EBNA2). The cases of MCL with EBER positivity did not have abnormal immune function or other lymphomas. Moreover, their histopathological morphology was indicative of classical MCL. Cases of MCL with EBER positivity exhibited statistically significant differences in lactate dehydrogenase, anemia status, and MCL international prognostic index grouping (P=0.008, P=0.02, P=0.001, and P=0.011, respectively). The differences between the two groups in age, sex ratio, clinical manifestations, and immunohistochemical phenotypes were not statistically significant. Conclusions: The incidence of MCL with EBV infection was low (5.8%). Clinicopathologically, cases of MCL with EBER positivity were similar to their EBV-negative counterparts. Our findings revealed that most cells infected by EBV in MCL are background cells rather than tumor cells. This is inconsistent with data from previous studies, indicating that tumor cells in MCL may not be prone to EBV infection.

Thin liquid films down a vertical microfiber: Effect of curvature elasticity.

In this paper, we use a long-wave model to examine how the curvature elasticity modifies the famous Plateau-Rayleigh mechanism and the formation of viscous beads on a vertically placed fiber. By blending the analyses of linear stability, weakly nonlinear stability, exact nonlinear solutions, and numerical simulations, the effects of spontaneous curvature, surface bending rigidity, Gaussian curvature, and Van der Waals forces on the Plateau-Rayleigh mechanism and breakup of the liquid film are examined. The spontaneous curvature and surface bending rigidity are stabilizing the interface, which can reduce the amplitude and wave speed of nonlinear traveling waves and retard the breakup of film caused by Van der Waals attractions. However, the Gaussian curvature effect reinforces the Plateau-Rayleigh mechanism, which accelerates the rupture of film.

G6pd-Deficient Mice Are Protected From Experimental Cerebral Malaria and Liver Injury by Suppressing Proinflammatory Response in the Early Stage of Plasmodium berghei Infection.

Epidemiological studies provide compelling evidence that glucose-6-phosphate dehydrogenase (G6PD) deficiency individuals are relatively protected against Plasmodium parasite infection. However, the animal model studies on this subject are lacking. Plus, the underlying mechanism in vivo is poorly known. In this study, we used a G6pd-deficient mice infected with the rodent parasite Plasmodium berghei (P.berghei) to set up a malaria model in mice. We analyzed the pathological progression of experimental cerebral malaria (ECM) and acute liver injury in mice with different G6pd activity infected with P.berghei. We performed dual RNA-seq for host-parasite transcriptomics and validated the changes of proinflammatory response in the murine model. G6pd-deficient mice exhibited a survival advantage, less severe ECM and mild liver injury compared to the wild type mice. Analysis based on dual RNA-seq suggests that G6pd-deficient mice are protected from ECM and acute liver injury were related to proinflammatory responses. Th1 differentiation and dendritic cell maturation in the liver and spleen were inhibited in G6pd-deficient mice. The levels of proinflammatory cytokines were reduced, chemokines and vascular adhesion molecules in the brain were significantly down-regulated, these led to decreased cerebral microvascular obstruction in G6pd-deficient mice. We generated the result that G6pd-deficiency mediated protection against ECM and acute liver injury were driven by the regulatory proinflammatory responses. Furthermore, bioinformatics analyses showed that P.berghei might occur ribosome loss in G6pd-deficient mice. Our findings provide a novel perspective of the underlying mechanism of G6PD deficiency mediated protection against malaria in vivo.

The glucose-6-phosphate dehydrogenase Mahidol variant protects against uncomplicated Plasmodium vivax infection and reduces disease severity in a Kachin population from northeast Myanmar.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common red cell disorders in the world. The aim of this study was to investigate whether the G6PD Mahidol variant and haplotype 1311 T/93C, which are prevalent in the Kachin ethnic population along the China-Myanmar border area, offer protection against Plasmodium vivax infection. Malaria was monitored in nine villages near the Laiza township, Kachin State, Myanmar, where 258 cases of uncomplicated P. vivax were identified in 2013-2017. From the same villages, 250 unrelated, malaria-free participants were recruited to serve as the control cohort. Quantitative enzyme activity analysis in 100 healthy individuals identified that both male hemizygotes and female heterozygotes of the G6PD Mahidol variant had on average ~40% lower enzyme activity relative to the wild-type individuals. Compared with the overall prevalence of 25.2% in the control cohort, the G6PD Mahidol variant had a significantly lower prevalence (7.0%) among the 258 vivax patients (P <  .0001, χ2 test). Logistic regression analysis of G6PD genotypes stratified by sex showed that the individuals with the Mahidol 487A allele had dramatically reduced odds of having acute vivax malaria (adjusted odds ratio = 0.213 for male 487A hemizygotes, P < .0001, and 0.248 for female 487GA heterozygotes, P < .001). Furthermore, both 487A hemizygous male and 487GA heterozygous female patients had significantly lower asexual parasitemias than the wild-type patients, suggesting a potential effect on alleviating disease severity. In contrast, the silent mutation haplotype 1311 T/93C was highly prevalent (49.6%) in the study population, but it was not associated with altered G6PD enzymatic activities nor did it seem to provide protection against vivax infection or disease severity. Taken together, this study provided evidence that the Mahidol G > A mutation offers protection against P. vivax infection and potentially reduces disease severity in a Kachin population.

The correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma patients: a single center case series.

OBJECTIVE: To investigate the correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma (LADC) patients. METHODS: We reviewed 428 consecutive, surgically resected cases of LADC from October 2015 to December 2016 from our center. PD-L1 expression was evaluated based on tumor proportion score (TPS). Correlation and co-occurrence of PD-L1 expression level with those of classical driver genes, such as EGFR, ALK, ROS-1, and KRAS and with clinical variables and disease-free survival (DFS) were analyzed. RESULTS: Seventy of the 428 cases (16.4%) showed TPS ≥ 1%, and 21 cases (4.9%) showed TPS ≥ 50%. PD-L1 positive expression was significantly associated with male gender, smoking, advanced TNM stage, and solid histologic subtype. Both TPS ≥ 1% and ≥ 50% were correlated with the absence of an EGFR mutation (P < 0.001) and the presence of ALK rearrangement ( P = 0.024). KRAS mutation was associated with TPS ≥ 50% (P = 0.035). PD-L1 positivity commonly overlapped with the alterations of classical driver oncogenes (58.5% with TPS ≥ 1% and 42.9% with TPS ≥ 50%). Approximately three-quarters of PD-L1 positive cases co-occurred with classical therapeutic-gene aberrations in cases with stage III/IV cancer or cancer progression. LADC could be divided into four subgroups based on the expression profile of current routine biomarkers for potential therapeutic strategies. CONCLUSIONS: PD-L1 expression is not only closely correlated with classic gene alterations but also commonly overlaps with the aberrations of classical driver oncogenes in Chinese LADC patients. These findings provide a useful overview of clinical strategies that rely on the profile of routinely used molecular biomarkers.