689 research outputs found
Minimal residual disease detection with tumor-specific CD160 correlates with event-free survival in chronic lymphocytic leukemia
In chronic lymphocytic leukemia (CLL), the detection of minimal residual disease (MRD) correlates with outcome in the trial setting. However, MRD assessment does not guide routine clinical management and its assessment remains complex. We incorporated detection of the B cell, tumor-specific antigen CD160 to develop a single-tube, flow cytometry assay (CD160FCA) for CLL MRD to a threshold of 10(−4) to 10(−5). One hundred and eighty-seven patients treated for CLL were enrolled. Utilizing the CD160FCA methodology, there was a high level of comparison between blood and bone marrow (R=0.87, P<0.001). In a validation cohort, CD160FCA and the international standardised approach of the European Research Initiative on CLL group demonstrated high concordance (R=0.91, P<0.01). Patients in complete remission (CR) and CD160FCA negative had longer event-free survival (EFS) (63 vs 16 months, P<0.01) and prolonged time to next treatment (60 vs 15 months, P<0.001) vs MRD positive patients; with a median time to MRD positivity of 36 months. In multivariate analysis, CD160FCA MRD detection was independently predictive of EFS in patients in CR and even predicted EFS in the good-risk cytogenetic subgroup. CD160FCA offers a simple assay for MRD detection in CLL and gives prognostic information across different CLL risk groups
Non-malleable encryption: simpler, shorter, stronger
In a seminal paper, Dolev et al. [15] introduced the notion of non-malleable encryption (NM-CPA). This notion is very intriguing since it suffices for many applications of chosen-ciphertext secure encryption (IND-CCA), and, yet, can be generically built from semantically secure (IND-CPA) encryption, as was shown in the seminal works by Pass et al. [29] and by Choi et al. [9], the latter of which provided a black-box construction. In this paper we investigate three questions related to NM-CPA security: 1. Can the rate of the construction by Choi et al. of NM-CPA from IND-CPA be improved? 2. Is it possible to achieve multi-bit NM-CPA security more efficiently from a single-bit NM-CPA scheme than from IND-CPA? 3. Is there a notion stronger than NM-CPA that has natural applications and can be achieved from IND-CPA security? We answer all three questions in the positive. First, we improve the rate in the scheme of Choi et al. by a factor O(λ), where λ is the security parameter. Still, encrypting a message of size O(λ) would require ciphertext and keys of size O(λ2) times that of the IND-CPA scheme, even in our improved scheme. Therefore, we show a more efficient domain extension technique for building a λ-bit NM-CPA scheme from a single-bit NM-CPA scheme with keys and ciphertext of size O(λ) times that of the NM-CPA one-bit scheme. To achieve our goal, we define and construct a novel type of continuous non-malleable code (NMC), called secret-state NMC, as we show that standard continuous NMCs are not enough for the natural “encode-then-encrypt-bit-by-bit” approach to work. Finally, we introduce a new security notion for public-key encryption that we dub non-malleability under (chosen-ciphertext) self-destruct attacks (NM-SDA). After showing that NM-SDA is a strict strengthening of NM-CPA and allows for more applications, we nevertheless show that both of our results—(faster) construction from IND-CPA and domain extension from one-bit scheme—also hold for our stronger NM-SDA security. In particular, the notions of IND-CPA, NM-CPA, and NM-SDA security are all equivalent, lying (plausibly, strictly?) below IND-CCA securit
Increased autocrine interleukin-6 production is significantly associated with worse clinical outcome in patients with chronic lymphocytic leukemia.
Chronic lymphocytic leukemia (CLL) remains incurable with current standard therapy. We have previously reported that an increased expression of interleukin-6 (IL-6) receptor CD126 leads to resistance of CLL cells to chemotherapy and worse prognosis for patients with CLL. In this study, we determine whether autocrine IL-6 production by CLL B cells is associated with poor clinical outcome and explore IL-6-mediated survival mechanism in primary CLL cells. Our results demonstrate that higher levels of autocrine IL-6 are significantly associated with shorter absolute lymphocyte doubling time, patients received treatment, without complete remission, advanced Binet stages, 17p/11q deletion, and shorter time to first time treatment and progression-free survival. IL-6 activated both STAT3 and nuclear factor kappa B (NF-κB) in primary CLL cells. Blocking IL-6 receptor and JAK2 inhibited IL-6-mediated activation of STAT3 and NF-κB. Our study demonstrates that an increased autocrine IL-6 production by CLL B-cells are associated with worse clinical outcome for patients with CLL. IL-6 promotes CLL cell survival by activating both STAT3 and NF-κB through diverse signaling cascades. Neutralizing IL-6 or blocking IL-6 receptor might contribute overcoming the resistance of CLL cells to chemotherapy. We propose that the measurement of autocrine IL-6 could be a useful approach to predict clinical outcome.National Natural Science Foundation of China. Grant Numbers: 81570194, 81172109, 8157019
Pioglitazone Enhances the Beneficial Effects of Glucocorticoids in Experimental Nephrotic Syndrome
Glucocorticoids are the primary therapy for nephrotic syndrome (NS), but have serious side effects and are ineffective in ~20-50% of patients. Thiazolidinediones have recently been suggested to be renoprotective, and to modulate podocyte glucocorticoid-mediated nuclear receptor signaling. We hypothesized that thiazolidinediones could enhance glucocorticoid efficacy in NS. We found that puromycin aminonucleoside-induced proteinuria in rats was significantly reduced by both high-dose glucocorticoids (79%) and pioglitazone (61%), but not low-dose glucocorticoids (25%). Remarkably, pioglitazone + low-dose glucocorticoids also reduced proteinuria (63%) comparably to high-dose glucocorticoids, whereas pioglitazone + high-dose glucocorticoids reduced proteinuria to almost control levels (97%). Molecular analysis revealed that both glucocorticoids and pioglitazone enhanced glomerular synaptopodin and nephrin expression, and reduced COX-2 expression, after injury. Furthermore, the glomerular phosphorylation of glucocorticoid receptor and Akt, but not PPARγ, correlated with treatment-induced reductions in proteinuria. Notably, clinical translation of these findings to a child with refractory NS by the addition of pioglitazone to the treatment correlated with marked reductions in both proteinuria (80%) and overall immunosuppression (64%). These findings together suggest that repurposing pioglitazone could potentially enhance the proteinuria-reducing effects of glucocorticoids during NS treatment
Determining factors of thermoelectric properties of semiconductor nanowires
It is widely accepted that low dimensionality of semiconductor heterostructures and nanostructures can significantly improve their thermoelectric efficiency. However, what is less well understood is the precise role of electronic and lattice transport coefficients in the improvement. We differentiate and analyze the electronic and lattice contributions to the enhancement by using a nearly parameter-free theory of the thermoelectric properties of semiconductor nanowires. By combining molecular dynamics, density functional theory, and Boltzmann transport theory methods, we provide a complete picture for the competing factors of thermoelectric figure of merit. As an example, we study the thermoelectric properties of ZnO and Si nanowires. We find that the figure of merit can be increased as much as 30 times in 8-Å-diameter ZnO nanowires and 20 times in 12-Å-diameter Si nanowires, compared with the bulk. Decoupling of thermoelectric contributions reveals that the reduction of lattice thermal conductivity is the predominant factor in the improvement of thermoelectric properties in nanowires. While the lattice contribution to the efficiency enhancement consistently becomes larger with decreasing size of nanowires, the electronic contribution is relatively small in ZnO and disadvantageous in Si
Absorption and distribution of etoricoxib in plasma, CSF, and wound tissue in patients following hip surgery—a pilot study
The perioperative administration of selective cyclooxygenase-2 (COX-2)-inhibitors to avoid postoperative pain is an attractive option: they show favorable gastro-intestinal tolerability, lack inhibition of blood coagulation, and carry a low risk of asthmatic attacks. The purpose of this study was to determine the cerebrospinal fluid (CSF), plasma, and tissue pharmacokinetics of orally administered etoricoxib and to compare it with effect data, i.e., COX-2-inhibition in patients after hip surgery. The study was performed in a blinded, randomized, parallel group design. A total of 12 adult patients were included who received 120 mg etoricoxib (n = 8) or placebo (n = 4) on day 1 post-surgery. Samples from plasma, CSF, and tissue exudates were collected over a period of 24 h post-dosing and analyzed for etoricoxib and prostaglandin E2 (PGE2) using liquid chromatography-tandem mass spectrometry and immuno-assay techniques. CSF area under the curve (AUC) [AUCs(O–24h)] for etoricoxib amounted to about 5% of the total AUC in plasma (range: 2–7%). Individual CSF lag times with respect to (50%) peak plasma concentration were ≤2 h in all but one case (median: 1 h). PGE2 production in tissue was significantly blocked by the COX-2 inhibitor starting with the appearance of etoricoxib in tissue and lasting for the whole observation period of 24 h (P < 0.01). In conclusion, etoricoxib reaches the CSF and site of surgery at effective concentrations and reduces PGE2 production at the presumed site of action
Continuous NMC Secure Against Permutations and Overwrites, with Applications to CCA Secure Commitments
Non-Malleable Codes (NMC) were introduced by Dziembowski, Pietrzak and Wichs in ICS 2010 as a relaxation of error correcting codes and error detecting codes. Faust, Mukherjee, Nielsen, and Venturi in TCC 2014 introduced an even stronger notion of non-malleable codes called continuous non-malleable codes where security is achieved against continuous tampering of a single codeword without re-encoding. We construct information theoretically secure CNMC resilient to bit permutations and overwrites, this is the first Continuous NMC constructed outside of the split-state model. In this work we also study relations between the CNMC and parallel CCA commitments. We show that the CNMC can be used to bootstrap a self-destruct parallel CCA bit commitment to a self-destruct parallel CCA string commitment, where self-destruct parallel CCA is a weak form of parallel CCA security. Then we can get rid of the self-destruct limitation obtaining a parallel CCA commitment, requiring only one-way functions
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation
Albuterol enantiomer levels, lung function and QTc interval in patients with acute severe asthma and COPD in the emergency department
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