Random projection to preserve patient privacy

With the availability of accessible and widely used cloud services, it is natural that large components of healthcare systems migrate to them; for example, patient databases can be stored and processed in the cloud. Such cloud services provide enhanced flexibility and additional gains, such as availability, ease of data share, and so on. This trend poses serious threats regarding the privacy of the patients and the trust that an individual must put into the healthcare system itself. Thus, there is a strong need of privacy preservation, achieved through a variety of different approaches. In this paper, we study the application of a random projection-based approach to patient data as a means to achieve two goals: (1) provably mask the identity of users under some adversarial-attack settings, (2) preserve enough information to allow for aggregate data analysis and application of machine-learning techniques. As far as we know, such approaches have not been applied and tested on medical data. We analyze the tradeoff between the loss of accuracy on the outcome of machine-learning algorithms and the resilience against an adversary. We show that random projections proved to be strong against known input/output attacks while offering high quality data, as long as the projected space is smaller than the original space, and as long as the amount of leaked data available to the adversary is limited

Managing rare and undetectable events in risk assessment: the case of a satellite system launch project

Assessing the wide diversity of risk types in large and complex projects using the traditional hyperbolic iso-risks curves may seem a simplistic and reductive approach, and evaluating the risk factor through the multiplication of likelihood and severity parameters results in defining as dangerous those risks that are associated either with rare but devastating consequences or with probable but minor effects. In this work, the authors aimed at focusing on those risks that, despite their low occurrence probability, may significantly compromise a project result. To this extent, a different formula has been used to compute the risk factor, keeping into account risk detectability and evaluating the potential consequences in four different domains (cost, time, performance, reputation). This approach has been validated on the case of a large industrial project related to the launch of an innovative mobile telecommunications system, collecting the experts' opinions in a primary Italian firm in aerospace industry

Functional Implications in Apoptosis by Interferon Inducible Gene Product 1-8D, the Binding Protein to Adenovirus Preterminal Protein

Adenovirus (Ad) precursor to the terminal protein (pTP) plays an essential roles in the viral DNA replication. Ad pTP serves as a primer for the synthesis of a new DNA strand during the initiation step of replication. In addition, Ad pTP forms organized spherical replication foci on the nuclear matrix (NM) and anchors the viral genome to the NM. Here we identified the interferon inducible gene product 1-8D (Inid) as a pTP binding protein by using a two-hybrid screen of a HeLa cDNA library. Of the clones obtained in this assay, nine were identical to the Inid, a 13-kDa polypeptide that shares homology with genes 1-8U and Leu-13/9-27, most of which have little known functions. The entire open reading frame (ORF) of Inid was cloned into the tetracycline inducible expression vector in order to determine the biological functions related with adenoviral infection. When Inid was introduced to the cells along with adenoviruses, fifty to sixty percent of Ad-infected cells expressing Inid had rounded morphology, which was suggestive of apoptosis. Results from the terminal deoxynucleotidyl transferase (TdT) and DNA fragmentation assays confirmed that Inid induces apoptosis in Ad-infected or in uninfected cells. The Inid binding to pTP may target the cell for apoptotic destruction as a host defense mechanism against the viral infection

On board Processor and Processing Strategies for Next Generation Reconfigurable Satellite Payloads

Today, the increasing demand in higher data rates necessitates new methods as well as higher flexibility for satellite telecommunication payloads in order to address a variety of applications and customers. This paper presents one of these processing strategies that is applicable to today’s processing satellite payloads aiming to meet those demands. For this purpose, a two-tier filter bank is designed as part of a digital onboard processor, which first divides the spectrum at the output of the ADC into a number of sub-bands extracting all the stacked channels in the digital domain. Following the analysis section of the first tier of operations, the extracted channels go under a secondary channelisation process to obtain much finer granularity of 31.25 kHz or 50 kHz depending on the communication standard used for data transmission. The implementation of the channeliser was delivered on a bit-true simulation model and the input and the output of the channelisers were compared and evaluated both in the time and frequency domains

Altered Expression of Adenovirus 12 DNA-Binding Protein but Not DNA Polymerase during Abortive Infection of Hamster Cells

Replication of human adenovirus type 12 DNA is blocked in abortively infected baby hamster kidney cells. The activity and accumulation of adenovirus 12 DNA polymerase is equivalent in infected hamster and human cell extracts. However, the accumulation of adenovirus type 12 DNA-binding protein is approximately 120-fold lower in extracts from infected hamster cells when compared to infected permissive human cells. This difference in accumulation is not because of replication of viral DNA during productive infection, since this difference is observed in the presence of hydroxyurea. The DNA-binding protein from infected hamster cells retains the ability to bind denatured DNA-cellulose. An adenovirus 5 early region 1 transformed hamster cell line competent to complement the adenovirus 12 DNA replication defect also stimulates accumulation of the DNA-binding protein even when the cells are treated with hydroxyurea. Thus, the reduced expression of the viral DNA-binding protein may play a role in the mechanism of abortive infection of hamster cells by adenovirus 12

Influence of bulla volume on postbullectomy outcome

Objective: To quantify the contribution of the resected volume and the presence of associated, functionally significant emphysema to the postoperative improvement of pulmonary function after resection of giant lung bullae. Design: Patients undergoing elective surgery for giant bullae who had complete pulmonary function and radiographic studies performed were reviewed retrospectively. Setting: All 25 patients underwent surgery at the thoracic surgery unit of the University of Pisa, Pisa, Italy. Methods: Pulmonary function was assessed before and 12 months after surgery. On the chest radiograph, the location of bullae, and the signs of compression and emphysema were evaluated. The radiographic total lung capacity (TLCX-ray) and the volume of bullae were measured according to the ellipse method. Postoperatively, functional and radiographic changes were analyzed. The percentage change in forced expiratory volume in 1 s(ΔFEV1%) after surgery was the main outcome measure. The influence of factors related to emphysema and bulla volume on the functional improvement postbullectomy was assessed by stepwise multiple regression. Results: Before surgery, the TLCx-ray overestimated the TLC measured by nitrogen washout, with a mean difference between the two measurements of 1.095 L. A close relationship was found between the TLCx-ray and the plethysmographic TLC (n=6; r=0.95). After surgery, dyspnea lessened (P<0.05) and FEV1 increased (P<0.01). Statistically, the radiographic bulla volume was the single most important factor determining the ΔFEV1% (r=0.80, P<0.0001). Conclusions: These findings suggest that the preoperative size of bullae is the most important contributor to the improvement in ventilatory capacity after bullectomy, and that it is possible to predict the expected increase of postoperative FEV1 from preoperative bulla volume

Adherence in HIV-positive patients treated with single-tablet regimens and multi-pill regimens: findings from the COMPACT study

The use of Combination AntiRetroviral Therapy (cART) has decreased the morbidity and mortality of patients infected with HIV. However, adherence to cART remains crucial to prevent virological failure and disease progression. The aim of this study was to assess adherence to treatment among patients treated with Single Tablet Regimen (STR) or with multi-pill regimens based on Protease Inhibitors (PI), Non-Nucleoside Reverse-Transcriptase Inhibitors (NNRTI), or raltegravir (RAL). An observational retrospective cohort analysis based on administrative and clinical databases was conducted at the National Institute for Infectious Diseases (Rome, Italy). HIV-positive patients treated with a cART between Jan 1st, 2008&#x2013;Dec 31st, 2010 were included. Patients were followed-up for one year since the first prescription during the inclusion period or up to death or switch of at least one drug of the regimen. Adherence and selective non-adherence (days without backbone or 3rd drug) were calculated using pharmacy refill compliance [1]. cART regimens were classified based on number of daily pills (STR vs multi-pill regimen) and on type of third drug. Viral Load (VL) and CD4 cell counts at the end of the follow-up were evaluated. A total of 1,604 patients were analyzed, 70.0% male, age 45.0&#x00B1;8.7, 14.3% newly treated. Patients on STR were 159 (9.9%), PI 878 (54.7%), NNRTI 523 (32.6%), RAL 44 (2.7%). Presence of at least one AIDS-defining conditions (according to Centers for Disease Control classification) was 30% in the STR group, 34% PI, 26% NNRTI, 34% RAL (p=n.s.). Adherence was 80.4&#x00B1;14.7% for STR, 71.8&#x00B1;21.8% PI, 77.1&#x00B1;20.3% NNRTI, 74.0&#x00B1;22.4% RAL. Selective non-adherence was 5.5% (18 days) PI, 2.8% (8 days) NNRTI, 12.5% (43 days) RAL (Figure 1). At the end of the follow-up, VL/CD4 values were available among 709 patients (44%); CD4 count &#x003E;500 cell/mm3 was observed among 61% of patients on STR, 44% PI, 48% NNRTI, 42% RAL and VL &#60; 50 copies/ml was observed among 96% of patients on STR, 78% PI, 88% NNRTI, 87% RAL. Interruptions in cART refill remain a relevant problem across all cART regimens. Patients on STR displayed a higher adherence rate compared to multi-pill regimes (PI, NNRTI, and RAL), primarily due to lack of selective non-adherence. Patients on STR experienced also higher rates of VL &#60; 50 and CD4 &#x003E; 500. The use of an STR regimen appears an effective therapeutic option to avoid selective non-adherence and, consequently, to prevent virological failure and disease progression

Tympanic cholesterol granuloma and exclusive endoscopic approach

Objective: Background: Case Report: Conclusions: Unusual or unexpected effect of treatment Cholesterol granuloma is a histological entity containing cholesterol crystals surrounded by foreign-body giant cells and chronic inflammation. Tympanic cholesterol granuloma is a rare disease, while petrous bone cholesterol granuloma is more common. Surgery consists of elective management in most cases of CGs. There are several types of surgery described to treat cholesterol granuloma; however, a case treated by primary endoscopic ear surgery has not yet been described. The aim of this case report is to present the endoscopic characteristics of cholesterol granulomas and show how endoscopic ear surgery is possible in isolated and selected cases with this pathology. We report the case of a 65-year-old patient affected by a cholesterol granuloma of the middle ear, with progressive hearing impairment and fullness of the left ear. The granuloma was diagnosed via medical imaging using magnetic resonance imaging, which identified the typical high signal intensity in T1-and T2-weighted images. In this case, cholesterol granuloma was limited to the epitympanic and mesotympanic regions. For small cholesterol granulomas confined to the middle ear, a canal wall-up or wall-down tympanoplasty plus ventilation tube insertion are usually performed. In this case, primary endoscopic surgery was performed under general anaesthesia to remove the presumed cholesterol granuloma. It was completely removed by this approach, without facial nerve injuries or postoperative complications. The patient had no disease recurrence at clinical and radiological investigation at 1-year follow-up. An exclusive endoscopic approach to remove cholesterol granuloma is feasible. However, it should only be performed in selected cases

Facial nerve dehiscence and cholesteatoma: a comparison between decades

OBJECTIVES: To evaluate the incidence of facial canal dehiscence (FCD) and other intraoperative findings over the last 20 years as well as correlation with the Japanese Otological Society/European Academy of Otology and Neurotology classification in patients with cholesteatoma. MATERIALS and METHODS: A total of 469 patients operated from 1998 to 2018 were selected and divided into 2 groups of 10 years each. RESULTS: Dehiscence was significantly higher in patients with a history of pathology longer than 5 years (22.7%). Higher values were observed in revision surgery, 44.4% in the first period and 41.7% in the second. The tympanic segment was the one most frequently involved, affecting 92% of patients in the first period and 97% of patients in the second. Dehiscence occurred significantly more often in patients with a semicircular canal fistula, 14.8% in the first decade and 8.8% in the second. The incidence of FCD was significantly higher in patients with primary cholesteatoma (especially in those with combined pars tensa-flaccida) than in those with a secondary acquired one, 31.5% vs 7.4% in the first period, 21.1% vs 7.4% in the second, and in those with a stage III disease, 42% in the first period, 33.3% in the second. CONCLUSION: Patients with a shorter history of cholesteatoma as well as those not previously operated had a lower incidence of FCD. The tym-panic tract of the facial nerve remains the most frequent site of dehiscence, while the association between dehiscence and fistula of the semicircular canal remains strong. Patients with combined pars tensa-pars flaccida and stage III cholesteatoma have a higher incidence of FCD

Bcl-2 protein: a prognostic factor inversely correlated to p53 in non-small-cell lung cancer.

Non-small-cell lung cancer (NSCLC) prognosis is strictly related to well-established clinicopathological parameters which have unfortunately become insufficient in the prognostic evaluation of this type of cancer. As p53 and bcl-2 gene deregulations are frequently involved in several types of epithelial malignancies, we investigated the Bcl-2 and p53 protein expression in 91 and 101 cases of NSCLC respectively. The expression was then compared with established indicators of prognosis and biological behaviour of the tumours. No relationship was observed between Bcl-2 and either clinicopathological or biological parameters such as histology, grading, tumour status, nodal metastasis and proliferative activity evaluated by scoring proliferating cell nuclear antigen expression and Ki-67 immunoreactivity. However, the mean Bcl-2 expression was significantly lower in patients who developed metastasis during follow-up or died of metastatic disease (P = 0.006 and P = 0.01 respectively). Moreover, survival probability was higher in patients who expressed the Bcl-2 protein (P = 0.0002). In contrast with this, p53 protein accumulation was observed in tumours with metastatic nodal involvement (P = 0.02) or in patients who developed metastasis during follow-up (P = 0.01), although no correlation was found between p53 expression and overall survival. An inverse relationship was also found between Bcl-2 and the anti-oncogene protein product p53 (P = 0.01). Thus, a high proportion of NSCLCs express p53 and Bcl-2 proteins and their expression may have prognostic importance