Facing the blockchain endpoint vulnerability, an SGX-based solution for secure eHealth auditing

According to McAfee Labs, even in 2019, the eHealth sector is confirmed as one of the most critical in terms of cybersecurity incidents. It is estimated that more than 176 million patient records were target of attacks between 2009 and 2017, and with a single attack, in 2018, more than 1.4 million patient records were affected at UnityPoint Health. To cope with such a dramatic situation, one of the main strategic priority in the eHealth field is represented by the adoption of Blockchain. Specifically, according to a Deloittes survey, 55% of healthcare executives believe that blockchain technology will disrupt the healthcare industry. Unfortunately, while blockchain provides a valuable tool for enhancing the security of health applications and related data, it cannot be assumed as a panacea for data security. As an example, the so-called Endpoint Vulnerability issue is a well-known problem of Blockchain-based solutions: in such a case the attacker successful in gaining control of the end-point can tamper data off-chain during its generation and/or before it is sent to the chain. In this paper, we face such an issue by shielding the endpoint through the Intel Software Guard eXtension (SGX) technology. We demonstrate our solution for an auditing software belonging to the European eHealth management system (namely OpenNCP). We also discuss how our solution can be generalized to any other Blockchain-based solution. Finally, an experimental evaluation has been conducted to prove the actual feasibility of the proposed solution under the requirements of the real eHealth system

The Cupuacu (Theobroma Grandiflorum) fruit. High performance liquid chromatographic determination of antioxidant phenolic substances in cupuacu seed powder

A method for the qualitative analysis of antioxidant phenolic substances in cupuacu seed powder by high performance liquid chromatography is described. We have used n-exhane to degrease the cupuacu seed powder and a methanol-water (80:20) solution for the extraction of the analytes. HPLC separation was carried out by using a binary gradient elution utilizing methanol-acetonitrile 1:1 (v/v) and 0.5% (w/v) phosphoric acid. Spectral scans were continuously collected in the range 210-370 nm and the spectrophotometric chromatogram was plotted at 280 nm. Spectrofluorimetric detection was carried out with excitation at 280 nm and emission at 330 nm. Epicatechin and quercetin were identified by comparing the chromatographic behaviour and the UV spectrum of the extracted components with those of pure standards, while the spectrofluorimetric detection, by stopped flow technique, has allowed the identification of catechin and has confirmed the spectrophotometric identification of epicatechin

Lubricin is expressed in chondrocytes derived from osteoarthritic cartilage encapsulated in poly (ethylene glycol) diacrylate scaffold

Osteoarthritis (OA) is characterized by degenerative changes within joints that involved quantitative and/or qualitative alterations of cartilage and synovial fluid lubricin, a mucinous glycoprotein secreted by synovial fibroblasts and chondrocytes. Modern therapeutic methods, including tissue-engineering techniques, have been used to treat mechanical damage of the articular cartilage but to date there is no specific and effective treatment. This study aimed at investigating lubricin immunohistochemical expression in cartilage explant from normal and OA patients and in cartilage constructions formed by Poly (ethylene glycol) (PEG) based hydrogels (PEG-DA) encapsulated OA chondrocytes. The expression levels of lubricin were studied by immunohistochemistry: i) in tissue explanted from OA and normal human cartilage; ii) in chondrocytes encapsulated in hydrogel PEGDA from OA and normal human cartilage. Moreover, immunocytochemical and western blot analysis were performed in monolayer cells from OA and normal cartilage. The results showed an increased expression of lubricin in explanted tissue and in monolayer cells from normal cartilage, and a decreased expression of lubricin in OA cartilage. The chondrocytes from OA cartilage after 5 weeks of culture in hydrogels (PEGDA) showed an increased expression of lubricin compared with the control cartilage. The present study demonstrated that OA chondrocytes encapsulated in PEGDA, grown in the scaffold and were able to restore lubricin biosynthesis. Thus our results suggest the possibility of applying autologous cell transplantation in conjunction with scaffold materials for repairing cartilage lesions in patients with OA to reduce at least the progression of the disease

Privacy-Preserving Credit Scoring via Functional Encryption

The majority of financial organizations managing confidential data are aware of security threats and leverage widely accepted solutions (e.g., storage encryption, transport-level encryption, intrusion detection systems) to prevent or detect attacks. Yet these hardening measures do little to face even worse threats posed on data-in-use. Solutions such as Homomorphic Encryption (HE) and hardware-assisted Trusted Execution Environment (TEE) are nowadays among the preferred approaches for mitigating this type of threats. However, given the high-performance overhead of HE, financial institutions —whose processing rate requirements are stringent— are more oriented towards TEE-based solutions. The X-Margin Inc. company, for example, offers secure financial computations by combining the Intel SGX TEE technology and HE-based Zero-Knowledge Proofs, which shield customers’ data-in-use even against malicious insiders, i.e., users having privileged access to the system. Despite such a solution offers strong security guarantees, it is constrained by having to trust Intel and by the SGX hardware extension availability. In this paper, we evaluate a new frontier for X-Margin, i.e., performing privacy-preserving credit risk scoring via an emerging cryptographic scheme: Functional Encryption (FE), which allows a user to only learn a function of the encrypted data. We describe how the X-Margin application can benefit from this innovative approach and —most importantly— evaluate its performance impact

Neuropsychiatric Lupus Erythematosus

Neuropsychiatric involvement in patients with Systemic Lupus Erythematosus (SLE), first mentioned by Kaposi more than 100 years ago, still remains one of the main challenge facing rheumatologist and other physicians. The diagnosis of neuropsychiatric SLE (NPSLE) is complex not only because of the considerable prevalence variation (14-80%) but also because of the wide spectrum of NP manifestations. They vary from overt neurologic alterations (seizure, psychosis), to subtle abnormalities (neurocognitive dysfunctions). Different NP manifestations result from a variety of mechanisms including antibodies, vasculitis, thrombosis, hemorrhages and cytokine-mediated damages. Of note, despite the dramatic clinical manifestations, too often changes at the morphological neuroimaging techniques are minimal and non specific. There is no one diagnostic tool specific for NPSLE and diagnosis must be based on the combinated use of immunoserological tests, functional and anatomical neuroimaging and standardized specific criteria. Symptomatic, immunosuppressive and anticoagulant therapies are the main strategies available in the management of these patients. Therapy for CNS lupus should be adjusted according to the needs of the individual patients. The coming years promise to be an important time for the development of new neuroimaging techniques and for the study of disease mechanism. An early and objective identification of brain involvement will allow for appropriate treatment to avoid severe complications

Capsaicin 8% patch and chronic postsurgical neuropathic pain

(1) Background: Surgery is a frequent cause of persistent pain, defined chronic post-surgical pain (CPSP). The capsaicin 8% patch (Qutenza®) is approved for the treatment of postherpetic neuralgia (PHN) and for diabetic peripheral neuropathy (DPN) of the feet. We propose a review of the literature on use of the capsaicin 8% patch to treat neuropathic pain associated with surgery; (2) Methods: We identified the articles by searching electronic databases using a combination of such terms as “capsaicin 8% patch”, “Qutenza®”, and “chronic postsurgical pain”; (3) Results: We identified 14 selected studies reporting on a total of 632 CPSP cases treated with capsaicin 8% patch. Treatment with the capsaicin 8% patch significantly reduced the average pain intensity. Only 5 studies reported adverse events (AEs) after the patch application. The most common AEs were erythema, burning sensation and pain; (4) Conclusions: Our review indicate that capsaicin 8% patch treatment for CPSP is effective, safe and well tolerated, but randomized controlled trials on efficacy, safety and tolerability should be conducted

Lamellipodium extension and membrane ruffling require different SNARE-mediated trafficking pathways

<p>Abstract</p> <p>Background</p> <p>Intracellular membrane traffic is an essential component of the membrane remodeling that supports lamellipodium extension during cell adhesion. The membrane trafficking pathways that contribute to cell adhesion have not been fully elucidated, but recent studies have implicated SNARE proteins. Here, the functions of several SNAREs (SNAP23, VAMP3, VAMP4 and syntaxin13) are characterized during the processes of cell spreading and membrane ruffling.</p> <p>Results</p> <p>We report the first description of a SNARE complex, containing SNAP23, syntaxin13 and cellubrevin/VAMP3, that is induced by cell adhesion to an extracellular matrix. Impairing the function of the SNAREs in the complex using inhibitory SNARE domains disrupted the recycling endosome, impeded delivery of integrins to the cell surface, and reduced haptotactic cell migration and spreading. Blocking SNAP23 also inhibited the formation of PMA-stimulated, F-actin-rich membrane ruffles; however, membrane ruffle formation was not significantly altered by inhibition of VAMP3 or syntaxin13. In contrast, membrane ruffling, and not cell spreading, was sensitive to inhibition of two SNAREs within the biosynthetic secretory pathway, GS15 and VAMP4. Consistent with this, formation of a complex containing VAMP4 and SNAP23 was enhanced by treatment of cells with PMA. The results reveal a requirement for the function of a SNAP23-syntaxin13-VAMP3 complex in the formation of lamellipodia during cell adhesion and of a VAMP4-SNAP23-containing complex during PMA-induced membrane ruffling.</p> <p>Conclusions</p> <p>Our findings suggest that different SNARE-mediated trafficking pathways support membrane remodeling during ECM-induced lamellipodium extension and PMA-induced ruffle formation, pointing to important mechanistic differences between these processes.</p

The feasibility and applications of non-invasive cardiac monitoring in obese patients undergoing day-case surgery: Results of a prospective observational study

Aims: This prospective observational study evaluates the utility of non-invasive cardiac monitoring in obese patients in the day-surgery case, considering factors, such as Body Mass Index (BMI) and anaesthesia technique. Background: Obese patients are more likely to be admitted to hospital or to get hospitalized because they are more prone to concomitant diseases and obesity itself is not a contraindication to day surgery. Obese patients are a high-risk patient population that may particularly benefit from monitoring perioperative haemodynamic variations. Methods: In this observational study, we compared haemodynamic variations between overweight or obese and normal weight patients undergoing day-case surgery. We adopted NICOM® as a non-invasive cardiac output monitoring. Objective: The aim of the current study was to investigate the haemodynamic impact of BMI and anaesthesia technique during day-case surgery procedures. The other goal was to evaluate the feasibility and applications of non-invasive cardiac output monitoring among the obese population in day-surgery. Results: 74 patients were included in the study. 34 were overweight or obese (weight 84 ± 10 kg, height 160 ± 10 cm, BMI ≈ 30 kg/m2), 40 were normal weight (weight 63 ± 15 kg, height 160 ± 10 cm, BMI ≈ 22 kg/m2). Compared to normal-weight patients, obese patients show an increase in blood pressure with a return to baseline values at the end of surgery (p &lt; 0.05). The Cardiac Output (CO) shows a similar trend, whereas the heart rate is normal. A decrease in the Cardiac Index (CI) during the operation was noticed in both groups, the one in obese patients (p = 0.24) being greater. In the same way, the Stroke Volume Index (SVI) was lower in obese patients during surgery (p &lt; 0.05). In spinal anaesthesia, the Total Peripheral Resistance Index (TPRI) was not statistically different between the groups of study. As for the TPRI in obese patients, we reported values similar to the ones in non-obese patients in spinal anaesthesia. In local anesthesia, TPRI was higher in obese patients than in non-obese. Conclusion: Cardiovascular alterations in relation to obesity include an increase in blood pressure, CO and SV. An inadequate monitoring of haemodynamic parameters is a risk factor for perioperative complications. NICOM® provides a continuous, non-invasive haemodynamic measurement