665 research outputs found

    Enabling analytics on sensitive medical data with secure multi-party computation

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    While there is a clear need to apply data analytics in the healthcare sector, this is often difficult because it requires combining sensitive data from multiple data sources. In this paper, we show how the cryptographic technique of secure multiparty computation can enable such data analytics by performing analytics without the need to share the underlying data. We discuss the issue of compliance to European privacy legislation; report on three pilots bringing these techniques closer to practice; and discuss the main challenges ahead to make fully privacy-preserving data analytics in the medical sector commonplace

    HLA-matched platelet transfusions are effective only in refractory patients with positive HLA antibody screening

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    BACKGROUND Recipients of platelet transfusions with 1-hour corrected count increments (1hCCIs) of 7.5 or less on two subsequent platelet transfusions with random platelets may benefit from human leukocyte antigen (HLA)-matched platelet concentrates. We aimed to quantify the efficacy of HLA-matched platelets concentrates expressed in 1hCCIs. METHODS We performed a cohort study among consecutive refractory patients who received HLA-matched platelet concentrates in the Netherlands between 1994 and 2017. We performed mixed-model linear regression comparing 1hCCIs after HLA split-antigen-matched transfusions with 1hCCIs after HLA-mismatched transfusions, adjusted for within-patient correlations. A donor-to-patient match was categorized as a split-match if all donor HLA-A and -B antigens were present in the patient as well; that is, donor and patient were HLA identical or compatible. Subgroup analyses were performed for patients with positive or negative HLA antibody screens. Finally, the additional effect of ABO mismatches on 1hCCIs was investigated. RESULTS The 1hCCI after an HLA-matched transfusion was 14.09 (95% reference interval, 1.13-29.89). This was 1.94 (95% confidence interval [CI], 0.74-3.15) higher than 1hCCI after HLA-mismatched transfusions. In patients with negative HLA antibody screening tests, HLA matching did not affect 1hCCIs. Conditional on HLA matching, 1hCCIs decreased by 3.70 (95% CI, -5.22 to -2.18) with major ABO mismatches. CONCLUSION Matched platelet concentrates yielded maximal 1hCCIs, whereas mismatched transfusions still resulted in adequate increments. There is no indication for HLA-matched platelets in patients with negative antibody screens

    Ensuring HLA-matched platelet support requires an ethnic diverse donor population

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    BACKGROUND: Patients refractory for platelet transfusions benefit from human leukocyte antigen (HLA)-matched platelet transfusions. Differences in ethnic background of patients and donors could hamper the availability of sufficient numbers of HLA-matched donors for all patients. We evaluated our HLA-matched donor program and explored the role of ethnic background of patients related to the number of available donors. METHODS: We performed a cohort study among consecutive patients who received HLA-matched platelet concentrates in the Netherlands between 1994 and 2017. The number of available matched donors was determined per patient. Haplotypes were constructed from genotypes with computer software (PyPop). Based on haplotypes, HaploStats, an algorithm from the National Marrow Donor Program, was used to assess the most likely ethnic background for patients with 5 or fewer and 30 or more donors. RESULTS: HLA typing was available for 19,478 donors in September 2017. A total of 1206 patients received 12,350 HLA-matched transfusions. A median of 83 (interquartile range, 18-266) donors were available per patient. For 95 (10.3%) patients, 5 or fewer donors were available. These patients were more likely to have an African American background, whereas patients with 30 or more donors were more often from Caucasian origin, compared with Caucasian origin for patients with 30 donors. CONCLUSION: Adequate transfusion support could be guaranteed for most but not all refractory patients. More non-Caucasian donors are required to ensure the availability of HLA-matched donors for all patients in the Netherlands

    Search for a Standard Model Higgs boson in the mass range 200-600 GeV in the H→ZZ→ℓ+ℓ−qq¯ decay channel with the ATLAS detector

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    A search for a heavy Standard Model Higgs boson decaying via H→ZZ→ℓ+ℓ−qq¯, where ℓ=e or μ, is presented. The search uses a data set of pp collisions at √s =7 TeV, corresponding to an integrated luminosity of 4.7 fb−1 collected in 2011 by the ATLAS detector at the CERN LHC. No significant excess of events above the estimated background is found. Upper limits at 95% confidence level on the production cross section of a Higgs boson with a mass in the range between 200 and 600 GeV are derived. A Standard Model Higgs boson with a mass in the range 300 GeV≤mH ≤ 322 GeV or 353 GeV ≤mH ≤ 410 GeV is excluded at 95% CL. The corresponding expected exclusion range is 351 GeV ≤mH ≤ 404 GeV at 95% CL
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