mRNA Vaccine - A New Cancer Treatment Strategy.

The corresponding mRNA vaccines Comirnaty (BNT162b2) and Spikevax (mRNA-1273) have been authorized for emergency use since the COVID-19 outbreak. Most clinical researches have also discovered that the mRNA vaccine is a revolutionary strategy for preventing and treating numerous diseases, including cancers. Unlike viral vectors or DNA vaccines, mRNA vaccines cause the body to directly produce proteins following injection. Delivery vectors and mRNAs that encode tumor antigens or immunomodulatory molecules work together to trigger an anti-tumor response. Before mRNA vaccines may be employed in clinical trials, a number of challenges need to be resolved. These include establishing effective and safe delivery systems, generating successful mRNA vaccines against diverse types of cancers, and proposing improved combination therapy. Therefore, we need to improve vaccine-specific recognition and develop mRNA delivery mechanisms. This review summarizes the complete mRNA vaccines' elemental composition and discusses recent research progress and future direction for mRNA tumor vaccines.

Interdisciplinary collaboration and computer-assisted home healthcare referral in the emergency department: a retrospective cohort study.

AIM: Home healthcare (HHC) provides continuous care for disabled patients. However, HHC referral after the emergency department (ED) discharge remains unclear. Thus, this study aimed its clarification. METHODS: A computer-assisted HHC referral by interdisciplinary collaboration among emergency physicians, case managers, nurse practitioners, geriatricians, and HHC nurses was built in a tertiary medical center in Taiwan. Patients who had HHC referrals after ED discharge between February 1, 2020 and September 31, 2020, were recruited into the study. A non-ED HHC cohort who had HHC referrals after hospitalization from the ED was also identified. Comparison for clinical characteristics and uses of medical resources was performed between ED HHC and non-ED HHC cohorts. RESULTS: The model was successfully implemented. In total, 34 patients with ED HHC and 40 patients with non-ED HHC were recruited into the study. The female proportion was 61.8% and 67.5%, and the mean age was 81.5 and 83.7 years in ED HHC and non-ED HHC cohorts, respectively. No significant difference was found in sex, age, underlying comorbidities, and ED diagnoses between the two cohorts. The ED HHC cohort had a lower median total medical expenditure within 3 months (34,030.0 vs. 56,624.0 New Taiwan Dollars, p = 0.021) compared with the non-ED HHC cohort. Compared to the non-ED HHC cohort, the ED HHC cohort had a lower ≤ 1 month ED visit, ≤ 6 months ED visit, and ≤ 3 months hospitalization; however, differences were not significant. CONCLUSION: An innovative ED HHC model was successfully implemented. Further studies with more patients are warranted to investigate the impact.

Blockchain-based healthcare management system with two-side verifiability.

The lack of data outsourcing in healthcare management systems slows down the intercommunication and information sharing between different entities. A standard solution is outsourcing the electronic health record (EHR) to a cloud service provider (CSP). The outsourcing of the EHR should be performed securely without compromising the CSP functionalities. Searchable encryption would be a viable approach to ensure the confidentiality of the data without compromising searchability and accessibility. However, most existing searchable encryption solutions use centralised architecture. These systems have trust issues as not all the CSPs are fully trusted or honest. To address these problems, we explore blockchain technology with smart contract applications to construct a decentralised system with auditable yet immutable data storage and access. First, we propose a blockchain-based searchable encryption scheme for EHR storage and updates in a decentralised fashion. The proposed scheme supports confidentiality of the outsourced EHR, keyword search functionalities, verifiability of the user and the server, storage immutability, and dynamic updates of EHRs. Next, we implement a prototype using JavaScript and Solidity on the Ethereum platform to demonstrate the practicality of the proposed solution. Finally, we compare the performance and security of the proposed scheme against existing solutions. The result indicates that the proposed scheme is practical while providing the desired security features and functional requirements.