Smart contracts and homomorphic encryption for private P2P energy trading and demand response on blockchain.

Blockchain technology offers great value in terms of decentralization, data integrity, transparency, and traceability, however the transactional data is public, and accessible raising concerns about violating privacy regulations. For example, in the peer-to-peer energy trading and demand response use cases, the data stored in blockchain may allow a third party to infer the load profiles or even identify the behind the meter assets. In this paper, we employ homomorphic techniques to encrypt the energy transactional data stored on the blockchain allowing the smart contracts functions responsible for implementing the business logic of the energy flexibility trading and settlement to perform computations on encrypted data. As computations on smart contracts and public blockchains can be expensive, we have used the lighter version of the Partial Homomorphic Encryption scheme to obfuscate the energy data. To ensure the validity of the smart contracts' functions executed on encrypted data, we leverage on the consensus mechanism of the blockchain network, thus ensuring computation correctness. The solution was validated considering a micro-grid with 12 prosumers that trade their flexibility peer-to-peer (P2P). The results demonstrate the feasibility of maintaining encrypted energy data on the blockchain, executing smart contract functions on encrypted data, and preserving the privacy of computations. As anticipated, the trade-off for better privacy is the gas consumption overhead of the smart contracts' functions which is higher compared to the non-encrypted case, depending on the length of the public-private keys pair. Nonetheless, our solution exhibits consistent execution times for smart contracts, making it suitable for private networks where gas costs are of minimal concern.

Privacy-Preserving Computation for Peer-to-Peer Energy Trading on a Public Blockchain.

To ensure the success of energy transition and achieve the target of reducing the carbon footprint of energy systems, the management of energy systems needs to be decentralized. Public blockchains offer favorable features to support energy sector democratization and reinforce citizens' trust, such as tamper-proof energy data registration and sharing, decentralization, transparency, and support for peer-to-peer (P2P) energy trading. However, in blockchain-based P2P energy markets, transactional data are public and accessible, which raises privacy concerns related to prosumers' energy profiles while lacking scalability and featuring high transactional costs. In this paper, we employ secure multi-party computation (MPC) to assure privacy on a P2P energy flexibility market implementation in Ethereum by combining the prosumers' flexibility orders data and storing it safely on the chain. We provide an encoding mechanism for orders on the energy market to obfuscate the amount of energy traded by creating groups of prosumers, by splitting the amount of energy from bids and offers, and by creating group-level orders. The solution wraps around the smart contracts-based implementation of an energy flexibility marketplace, assuring privacy features on all market operations such as order submission, matching bids and offers, and commitment in trading and settlement. The experimental results show that the proposed solution is effective in supporting P2P energy flexibility trading, reducing the number of transactions, and gas consumption with a limited computational time overhead.

Therapies beyond Physiological Barriers and Drug Resistance: A Pilot Study and Review of the Literature Investigating If Intrathecal Trastuzumab and New Treatment Options Can Improve Oncologic Outcomes in Leptomeningeal Metastases from HER2-Positive Breast Cancer.

Leptomeningeal metastases (LM) are a rare but rapidly fatal complication defined by the spread of tumor cells within the leptomeninges and the subarachnoid space, found in approximately 10% of patients with HER2-positive breast cancers. This pilot study evaluated the efficacy of local treatment with intrathecal Trastuzumab (IT) added to systemic treatment. The oncologic outcome of 14 patients with HER2-positive LM is reported. Seven received IT, and seven received standard of care (SOC). The mean number of IT cycles administered was 12.14 ± 4.00. The response rate to CNS after IT treatment + SOC was 71.4%, and three patients (42.8%) obtained durable responses lasting more than 12 months. The median progression-free survival (mPFS) after LM diagnosis was six months, and the median overall survival (mOS) was ten months. The mean values of the PFS in favor of IT therapy (10.6 mo vs. 6.6 mo) and OS (13.7 vs. 9.3 mo) suggest a non-negligible investigation direction in the sense of exploiting intrathecal administration as a possible treatment modality in these patients. Adverse events reported were local pain related to intrathecal administration and one case of arachnoiditis, hematoma, and CSF fistulae. Intrathecal administration of Trastuzumab, alongside systemic treatment and radiotherapy, might improve oncologic outcomes in LM HER2-positive breast cancer with manageable toxicity.

Upstaging and Downstaging in Gliomas-Clinical Implications for the Fifth Edition of the World Health Organization Classification of Tumors of the Central Nervous System.

In 2021, the 5th edition of the WHO Classification of Tumors of the Central Nervous System (WHO-CNS5) was published as the sixth volume of the international standard for brain and spinal cord tumor classification. The most remarkable practical change in the current classification involves grading gliomas according to molecular characterization. IDH mutant (10%) and IDH wild-type tumors (90%) are two different entities that possess unique biological features and various clinical outcomes regarding treatment response and overall survival. This article presents two comparative cases that highlight the clinical importance of these new classification standards. The first clinical case aimed to provide a comprehensive argument for determining the IDH status in tumors initially appearing as low-grade astrocytoma upon histologic examination, thus underlining the importance of the WHO-CNS5. The second case showed the implications of the histologic overdiagnosis of glioblastoma using the previous classification system with a treatment span of 7 years that proceeded through full-dose re-irradiation up to metronomic therapy. The new WHO-CNS5 classification significantly impacted complex neurooncological cases, thus changing the initial approach to a more precise therapeutic management.

Fetal Surveillance in Pregnancies with Myasthenia Gravis.

Myasthenia gravis (MG) is an autoimmune condition, that commonly impacts adult women of reproductive age. Myasthenia gravis in pregnancy is rare, but the incidence is higher in different geographical areas. Pregnancies in mothers with MG can have an unfortunate outcome. Acetylcholine receptor antibodies may pass into the fetal circulation and can affect the fetal neuromuscular junction, generating transient MG or even fetal arthrogryposis. The 2016 and 2021 International Consensus Guidance for Management of Myasthenia Gravis issued by Myasthenia Gravis Foundation of America is lacking in recommendation for fetal surveillance for pregnancies in women with MG. The aim of this paper is to highlight fetal and neonatal complications in mothers with MG and to offer antenatal care insights. Close maternal and pregnancy monitoring can improve pregnancy outcome. Patients with MG should be encouraged to conceive, to avoid triggers for exacerbations of the disease during pregnancy and a multidisciplinary team should be established to ensure the optimal support and therapy.

Novel C19orf12 loss-of-function variant leading to neurodegeneration with brain iron accumulation.

Neurodegeneration with brain iron accumulation (NBIA) is a group of inherited disorders characterised by cerebral iron overload mainly in the basal ganglia. Mitochondrial membrane protein-associated neurodegeneration (MPAN) is a form of NBIA caused by pathogenic C19orf12 gene variants. We report on a Romanian patient with MPAN confirmed through exome sequencing, revealing a homozygous nonsense variant in the C19orf12 gene, NM_001031726.3: c.215T>G (p.Leu72*), that co-segregates with disease in tested relatives: the patient`s parents, younger brother and paternal uncle are heterozygous carriers. This is a novel disease-causing variant in the C19orf12 gene and the first reported MPAN case in a Romanian patient.