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Background & aimsHepatoblastoma (HB) and hepatocellular carcinoma (HCC) are the predominant liver cancers in children, though their respective treatment options and associated outcomes differ dramatically. Risk stratification using a combination of clinical, histological, and molecular parameters can improve treatment selection, but it is particularly challenging for tumors with mixed histological features, including those in the recently created hepatocellular neoplasm not otherwise specified (HCN NOS) provisional category. We aimed to perform the first molecular characterization of clinically annotated cases of HCN NOS.MethodsWe tested whether these histological features are associated with genetic alterations, cancer gene dysregulation, and outcomes. Namely, we compared the molecular features of HCN NOS, including copy number alterations, mutations, and gene expression profiles, with those in other pediatric hepatocellular neoplasms, including HBs and HCCs, as well as HBs demonstrating focal atypia or pleomorphism (HB FPAs), and HBs diagnosed in older children (>8).ResultsMolecular profiles of HCN NOS and HB FPAs revealed common underlying biological features that were previously observed in HCCs. Consequently, we designated these tumor types collectively as HBs with HCC features (HBCs). These tumors were associated with high mutation rates (∼3 somatic mutations/Mb) and were enriched with mutations and alterations in key cancer genes and pathways. In addition, recurrent large-scale chromosomal gains, including gains of chromosomal arms 2q (80%), 6p (70%), and 20p (70%), were observed. Overall, HBCs were associated with poor clinical outcomes.ConclusionsOur study indicates that histological features seen in HBCs are associated with combined molecular features of HB and HCC, that HBCs are associated with poor outcomes irrespective of patient age, and that transplanted patients are more likely to have good outcomes than those treated with chemotherapy and surgery alone. These findings highlight the importance of molecular testing and early therapeutic intervention for aggressive childhood hepatocellular neoplasms.Lay summaryWe molecularly characterized a class of histologically aggressive childhood liver cancers and showed that these tumors are clinically aggressive and that their observed histological features are associated with underlying recurrent molecular features. We proposed a diagnostic algorithm to identify these cancers using a combination of histological and molecular features, and our analysis suggested that these cancers may benefit from specialized treatment strategies that may differ from treatment guidelines for other childhood liver cancers.

The oil and gas industry remains critical to the global economy, as it contributes to the provision of energy and raw materials. Nonetheless, this sector continued to face clear challenges in operational effectiveness, risk and security. Regular tracking methods are limited to latency issues; they are not secure, and data may face integrity issues. To this end, this paper lays out an efficient fog-enabled private blockchain-based identity authentication approach for oil and gas field monitoring. By integrating IoT devices to blockchain,, decentralized control systems are created that enhance security, transparency, and efficient execution of transactions. In this scheme, by making full use of the decentralized structure of blockchain technology and applying the computational power of fog nodes, a secure and efficient identity authentication framework is designed. Fog nodes are an intermediary between IoT devices and blockchain technology, providing lower latency in communication, and therefore more efficient. The main contributions of this paper include: developing a decentralized authentication system based on private blockchains and fog nodes to overcome the drawbacks of centralized models. Create a network model using a private blockchain that dramatically improves feasibility by incorporating strict admission and authorization procedures. Hence, this leads to simultaneous registrations with minimal network time consensus Authentication that incorporating fuzzy extractor to connect the privacy-centric approach and to improve the security analysis and performance evaluation proving that the proposed solution provides better. According to the previous security analysis, it is clear that the scheme conflicts with different types of threats including DoS, MITM attacks, replay, Sybil, and message substitution attacks. The performance evaluation also shows low computational and communication costs, high compatibility, and real-time operation, which indicates that the proposed scheme is effective and can be implemented as a real-time oil and gas field monitoring system. [ABSTRACT FROM AUTHOR]

Context.--Biliary atresia (BA) patients can have portal vein (PV) abnormalities. Objective.--To investigate the explant pathology of BA patients transplanted in adulthood with a focus on portal venous abnormalities. Design.--Adult BA liver explants were reviewed, along with prior biopsies, Kasai portoenterostomy (KP), and relevant medical records. Results.--Three explants were identified; all patients were female, with age at diagnosis, KP, and liver transplantation (LT) as follows: (1) less than 1 week, 8 days, and 25 years; (2) 15 weeks, 16 weeks, and 32 years; and (3) 7 weeks, 8 weeks, and 33 years, respectively, with normalization of conjugated bilirubin within 6 months of KP and development of portal hypertension (PHTN) within 3 years of KP for all 3. The first 2 had recurrent cholangitis. Duration of pre-LT PHTN was 22, 29, and 30 years, and that of pre-LT cholangitis was 9, 3, and 0 years, respectively. All 3 explants showed hilar and extrahepatic fibromyxoid intimal hyperplasia of the PV with parenchymal hepatoportal sclerosis. Cholestasis was limited to those with a history of cholangitis. Patient 3, without cholangitis, showed delicate septal fibrosis with peripheral accentuation without biliary cirrhosis. Conclusions.--In the context of a functioning KP, cholestasis and biliary cirrhosis are likely related to recurrent cholangitis, which may or may not occur after KP. In the absence of biliary cirrhosis, PHTN may be secondary to obliterative venopathy. Adult BA explants should be sampled thoroughly, with a focus on hilar/ perihilar connective tissue to include PV branches. Explants may not show biliary cirrhosis and should be reported with appropriate clinicopathologic correlation. [ABSTRACT FROM AUTHOR]

Electronic Healthcare Record (EHR) has been actively promoted recently. Healthcare records and paperbased medical prescriptions are scattered and unorganized in medical institutions and clinics, thereby prompting many efforts to advance the EHR from traditional clinical settings to an efficient electronic medical model to regulate health records appropriately and accurately. With the development of technology and data exchange over the Internet or local networks, protecting transmitted data in healthcare records is necessary. This paper presents a secure EHR system utilizing robust authentication and RSA digital signature. We performed formal and informal security analyses utilizing the Scyther tool and the Canetti-Krawczyk (CK) model. Therefore, the proposed scheme has a higher level of security than the previous relevant work by resisting the dangers of well-known cyberattacks, such as impersonation, DoS, replay, man-in-themiddle (MITM), and insider attacks. Our work balances the security complexity and the communication cost, and the comparison tables show that the proposed scheme has the lowest communication cost. Moreover, we presented a secure prescription through a QR code generated using the prescription and the physician's RSA digital signature. [ABSTRACT FROM AUTHOR]