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- Brännvall, Rickard, 1975-, et al.
(author)
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HEIDA : Software Examples for Rapid Introduction of Homomorphic Encryption for Privacy Preservation of Health Data
- 2023
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In: Studies in health technology and informatics. - : IOS Press. ; 302, s. 267-271
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Journal article (peer-reviewed)abstract
- Adequate privacy protection is crucial for implementing modern AI algorithms in medicine. With Fully Homomorphic Encryption (FHE), a party without access to the secret key can perform calculations and advanced analytics on encrypted data without taking part of either the input data or the results. FHE can therefore work as an enabler for situations where computations are carried out by parties that are denied plain text access to sensitive data. It is a scenario often found with digital services that process personal health-related data or medical data originating from a healthcare provider, for example, when the service is delivered by a third-party service provider located in the cloud. There are practical challenges to be aware of when working with FHE. The current work aims to improve accessibility and reduce barriers to entry by providing code examples and recommendations to aid developers working with health data in developing FHE-based applications. HEIDA is available on the GitHub repository: https://github.com/rickardbrannvall/HEIDA.
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| 2. |
- Brännvall, Rickard, 1975-, et al.
(author)
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Homomorphic encryption enables private data sharing for digital health : Winning entry to the Vinnova innovation competition Vinter 2021-22
- 2022
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In: 34th Workshop of the Swedish Artificial Intelligence Society, SAIS 2022. - : Institute of Electrical and Electronics Engineers Inc.. - 9781665471268
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Conference paper (peer-reviewed)abstract
- People living with type 1 diabetes often use several apps and devices that help them collect and analyse data for a better monitoring and management of their disease. When such health related data is analysed in the cloud, one must always carefully consider privacy protection and adhere to laws regulating the use of personal data. In this paper we present our experience at the pilot Vinter competition 2021-22 organised by Vinnova. The competition focused on digital services that handle sensitive diabetes related data. The architecture that we proposed for the competition is discussed in the context of a hypothetical cloud-based service that calculates diabetes self-care metrics under strong privacy preservation. It is based on Fully Homomorphic Encryption (FHE)-a technology that makes computation on encrypted data possible. Our solution promotes safe key management and data life-cycle control. Our benchmarking experiment demonstrates execution times that scale well for the implementation of personalised health services. We argue that this technology has great potentials for AI-based health applications and opens up new markets for third-party providers of such services, and will ultimately promote patient health and a trustworthy digital society.
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| 3. |
- Bäckström, David C, M.D. 1978-, et al.
(author)
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NfL as a biomarker for neurodegeneration and survival in Parkinson disease
- 2020
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In: Neurology. - : Wolters Kluwer. - 0028-3878 .- 1526-632X. ; 95:7, s. e827-e838
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To determine whether neurofilament light chain protein in CSF (cNfL), a sensitive biomarker of neuroaxonal damage, reflects disease severity or can predict survival in Parkinson disease (PD).METHODS: We investigated whether disease severity, phenotype, or survival in patients with new-onset PD correlates with cNfL concentrations around the time of diagnosis in the population-based New Parkinsonism in Umeå (NYPUM) study cohort (n = 99). A second, larger new-onset PD cohort (n = 194) was used for independent validation. Association of brain pathology with the cNfL concentration was examined with striatal dopamine transporter imaging and repeated diffusion tensor imaging at baseline and 1 and 3 years.RESULTS: Higher cNfL in the early phase of PD was associated with greater severity of all cardinal motor symptoms except tremor in both cohorts and with shorter survival and impaired olfaction. cNfL concentrations above the median of 903 ng/L conferred an overall 5.8 times increased hazard of death during follow-up. After adjustment for age and sex, higher cNfL correlated with striatal dopamine transporter uptake deficits and lower fractional anisotropy in diffusion tensor imaging of several axonal tracts.CONCLUSIONS: cNfL shows usefulness as a biomarker of disease severity and to predict survival in PD. The present results indicate that the cNfL concentration reflects the intensity of the neurodegenerative process, which could be important in future clinical trials.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with PD, cNfL concentrations are associated with more severe disease and shorter survival.
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| 4. |
- Bäckström, David C, M.D. 1978-, et al.
(author)
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Prediction and early biomarkers of cognitive decline in Parkinson disease and atypical parkinsonism: a population-based study
- 2022
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In: Brain Communications. - : Oxford University Press (OUP). - 2632-1297. ; 4:2
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Journal article (peer-reviewed)abstract
- Backstrom et al. report that, in a population-based cohort of patients with new-onset Parkinson disease, approximately half develop dementia within 10 years. Measurement of CSF biomarkers together with baseline cognitive function, olfaction and motor disease severity has high accuracy for predicting who will develop dementia. The progression of cognitive decline is heterogeneous in the three most common idiopathic parkinsonian diseases: Parkinson disease, multiple system atrophy and progressive supranuclear palsy. The causes for this heterogeneity are not fully understood, and there are no validated biomarkers that can accurately identify patients who will develop dementia and when. In this population-based, prospective study, comprehensive neuropsychological testing was performed repeatedly in new-onset, idiopathic parkinsonism. Dementia was diagnosed until 10 years and participants (N = 210) were deeply phenotyped by multimodal clinical, biochemical, genetic and brain imaging measures. At baseline, before the start of dopaminergic treatment, mild cognitive impairment was prevalent in 43.4% of the patients with Parkinson disease, 23.1% of the patients with multiple system atrophy and 77.8% of the patients with progressive supranuclear palsy. Longitudinally, all three diseases had a higher incidence of cognitive decline compared with healthy controls, but the types and severity of cognitive dysfunctions differed. In Parkinson disease, psychomotor speed and attention showed signs of improvement after dopaminergic treatment, while no such improvement was seen in other diseases. The 10-year cumulative probability of dementia was 54% in Parkinson disease and 71% in progressive supranuclear palsy, while there were no cases of dementia in multiple system atrophy. An easy-to-use, multivariable model that predicts the risk of dementia in Parkinson disease within 10 years with high accuracy (area under the curve: 0.86, P < 0.001) was developed. The optimized model adds CSF biomarkers to four easily measurable clinical features at baseline (mild cognitive impairment, olfactory function, motor disease severity and age). The model demonstrates a highly variable but predictable risk of dementia in Parkinson disease, e.g. a 9% risk within 10 years in a patient with normal cognition and CSF amyloid-beta(42) in the highest tertile, compared with an 85% risk in a patient with mild cognitive impairment and CSF amyloid-beta(42) in the lowest tertile. Only small or no associations with cognitive decline were found for factors that could be easily modifiable (such as thyroid dysfunction). Risk factors for cognitive decline in multiple system atrophy and progressive supranuclear palsy included signs of systemic inflammation and eye movement abnormalities. The predictive model has high accuracy in Parkinson disease and might be used for the selection of patients into clinical trials or as an aid to improve the prevention of dementia.
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| 6. |
- Forsgren, Henrik, et al.
(author)
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Homomorphic Encryption Enables Data and Algorithm Confidentiality for Remote Monitoring and Control : An Application to Data Center Systems
- 2023
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In: Companion Proceedings of the 14th ACM International Conference on Future Energy Systems. - : Association for Computing Machinery. ; , s. 85-90
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Conference paper (peer-reviewed)abstract
- The design of intelligent algorithms used for device monitoring and control can be costly and is an investment that must be protected against reverse engineering by competitors. An algorithm can be safeguarded by running remotely from the cloud instead of locally on the equipment hardware. However, such a setup requires that sensitive data is sent from the device to the cloud. Fully Homomorphic Encryption (FHE) is an emerging technology that offers a solution to this problem since it enables computation on encrypted data. A cloud service using FHE can protect its proprietary algorithms while simultaneously offering customer data confidentiality. The computational overhead for the technology is, however, still very high. This work reports on a practical investigation of using FHE for data center remote control problems: What applications are feasible today? And at what cost?
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| 7. |
- Nasr, Patrik, et al.
(author)
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A rapid, non-invasive, clinical surveillance for CachExia, sarcopenia, portal hypertension, and hepatocellular carcinoma in end-stage liver disease : the ACCESS-ESLD study protocol
- 2023
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In: BMC Gastroenterology. - : BioMed Central (BMC). - 1471-230X. ; 23:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Liver cirrhosis, the advanced stage of many chronic liver diseases, is associated with escalated risks of liver-related complications like decompensation and hepatocellular carcinoma (HCC). Morbidity and mortality in cirrhosis patients are linked to portal hypertension, sarcopenia, and hepatocellular carcinoma. Although conventional cirrhosis management centered on treating complications, contemporary approaches prioritize preemptive measures. This study aims to formulate novel blood- and imaging-centric methodologies for monitoring liver cirrhosis patients.METHODS: In this prospective study, 150 liver cirrhosis patients will be enrolled from three Swedish liver clinics. Their conditions will be assessed through extensive blood-based markers and magnetic resonance imaging (MRI). The MRI protocol encompasses body composition profile with Muscle Assement Score, portal flow assessment, magnet resonance elastography, and a abbreviated MRI for HCC screening. Evaluation of lifestyle, muscular strength, physical performance, body composition, and quality of life will be conducted. Additionally, DNA, serum, and plasma biobanking will facilitate future investigations.DISCUSSION: The anticipated outcomes involve the identification and validation of non-invasive blood- and imaging-oriented biomarkers, enhancing the care paradigm for liver cirrhosis patients. Notably, the temporal evolution of these biomarkers will be crucial for understanding dynamic changes.TRIAL REGISTRATION: Clinicaltrials.gov, registration identifier NCT05502198. Registered on 16 August 2022. Link: https://classic. CLINICALTRIALS: gov/ct2/show/NCT05502198 .
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| 8. |
- Nilsson, Johanna, 1993, et al.
(author)
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Cerebrospinal fluid biomarkers of synaptic dysfunction are altered in Parkinson's disease and related disorders
- 2023
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In: Movement Disorders. - : John Wiley & Sons. - 0885-3185 .- 1531-8257. ; 38:2, s. 267-277
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Journal article (peer-reviewed)abstract
- Background: Synaptic dysfunction and degeneration are central contributors to the pathogenesis and progression of parkinsonian disorders. Therefore, identification and validation of biomarkers reflecting pathological synaptic alterations are greatly needed and could be used in prognostic assessment and to monitor treatment effects.Objective: To explore candidate biomarkers of synaptic dysfunction in Parkinson's disease (PD) and related disorders.Methods: Mass spectrometry was used to quantify 15 synaptic proteins in two clinical cerebrospinal fluid (CSF) cohorts, including PD (n1 = 51, n2 = 101), corticobasal degeneration (CBD) (n1 = 11, n2 = 3), progressive supranuclear palsy (PSP) (n1 = 22, n2 = 21), multiple system atrophy (MSA) (n1 = 31, n2 = 26), and healthy control (HC) (n1 = 48, n2 = 30) participants, as well as Alzheimer's disease (AD) (n2 = 23) patients in the second cohort.Results: Across both cohorts, lower levels of the neuronal pentraxins (NPTX; 1, 2, and receptor) were found in PD, MSA, and PSP, compared with HC. In MSA and PSP, lower neurogranin, AP2B1, and complexin-2 levels compared with HC were observed. In AD, levels of 14-3-3 zeta/delta, beta- and gamma-synuclein were higher compared with the parkinsonian disorders. Lower pentraxin levels in PD correlated with Mini-Mental State Exam scores and specific cognitive deficits (NPTX2; rho = 0.25–0.32, P < 0.05) and reduced dopaminergic pre-synaptic integrity as measured by DaTSCAN (NPTX2; rho = 0.29, P = 0.023). Additionally, lower levels were associated with the progression of postural imbalance and gait difficulty symptoms (All NPTX; β-estimate = −0.025 to −0.038, P < 0.05) and cognitive decline (NPTX2; β-estimate = 0.32, P = 0.021).Conclusions: These novel findings show different alterations of synaptic proteins in parkinsonian disorders compared with AD and HC. The neuronal pentraxins may serve as prognostic CSF biomarkers for both cognitive and motor symptom progression in PD.
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