Wanfang Data (China)

BACKGROUND: The association of genetic polymorphisms and clopidogrel efficacy in patients with ischemic stroke or transient ischemic attack (TIA) remains controversial. We performed a systematic review and meta-analysis to assess the association between genetic polymorphisms, especially CYP2C19 genotype, and clopidogrel efficacy for ischemic stroke or TIA. METHODS: We conducted a comprehensive search of PubMed and EMBASE from their inceptions to June 24, 2016. Studies that reported clopidogrel-treated patients with stroke or TIA and with information on genetic polymorphisms were included. The end points were stroke, composite vascular events, and any bleeding. RESULTS: Among 15 studies of 4762 patients with stroke or TIA treated with clopidogrel, carriers of CYP2C19 loss-of-function alleles (*2, *3, and *8) were at increased risk of stroke in comparison with noncarriers (12.0% versus 5.8%; risk ratio, 1.92, 95% confidence interval, 1.57-2.35; P<0.001). Composite vascular events were also more frequent in carriers of CYP2C19 loss-of-function alleles than in noncarriers (13.7% versus 9.4%; risk ratio, 1.51, 95% confidence interval, 1.10-2.06; P=0.01), whereas bleeding rates were similar (2.4% versus 3.1%; risk ratio, 0.89, 95% confidence interval, 0.58-1.35; P=0.59). There was no evidence of statistical heterogeneity among the included studies for stroke, but there was for composite vascular events. Genetic variants other than CYP2C19 were not associated with clinical outcomes, with the exception that significant associations of PON1, P2Y12, and COX-1 with outcomes were observed in 1 study. CONCLUSIONS: Carriers of CYP2C19 loss-of-function alleles are at greater risk of stroke and composite vascular events than noncarriers among patients with ischemic stroke or TIA treated with clopidogrel.

OBJECTIVES: The evolution of multimorbidity describes the continuum from a healthy status to the development of a single disease and further progression to multimorbidity with additional diseases. We investigated the evolution of cardiometabolic multimorbidity and risk for mortality in a Chinese population. DESIGN: Longitudinal cohort study using data from the CHinese Electronic health Records Research in Yinzhou (CHERRY) study, with 5.43 million person-years follow-up (median 5.16 years). PARTICIPANTS: Data for 1 038 704 adults (total 22 750 deaths) were analysed. EXPOSURE: Cardiometabolic multimorbidity was defined as ever being diagnosed with two or more of three diseases: hypertension, diabetes and cardiovascular disease (CVD). PRIMARY AND SECONDARY OUTCOME MEASURES: Age-adjusted and sex-adjusted HRs were calculated for all-cause mortality. RESULTS: The cardiometabolic disease status of 105 209 (10.1%) individuals changed during the follow-up. The prevalence of cardiometabolic multimorbidity increased from 2.41% (95% CI: 2.38% to 2.44%) to 5.94% (95% CI: 5.90% to 5.99%). Baseline multimorbidity status showed the HR (95% CI) was 1.37 (1.33 to 1.42) in those with one disease, 1.71 (1.64 to 1.79) in those with two diseases and 2.22 (2.00 to 2.46) in those with three diseases. The highest HRs were observed for CVD only (3.31, 95% CI: 3.05 to 3.59) or diabetes and CVD (3.12, 95% CI: 2.37 to 4.11). Those with hypertension only had the lowest HR (1.26, 95% CI: 1.22 to 1.30). Longitudinal data showed the HRs (95% CI) in patients with one, two and three diseases were 1.36 (1.32 to 1.41), 2.03 (1.96 to 2.10) and 2.16 (2.05 to 2.29), respectively. CONCLUSIONS: The prevalence of cardiometabolic multimorbidity in a general Chinese population increased more than doubled over 5 years, indicating rapid evolution of cardiometabolic multimorbidity. A history of CVD dominates the risk for mortality. A complementary strategy for primary and secondary prevention of cardiometabolic diseases is needed in China.

INTRODUCTION: Data based on electronic health records (EHRs) are rich with individual-level longitudinal measurement information and are becoming an increasingly common data source for clinical risk prediction worldwide. However, few EHR-based cohort studies are available in China. Harnessing EHRs for research requires a full understanding of data linkages, management, and data quality in large data sets, which presents unique analytical opportunities and challenges. The purpose of this study is to provide a framework to establish a uniquely integrated EHR database in China for scientific research. METHODS AND ANALYSIS: The CHinese Electronic health Records Research in Yinzhou (CHERRY) Study will extract individual participant data within the regional health information system of an eastern coastal area of China to establish a longitudinal population-based ambispective cohort study for cardiovascular care and outcomes research. A total of 1 053 565 Chinese adults aged over 18 years were registered in the health information system in 2009, and there were 23 394 deaths from 1 January 2009 to 31 December 2015. The study will include information from multiple epidemiological surveys; EHRs for chronic disease management; and health administrative, clinical, laboratory, drug and electronic medical record (EMR) databases. Follow-up of fatal and non-fatal clinical events is achieved through records linkage to the regional system of disease surveillance, chronic disease management and EMRs (based on diagnostic codes from the International Classification of Diseases, tenth revision). The CHERRY Study will provide a unique platform and serve as a valuable big data resource for cardiovascular risk prediction and population management, for primary and secondary prevention of cardiovascular events in China. ETHICS AND DISSEMINATION: The CHERRY Study was approved by the Peking University Institutional Review Board (IRB00001052-16011) in April 2016. Results of the study will be disseminated through published journal articles, conferences and seminar presentations, and on the study website (http://www.cherry-study.org).

Abstract Purpose: Taletrectinib (DS-6051b/AB-106) is an oral, tyrosine kinase inhibitor of ROS1 and NTRK with potent preclinical activity against ROS1 G2032R solvent-front mutation among others. We report the first-in-human U.S. phase I results of taletrectinib. Patients and Methods: Patients ≥18 years old with neuroendocrine tumors, with tumor-induced pain, or tumors harboring ROS1/NTRK rearrangements were eligible. Accelerated titration followed by modified continuous reassessment method and escalation with overdose control was used (50–1,200 mg once daily or 400 mg twice daily). Primary objectives were safety/tolerability, and MTD determination. Secondary objectives were food-effect pharmacokinetics and antitumor activity. Results: A total of 46 patients were enrolled. Steady-state peak concentration (Cmax) and exposure (AUC0-8) increased dose dependently from 50-mg to 800-mg once-daily doses. The ratio of the geometric mean of AUC0-24 between low-fat-diet-fed/fasted state was 123% (90% confidence interval, 104%–149%). Dose-limiting toxicities (grade 3 transaminases increase) occurred in two patients (1,200-mg once-daily dose). MTD was 800 mg once daily. Most common treatment-related adverse events were nausea (47.8%), diarrhea (43.5%), and vomiting (32.6%). Pain score reductions were observed in the 800-mg once-daily dose cohort. Confirmed objective response rate was 33.3% among the six patients with RECIST-evaluable crizotinib-refractory ROS1+ NSCLC. One patient with TPM3-NTRK1 differentiated thyroid cancer achieving a confirmed partial response of 27 months at data cutoff. We identified a cabozantinib-sensitive ROS1 L2086F as an acquired taletrectinib-resistance mutation. Conclusions: Taletrectinib has manageable toxicities at the MTD of 800 mg daily. Preliminary efficacy was observed in patients with crizotinib-refractory ROS1+ NSCLC.

BACKGROUND AND PURPOSE: The association between oxidized low-density lipoprotein (oxLDL) and the long-term prognosis of stroke is unclear. The aim of this study is to investigate whether oxLDL levels contribute to the prognosis of stroke and stroke subtypes. METHODS: All patients with ischemic stroke were recruited from the SOS-Stroke (Study of Oxidative Stress in Patients With Acute Ischemic Stroke) and classified into 5 different subtypes, according to the TOAST criteria (Trial of Org 10172 in Acute Stroke Treatment). We measured oxLDL levels and followed up with patients at 1 year after stroke onset. We analyzed the association between oxLDL and the clinical outcomes of death and poor functional outcome (modified Rankin Scale score of 3-6) of stroke and different stroke subtypes. RESULTS: Among the 3688 patients included in this study, 293 (7.94%) were deceased at the 1-year follow-up and 1020 (27.66%) had a poor functional outcome. Patients in the highest oxLDL quartile had a higher risk of 1-year stroke mortality (hazard ratio, 1.61; 95% confidence interval, 1.10-2.33; P<0.001) and a poor functional outcome (odds ratio, 1.48; 95% confidence interval, 1.15-1.89; P<0.001) compared with the lowest oxLDL quartile. In the subgroup analyses, oxLDL was only significantly associated with death and poor functional outcome in the large-artery atherosclerosis subgroup (P<0.05) and small-artery occlusion subgroup (P<0.05). CONCLUSIONS: High levels of oxLDL were associated with the high risk of death and poor functional outcome within 1 year after stroke onset, especially in large-artery atherosclerosis and small-artery occlusion stroke subtypes.

BACKGROUND: Accurate diagnosis of peanut allergy is a significant clinical challenge. Here, a novel diagnostic blood test using the peanut bead-based epitope assay ("peanut BBEA") was developed utilizing the LEAP cohort and then validated using two independent cohorts. METHODS: The development of the peanut BBEA diagnostic test followed the National Academy of Medicine's established guidelines with discovery performed on 133 subjects from the non-interventional arm of the LEAP trial and an independent validation performed on 82 subjects from the CoFAR2 and 84 subjects from the POISED study. All samples were analyzed using the peanut BBEA methodology, which measures levels of IgE to two Ara h 2 sequential (linear) epitopes and compares their combination to a threshold pre-specified in the model development phase. When a patient has an inconclusive outcome by skin prick testing (or sIgE), IgE antibody levels to this combination of two epitopes can distinguish whether the patient is "Allergic" or "Not Allergic." Diagnoses of peanut allergy in all subjects were confirmed by double-blind placebo-controlled food challenge and subjects' ages were 7-55 years. RESULTS: In the validation using CoFAR2 and POISED cohorts, the peanut BBEA diagnostic test correctly diagnosed 93% of the subjects, with a sensitivity of 92%, specificity of 94%, a positive predictive value of 91%, and negative predictive value of 95%. CONCLUSIONS: In validation of the peanut BBEA diagnostic test, the overall accuracy was found to be superior to existing diagnostic tests for peanut allergy including skin prick testing, peanut sIgE, and peanut component sIgE testing.

Evidence for the association between long-term exposure to ozone (O3) and cause-specific cardiovascular disease (CVD) mortality is inconclusive, and this association has rarely been evaluated at high O3 concentrations. We aim to evaluate the associations between long-term O3 exposure and cause-specific CVD mortality in a Chinese population. From 2009 to 2018, 744,882 subjects (median follow-up of 7.72 years) were included in the CHinese Electronic health Records Research in Yinzhou (CHERRY) study. The annual average concentrations of O3 and fine particulate matter (PM2.5), which were estimated using grids with a resolution up to 1 × 1 km, were assigned to the community address for each subject. The outcomes were deaths from CVD, ischemic heart disease (IHD), myocardial infarction (MI), stroke, and hemorrhagic/ischemic stroke. Time-varying Cox model adjusted for PM2.5 and individual-level covariates was used. The mean of annual average O3 concentrations was 68.05 μg/m3. The adjusted hazard ratio per 10 μg/m3 O3 increase was 1.22 (95% confidence interval [CI]: 1.13–1.33) for overall CVD mortality, 1.08 (0.91–1.29) for IHD, 1.21 (0.90–1.63) for MI, 1.28 (1.15–1.43) for overall stroke, 1.39 (1.16–1.67) for hemorrhagic stroke and 1.22 (1.00–1.49) for ischemic stroke, respectively. The study showed that subjects without hypertension had a higher risk for CVD mortality associated with long-term O3 exposure (1.66 vs. 1.15, p = 0.01). We observed the association between long-term exposure to high O3 concentrations and cause-specific CVD mortality in China, independent of PM2.5 and other CVD risk factors. This suggested an urgent need to control O3 pollution, especially in developing countries.

Owing to the openness in network topology and the absence of centralised administration in management, mobile ad hoc network (MANET) is vulnerable to attacks from malicious nodes. In order to decrease the hazards from these malicious nodes, the authors incorporate the concept of trust into the MANET, and build a trust management model which is divided into two parts: subjective trust evaluation model and trusted routing model. In subjective trust evaluation model, the credibility of nodes can be evaluated using analytic hierarchy process theory and fuzzy logic rules prediction method. Based on the fuzzy dynamic programming theory, in trusted routing model, the authors present a novel trusted routing algorithm which can kick out the untrustworthy nodes in order to obtain a reliable passage delivery route. As an application of the proposed trusted routing algorithm, a novel reactive routing protocol on the basis of the standard dynamic source routing protocol, called fuzzy trusted dynamic source routing (FTDSR) protocol is proposed. Several experiments have been conducted to evaluate the efficiency of the protocol in malicious node identification and attack resistance. The experimental results show that FTDSR can effectively detect the malicious nodes that guarantee the packet delivery ratio and the network throughput.

ABSTRACT: The quality control of fetal sonographic (FS) images is essential for the correct biometric measurements and fetal anomaly diagnosis. However, quality control requires professional sonographers to perform and is often labor-intensive. To solve this problem, we propose an automatic image quality assessment scheme based on multitask learning to assist in FS image quality control. An essential criterion for FS image quality control is that all the essential anatomical structures in the section should appear full and remarkable with a clear boundary. Therefore, our scheme aims to identify those essential anatomical structures to judge whether an FS image is the standard image, which is achieved by 3 convolutional neural networks. The Feature Extraction Network aims to extract deep level features of FS images. Based on the extracted features, the Class Prediction Network determines whether the structure meets the standard and Region Proposal Network identifies its position. The scheme has been applied to 3 types of fetal sections, which are the head, abdominal, and heart. The experimental results show that our method can make a quality assessment of an FS image within less a second. Also, our method achieves competitive performance in both the segmentation and diagnosis compared with state-of-the-art methods.

Graphene/ Bi 2 WO 6 composites have been synthesized by hydrothermal reduction at 160°C for 24 h using ethanol as the reducing agent. All as‐prepared composites were characterized using X‐ray diffraction ( XRD ), UV –vis diffuse reflectance spectroscopy, FT ‐ IR spectroscopy, Raman spectroscopy, scanning electron microscopy, high‐resolution transmission electron microscopy, N 2 adsorption, and photocatalytic activity evaluation. The effective charge separation of graphene/ Bi 2 WO 6 composites was caused by the electrical conduction of graphene which is the most important factor. The results have proved the formation of interfacial contact between graphene nanosheets and Bi 2 WO 6 nanoplates. The adsorptivity for azo dyes was enhanced greatly with the introduction of graphene. The oxy‐functional groups located at the edges of graphene were responsible for the enhanced adsorptivity. As‐prepared graphene/ Bi 2 WO 6 composites exhibited enhanced light absorption from UV to visible‐light region. In addition, the introduction of graphene would also result in smaller crystalline size and lower crystallinity of Bi 2 WO 6 . Graphene/ Bi 2 WO 6 composites containing an appropriate amount of graphene were proved to exhibit higher adsorptivities and photocatalytic activities for azo dyes. High photocatalytic activities of graphene/ Bi 2 WO 6 composites were considered to be the synergetic effects of high adsorption, high light absorption, and high electrical conduction induced by the introduction of graphene.

The existing data-driven approaches typically capture credibility-indicative representations from relevant articles for fake news detection, such as skeptical and conflicting opinions. However, these methods still have several drawbacks: 1) Due to the difficulty of collecting fake news, the capacity of the existing datasets is relatively small; and 2) there is considerable unverified news that lacks conflicting voices in relevant articles, which makes it difficult for the existing methods to identify their credibility. Especially, the differences between true and fake news are not limited to whether there are conflict features in their relevant articles, but also include more extensive hidden differences at the linguistic level, such as the perspectives of emotional expression (like extreme emotion in fake news), writing style (like the shocking title in clickbait), etc., the existing methods are difficult to fully capture these differences. To capture more general and wide-ranging differences between true and fake news, in this paper, directly from the different categories of news itself, we propose a Category-controlled Encoder-Decoder model (CED) to generate examples with category-differentiated features and extend the dataset capacity to achieve data enhancement effect, thus enhancing fake news detection. Specifically, to make the generated examples enrich more news features, we develop news-guided encoder to guide relevant articles to generate news-semantic context representations. To drive the generated examples to contain more category-differentiated features, we devise category-controlled decoder which relies on pattern-shared unit to respectively capture intra-category shared features within true or fake news, and employs restriction unit to force the two types of shared features to be more different for highlighting inter-category differentiated features. The experimental results on three datasets demonstrate the superiority of CED.

AbstrakAda beberapa faktor risiko yang meningkatkan angka kejadian pneumonia di negara berkembang yaitu: kurangnya pemberian Air Susu Ibu (ASI) eksklusif, gizi buruk, polusi udara dalam ruangan, Bayi Berat Lahir Rendah (BBLR) dan kurangnya imunisasi campak. Tujuan penelitian ini adalah menentukan faktor risiko yang berhubungan dengan kejadian pneumonia pada balita di Kelurahan Air Tawar Barat, Kota Padang. Penelitian ini menggunakan desain case control study, sampel terdiri dari 27 case dan 27 control. Data dikumpulkan dengan wawancara terpimpin serta melihat data rekam medik dan dianalisis dengan uji chi-square. Hasil penelitian mendapatkan balita pada kelompok kasus yang tidak mendapatkan ASI eksklusif (81,5%), paparan asap rokok (74,1%), riwayat bayi berat lahir rendah (3,7%), tidak mendapatkan imunisasi campak (40,7%) dan gizi kurang (25,9%). Hasil analisis bivariat menunjukkan terdapat hubungan yang bermakna antara status gizi dengan kejadian pneumonia (p=0,022; OR=9,1; 95%CI=1,034-80,089), sedangkan pemberian ASI eksklusif, paparan asap rokok, riwayat bayi berat lahir rendah dan imunisasi campak tidak terdapat hubungan yang bermakna terhadap pneumonia.Kata kunci: balita, faktor risiko, pneumonia AbstractPneumonia in developing countries are associated to the risk factors such as: lack of exclusive breastfeeding, malnutrition, indoor air pollution, low birth weight and lack of measles vaccinations. The objective of this study was to determine the risk factors associated on the occurrence of pneumonia among the children under five years of age in Air Tawar Barat district, Padang City. This study used case control study to the 27 cases and 27 control. The data were collected by guided interview and the medical records, than was analyzed by chi-square.test. The results of this study obtanined in the group of cases based on the low exclusive breastfeeding rates (81.5%), exposure to cigarette smoke (74.1%), a history of low birth weight (3.7%), did not get measles vaccinations (40.7%) and malnutrition (25.9%). The result of bivariate analysis shows the significant relationship between nutritional status on the occurrence of pneumonia (p=0.022; OR=9.1; 95% CI=1.034-80.089). The exclusive breastfeeding, exposure to cigarette smoke, a history of low birth weight and measles vaccinations are not significantly related to the occurrence of pneumonia. Keywords: children under five years of age, risk factors, pneumonia

BACKGROUND AND PURPOSE: Elevated soluble CD40 ligand (sCD40L) was shown to be related to cardiovascular events, but the role of sCD40L in predicting recurrent stroke remains unclear. METHODS: Baseline sCD40L levels were measured in 3044 consecutive patients with acute minor stroke and transient ischemic attack, who had previously been enrolled in the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Cox proportional-hazards model was used to assess the association of sCD40L with recurrent stroke. RESULTS: Patients in the top tertile of sCD40L levels had increased risk of recurrent stroke comparing with those in the bottom tertile, after adjusted for conventional confounding factors (hazard ratio, 1.49; 95% confidence interval, 1.11-2.00; P=0.008). The patients with elevated levels of both sCD40L and high-sensitive C-reactive protein also had increased risk of recurrent stroke (hazard ratio, 1.81; 95% confidence interval, 1.23-2.68; P=0.003). CONCLUSIONS: Elevated sCD40L levels independently predict recurrent stroke in patients with minor stroke and transient ischemic attack. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00979589.

Abstract With the application and comprehensive development of big data technology, the need for effective research on cloud workflow management and scheduling is becoming increasingly urgent. However, there are currently suitable methods for effective analysis. To determine how to effectively manage and schedule smart cloud workflows, this article studies big data from various aspects and draws the following conclusions: Compared with the original JStorm system, the response time is shortened by a maximum of 58.26% and an average of 23.18%, CPU resource utilization is increased by a maximum of 17.96% and an average of 11.39%, and memory utilization increased by a maximum of 88.7% and an average of 71.16%. In terms of optimizing the dynamic combination of web services, the overall performance of both the MOACO and CCA algorithms is better than that of the GA algorithm, and the average performance of the MOACO algorithm is better than that of the CCA algorithm. This paper also proposes a cloud workflow scheduling strategy based on an intelligent algorithm and realizes the two-tier scheduling of cloud workflow tasks by adjusting the combination strategy for cloud service resources. We have studied three representative intelligent algorithms (ACO, PSO and GA) and improved them for scheduling optimization. It can be clearly seen that in the same scenario, the optimal values of the different algorithms vary greatly for different test cases. However, the optimal solution curve is substantially consistent with the trend of the mean curve.

UNLABELLED: The incidence of pubic lice infestations is estimated to be between 1.3% and 4.6%, with an average incidence of 2% worldwide. It is also estimated that 70% to 80% of adults now remove pubic hair in part or entirety, using a variety of methods. It is hypothesized that the destruction of this pubic hair habitat may account for the falling incidence of pubic lice and may possibly lead to its eradication or atypical presentation. AIM: To report the changing incidence of pubic lice infestation from our unit over the last 10 years and assess its association, if any, with pubic hair removal of any kind. METHODS: Assessment of medical records and questionnaires were used to identify the incidence of hair removal and pubic lice infestation over a 10-year period. Data were anonymized and analyzed to identify any correlation. RESULTS: A significant and strong correlation between the falling incidence of pubic lice infections and increase in pubic hair removal was observed, with a Pearson correlation r value of 0.9686 (95% confidence intervals, 0.88-0.992). The P value is less than 0.0001. CONCLUSIONS: The increased incidence of hair removal may lead to atypical patterns of pubic lice infestations or its complete eradication as the natural habitat of this parasite is destroyed.

Abstract Structural, morphological and optical properties of CdS films, deposited by the pulsed laser ablation technique on SnO 2 :F/glass substrates, were studied as a function of time deposition. Up to our knowledge the properties of these films grown onto conducting polycrystalline substrates have not been reported before. The photoluminescence measurements showed the existence of an exciton peak at room temperature, as an indication of good crystalline quality of the layers. A thermal treatment was applied to the samples in a 100 mT Ar atmosphere at 400 °C for 30 min after the deposition of a CdCl 2 layer on them. Films characterization was carried out through X‐ray diffraction, photoluminescence and atomic force microscopy measurements. The structural, optical and morphological properties as a function of growth parameters are presented and discussed. Thermal treatment makes uniform the grain size in the samples, with a tendency to increase the grain size average. (© 2006 WILEY‐VCH Verlag GmbH &amp; Co. KGaA, Weinheim)

Abstract Fabrication of flexible micro‐supercapacitors (MSCs) on textiles as miniaturized power supplies for wearable electronics is still a great challenge. In this work, we proposed a facile protocol to fabricate MSCs directly on textiles by combining inkjet printing and extrusion printing. Benefiting from its multi‐step printing strategy, the textile‐based MSCs still maintain their unique porous electrode structure as well as rapid electron transferability. Compared with only extrusion printing, the MSCs with a multi‐step printing strategy exhibit a remarkably enhanced electrochemical performance (8.8 mF cm −2 @0.5 mA cm −2 , 1.0 mF cm −2 @5 mF cm −2 ), an elongated cycle life (6000 times), and superior mechanical flexibility (2000 times @90°). Moreover, benefiting from the digital printing capability, flexible MSCs in serials can be directly prepared and conveniently integrated with conductive textiles to support wearable electronics systems. This simple printing method would show extensive potential in the fabrication of energy‐based devices and wearable functional electronics.

Updated American or Chinese guidelines recommended calculating atherosclerotic cardiovascular disease (ASCVD) risk using the Pooled Cohort Equations (PCE) or Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) models; however, evidence on performance of both models in Asian populations is limited. The authors aimed to evaluate the accuracy of the PCE or China-PAR models in a Chinese contemporary cohort. Data were extracted from the CHERRY (CHinese Electronic health Records Research in Yinzhou) study. Participants aged 40 to 79 years without prior ASCVD at baseline from 2010 to 2016 were included. ASCVD was defined as nonfatal or fatal stroke, nonfatal myocardial infarction, and cardiovascular death. Models were assessed for discrimination and calibration. Among 226,406 participants, 5362 (2.37%) adults developed a first ASCVD event during a median of 4.60 years of follow-up. Both models had good discrimination: C-statistics in men were 0.763 (95% confidence interval [CI]: 0.754-0.773) for PCE and 0.758 (95% CI: 0.749-0.767) for China-PAR; C-statistics in women were 0.820 (95% CI: 0.812-0.829) for PCE and 0.811 (95% CI: 0.802-0.819) for China-PAR. The China-PAR model underpredicted risk by 20% in men and by 40% in women, especially in the highest-risk groups. However, PCE overestimated by 63% in men and inversely underestimated the risk by 34% in women with poor calibration (both P < 0.001). After recalibration, observed and predicted risks by recalibrated PCE were better aligned. In this large-scale population-based study, both PCE and China-PAR had good discrimination in 5-year ASCVD risk prediction. China-PAR outperformed PCE in calibration, whereas recalibration equalized the performance of PCE and China-PAR. Further specific models are needed to improve accuracy in the highest-risk groups.

WHO has declared COVID-19 a pandemic with more than 300,000 confirmed cases and more than 14,000 deaths. There is urgent need for accurate and rapid diagnostic kits. Here we report the development and validation of a COVID-19/SARS-CoV-2 S1 serology ELISA kit for the detection of total anti-virus antibody (IgG+IgM) titers in sera from either the general population or patients suspected to be infected. For indirect ELISA, CHO-expressed recombinant full length SARS-CoV-2-S1 protein with 6* His tag was used as the coating antigen to capture the SARS-CoV-2-S1 antibodies specifically. The specificity of the ELISA kit was determined to be 97.5%, as examined against total 412 normal human sera including 257 samples collected prior to the outbreak and 155 collected during the outbreak. The sensitivity of the ELISA kit was determined to be 97.5% by testing against 69 samples from hospitalized and/or recovered COVID-19 patients. The overall accuracy rate reached 97.3%. Most importantly, in one case study, the ELISA test kit was able to identify an infected person who had previously been quarantined for 14 days after coming into contact with a confirmed COVID-19 patient, and discharged after testing negative twice by nucleic acid test. With the assays developed here, we can screen millions of medical staffs in the hospitals and people in residential complex, schools, public transportations, and business parks in the epidemic centers of the outbreaks to fish out the “innocent viral spreaders”, and help to stop the further spreading of the virus.

In secure machine learning inference, most of the schemes assume that the server is semi-honest (honestly following the protocol but attempting to infer additional information). However, the server may be malicious (e.g., using a low-quality model or deviating from the protocol) in the real world. Although a few studies have considered a malicious server that deviates from the protocol, they ignore the verification of model accuracy (where the malicious server uses a low-quality model) meanwhile preserving the privacy of both the server's model and the client's inputs. To address these issues, we propose \textit{Fusion}, where the client mixes the public samples (which have known query results) with their own samples to be queried as the inputs of multi-party computation to jointly perform the secure inference. Since a server that uses a low-quality model or deviates from the protocol can only produce results that can be easily identified by the client, \textit{Fusion} forces the server to behave honestly, thereby addressing all those aforementioned issues without leveraging expensive cryptographic techniques. Our evaluation indicates that \textit{Fusion} is 48.06$\times$ faster and uses 30.90$\times$ less communication than the existing maliciously secure inference protocol (which currently does not support the verification of the model accuracy). In addition, to show the scalability, we conduct ImageNet-scale inference on the practical ResNet50 model and it costs 8.678 minutes and 10.117 GiB of communication in a WAN setting, which is 1.18$\times$ faster and has 2.64$\times$ less communication than those of the semi-honest protocol.