68 research outputs found

    Adversarial behaviours in mixing coins under incomplete information

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    Criminals can launder crypto-currencies through mixing coins, whose original purpose is preservation of privacy in the presence of traceability. Therefore, it is essential to elaborately design mixing polices to achieve both privacy and anti-money laundering. Existing work on mixing policies relies on the knowledge of a blacklist. However, these policies are paralysed under the scenario where the blacklist is unknown or evolving. In this paper, we regard the above scenario as games under incomplete information where parties put down a deposit for the quality of coins, which is suitably managed by a smart contract in case of mixing bad coins. We extend the poison and haircut policies to incomplete information games, where the blacklist is updated after mixing. We prove the existence of equilibria for the improved polices, while it is known that there is no equilibria in the original poison and haircut policies, where blacklist is public known. Furthermore, we propose a seminal suicide policy: the one who mixes more bad coins will be punished by not having the deposit refunded. Thus, parties have no incentives to launder money by leveraging mixing coins. In effect, all three policies contrast money laundering while preserving privacy under incomplete information. Finally, we simulate and verify the validity of these policies

    An Integrated Surveillance System to Examine Testing, Services, and Outcomes for Sexually Transmitted Diseases

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    Despite laws that require reporting of sexually transmitted diseases (STDs) to governmental health agencies, integrated surveillance of STDs remains challenging. Data and information about testing are fragmented from information on treatment and outcomes. To overcome this fragmentation, data from multiple electronic systems spanning clinical and public health environments were integrated to create an STD surveillance registry. Electronic health records, disease case records, and birth registry records were linked and then stored in a de-identified, secure server for use by health officials and researchers. The registry contains nearly 6 million tests for 628,138 individuals over a 12-year period. The registry supports efforts to understand the epidemiology of STDs as well as health services and outcomes for those diagnosed with STDs. Specialized disease registries hold promise for collaboration across clinical and public health domains to improve surveillance efforts, reduce health disparities, and increase prevention efforts at the local level

    Where Do People Go for Gonorrhea and Chlamydia Tests: A Cross-sectional View of the Central Indiana population, 2003-2014

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    Background Despite major efforts to control their spread, reported sexually transmitted infections (STI) are increasing. Using data from a mid-sized Midwest metropolitan area, we examined the settings in which individuals are tested for gonorrhea and chlamydia in relation to demographics and test result to determine where interventions may best be focused. Methods A de-identified and integrated registry, containing records from all patients tested for an STI from 2003-2014, was created by combining data from a large health information exchange and the reporting district’s STI Program located in Indianapolis, IN. Individual characteristics and visit settings where gonorrhea and chlamydia testing was performed were analyzed. Results We identified 298,946 individuals with 1,062,369 visits where testing occurred at least once between the ages of 13 and 44 years. Females were tested significantly more often than males and received testing more often in outpatient clinics whereas males were most often tested in the STI clinic. Individuals who utilized both STI and non-STI settings were more likely to have a positive test at an STI or ED visit (6.4% - 20.8%) than outpatient or inpatient setting (0.0-11.3%) (p<.0001). Test visits increased over the study period particularly in emergency departments, which showed a substantial increase in the number of positive test visits. Conclusions The most frequent testing sites remain STI clinics for men and outpatient clinics for women. Yet, emergency departments are increasingly a source of testing and morbidity. This makes them a valuable target for public health interventions that could improve care and population health

    Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

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    Background: The number of congenital syphilis (CS) cases in the United States are increasing. Effective prevention of CS requires routine serologic testing and treatment of infected pregnant women. The Centers for Disease Control and Prevention (CDC) recommends testing all pregnant women at their first prenatal visit and subsequent testing at 28 weeks gestation and delivery for women at increased risk. Methods: We conducted a cross-sectional cohort study of syphilis testing among pregnant women with a livebirth delivery from January 2014 to December 2016 in Marion County, Indiana. We extracted and linked maternal and infant data from the vital records in a local health department to electronic health records available in a regional health information exchange. We examined syphilis testing rates and factors associated with non-testing among women with livebirth delivery. We further examined these rates and factors among women who reside in syphilis prevalent areas. Results: Among 21260 pregnancies that resulted in livebirths, syphilis testing in any trimester, including delivery, increased from 71.7% in 2014 to 86.6% in 2016. The number of maternal syphilis tests administered only at delivery decreased from 16.6% in 2014 to 4.04% in 2016. Among women living in areas with high syphilis rates, syphilis screening rates increased from 79.6% in 2014 to 94.2% in 2016. Conclusion: Improvement in prenatal syphilis screening is apparent and encouraging, yet roughly 1-in-10 women do not receive syphilis screening during pregnancy. Adherence to recommendations set out by CDC improved over time. Given increasing congenital syphilis cases, the need for timely diagnoses and prevention of transmission from mother to fetus remains a priority for public health

    Integrating audio and visual modalities for multimodal personality trait recognition via hybrid deep learning

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    Recently, personality trait recognition, which aims to identify people’s first impression behavior data and analyze people’s psychological characteristics, has been an interesting and active topic in psychology, affective neuroscience and artificial intelligence. To effectively take advantage of spatio-temporal cues in audio-visual modalities, this paper proposes a new method of multimodal personality trait recognition integrating audio-visual modalities based on a hybrid deep learning framework, which is comprised of convolutional neural networks (CNN), bi-directional long short-term memory network (Bi-LSTM), and the Transformer network. In particular, a pre-trained deep audio CNN model is used to learn high-level segment-level audio features. A pre-trained deep face CNN model is leveraged to separately learn high-level frame-level global scene features and local face features from each frame in dynamic video sequences. Then, these extracted deep audio-visual features are fed into a Bi-LSTM and a Transformer network to individually capture long-term temporal dependency, thereby producing the final global audio and visual features for downstream tasks. Finally, a linear regression method is employed to conduct the single audio-based and visual-based personality trait recognition tasks, followed by a decision-level fusion strategy used for producing the final Big-Five personality scores and interview scores. Experimental results on the public ChaLearn First Impression-V2 personality dataset show the effectiveness of our method, outperforming other used methods

    Validation of ICD-10-CM Codes for Identifying Cases of Chlamydia and Gonorrhea

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    Background While researchers seek to use administrative health data to examine outcomes for individuals with sexually transmitted infections, the ICD-CM-10 codes used to identify persons with chlamydia and gonorrhea have not been validated. Objectives were to determine the validity of using ICD-10-CM codes to identify individuals with chlamydia and gonorrhea. Methods We utilized data from electronic health records gathered from public and private health systems from October 1, 2015 to December 31, 2016. Patients were included if they were aged 13-44 years and received either 1) laboratory testing for chlamydia or gonorrhea or 2) an ICD-10-CM diagnosis of chlamydia, gonorrhea, or an unspecified STI. To validate ICD-10-CM codes, we calculated positive and negative predictive values, sensitivity, and specificity based on the presence of a laboratory test result. We further examined the timing of clinical diagnosis relative to laboratory testing. Results The positive predictive values for chlamydia, gonorrhea, and unspecified STI ICD-10-CM codes were 87.6%, 85.0%, and 32.0%, respectively. Negative predictive values were high (>92%). Sensitivity for chlamydia diagnostic codes was 10.6% and gonorrhea was 9.7%. Specificity was 99.9% for both chlamydia and gonorrhea. The date of diagnosis occurred on or after the date of the laboratory result for 84.8% of persons with chlamydia, 91.9% for gonorrhea, and 23.5% for unspecified STI. Conclusions Disease specific ICD-10-CM codes accurately identify persons with chlamydia and gonorrhea. However, low sensitivities suggest that most individuals could not be identified in administrative data alone without laboratory test results

    Locally advanced rectal cancer with dMMR/MSI-H may be excused from surgery after neoadjuvant anti-PD-1 monotherapy: a multiple-center, cohort study

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    ObjectiveExamine patients with locally advanced rectal cancer (LARC) with deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H) who received neoadjuvant immunotherapy (nIT), and compare the outcomes of those who chose a watch-and-wait (WW) approach after achieving clinical complete response (cCR) or near-cCR with those who underwent surgery and were confirmed as pathological complete response (pCR).MethodsLARC patients with dMMR/MSI-H who received nIT were retrospectively examined. The endpoints were 2-year overall survival (OS), 2-year disease-free survival (DFS), local recurrence (LR), and distant metastasis (DM). The efficacy of programmed cell death protein-1 (PD-1) inhibitor, immune-related adverse events (irAEs), surgery-related adverse events (srAEs), and enterostomy were also recorded.ResultsTwenty patients who received a PD-1 inhibitor as initial nIT were examined. Eighteen patients (90%) achieved complete response (CR) after a median of 7 nIT cycles, including 11 with pCR after surgery (pCR group), and 7 chose a WW strategy after evaluation as cCR or near-cCR (WW group). Both groups had median follow-up times of 25.0 months. Neither group had a case of LR or DM, and the 2-year DFS and OS in each group was 100%. The two groups had similar incidences of irAEs (P=0.627). In the pCR group, however, 2 patients (18.2%) had permanent colostomy, 3 (27.3%) had temporary ileostomy, and 2 (18.2%) had srAEs.ConclusionNeoadjuvant PD-1 blockade had high efficacy and led to a high rate of CR in LARC patients with dMMR/MSI-H. A WW strategy appears to be a safe and reliable option for these patients who achieve cCR or near-cCR after nIT

    Utilization pattern of other preventive services during the US Medicare annual wellness visit

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    Annual wellness visit (AWV) was introduced for Medicare patients in 2011 to help patients stay healthy. The object of this study is to assess whether AWV have an impact on the use of other preventive services in the eligible population. Medicare claims for the full sample of beneficiaries who were continuously enrolled in fee-for-service Medicare in 2013 and 2014 were analyzed. The association between AWV and three other preventive services (depression screening [DPS], influenza virus vaccine [IVV], and sexually transmitted infection screening [STI]) were assessed. In addition, the utilization pattern of these three preventative services at AWV visit by the calendar month when beneficiaries had an AWV service was also assessed. Of 28 million eligible Medicare beneficiaries, 16.0% had AWV in 2014. The patients who had AWV had a significantly higher percentage of three preventive services than those who had no AWV: 63.8% vs. 41.6% in IVV, 4.9% vs. 0.5% in DPS, and 2.3% vs. 1.8% in STI. The percentages of beneficiaries who received IVV during an AWV visit varied significantly by calendar month: from <0.1% in June to 36.8% in October. AWV is associated with increased use of other preventive services. In addition, the association is significantly affected by type of other preventive services that may be highly related with seasonal factors

    Sexual Orientation and Related Viral Sexually Transmitted Disease Rates Among US Women Aged 15 to 44 Years

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    I used data from the 2002 National Survey of Family Growth to measure sexual orientation and viral sexually transmitted disease (STD) rates among US women aged 15 to 44 years. Sexual behavior and sexual identity data indicated that 1.3% to 1.9% of the women were lesbians and 3.1% to 4.8% were bisexual. Self-reported viral STD rates were significantly higher among bisexual women (15.0% to 17.2%) than among lesbians (2.3% to 6.7%). These findings support the need for STD prevention interventions that consider lesbians and bisexual women separately

    Saikosaponin D attenuates inflammatory response and cell apoptosis of lipopolysaccharide‐induced lung epithelial cells

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    Abstract Background Acute lung injury (ALI) is a prevalent complication of sepsis with high mortality rate. Saikosaponin D (SSD) is a triterpenoid saponin that has been reported to alleviate sepsis‐triggered renal injury in mice. Nonetheless, the therapeutic effect of SSD on sepsis‐evoked ALI is unclarified. Methods Lipopolysaccharide (LPS) from Escherichia coli 055:B5 was utilized to stimulate lung epithelial cell line MLE‐12. A mouse model of sepsis was established. CCK‐8 assay was employed for determining cytotoxicity. ELISA was utilized for determining proinflammatory cytokine production. Flow cytometry and western blotting were implemented for evaluating cell apoptosis. Hematoxylin–eosin staining was conducted for histologic analysis of murine lung tissues. Results SSD alleviated LPS‐triggered inflammation and cell apoptosis of MLE‐12 cells. SSD treatment ameliorated the pathological damages, inflammatory response, and cell apoptosis in the lungs of septic mice. Conclusion SSD protects against sepsis‐triggered ALI by inhibiting inflammation and cell apoptosis in MLE‐12 cells and septic mouse mice
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