Detection of COVID-19 using multimodal data from a wearable device: results from the first TemPredict Study.

Early detection of diseases such as COVID-19 could be a critical tool in reducing disease transmission by helping individuals recognize when they should self-isolate, seek testing, and obtain early medical intervention. Consumer wearable devices that continuously measure physiological metrics hold promise as tools for early illness detection. We gathered daily questionnaire data and physiological data using a consumer wearable (Oura Ring) from 63,153 participants, of whom 704 self-reported possible COVID-19 disease. We selected 73 of these 704 participants with reliable confirmation of COVID-19 by PCR testing and high-quality physiological data for algorithm training to identify onset of COVID-19 using machine learning classification. The algorithm identified COVID-19 an average of 2.75 days before participants sought diagnostic testing with a sensitivity of 82% and specificity of 63%. The receiving operating characteristic (ROC) area under the curve (AUC) was 0.819 (95% CI [0.809, 0.830]). Including continuous temperature yielded an AUC 4.9% higher than without this feature. For further validation, we obtained SARS CoV-2 antibody in a subset of participants and identified 10 additional participants who self-reported COVID-19 disease with antibody confirmation. The algorithm had an overall ROC AUC of 0.819 (95% CI [0.809, 0.830]), with a sensitivity of 90% and specificity of 80% in these additional participants. Finally, we observed substantial variation in accuracy based on age and biological sex. Findings highlight the importance of including temperature assessment, using continuous physiological features for alignment, and including diverse populations in algorithm development to optimize accuracy in COVID-19 detection from wearables.

[Relevance of tumor angiogenesis in occurrence and development of breast cancer].

OBJECTIVE: To detect the differential expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD) count in benign and malignant breast lesions to clarify the correlation of VEGF expression with the occurrence and progression of breast cancer and angiogenesis. METHODS: Immunohistochemistry (SP method) was used to examine the expression of VEGF and MVD count in 88 intra-operatively harvested samples of invasive ductal breast carcinoma, 25 samples of breast carcinoma in situ, 15 samples of atypical breast hyperplasia and 100 samples of benign breast lesions obtained. RESULTS: The positive rate of VEGF in invasive ductal breast carcinoma group was 70.5% and it was significantly higher than those of benign breast lesions, atypical breast hyperplasia and breast carcinoma in situ groups ( 22.0%, 33.3% and 56.0% respectively, P = 0.000). The positive rate of VEGF with lymph node metastasis was higher than that without lymph node metastasis (P = 0.015). The positive rate of VEGF in Stages II b- III was higher than that in Stages I - II a (P = 0.006). The positive rate of VEGF in C-erbB-2 positive group was higher than that in C-erbB-2 negative group (P = 0.016). An elevated expression of VEGF was observed as the tissue differentiation degree increased (P = 0.017). The MVD value of invasive ductal breast carcinoma group was 23 +/- 15 and it was significantly higher than those of benign breast lesions, atypical breast hyperplasia and breast carcinoma in situ groups (14 +/- 4, 18 +/- 4 and 20 +/- 6 respectively, P = 0.000). In invasive ductal breast carcinoma group, a significant higher MVD value was observed as the tissue differentiation degree increased (P = 0.006). The MVD value in VEGF positive group was higher than that in VEGF negative group (P = 0.000). In invasive ductal breast carcinoma, the MVD count increased significantly with the elevated expression of VEGF (P = 0.000). CONCLUSION: In invasive ductal breast carcinoma, angiogenesis and metastasis are mediated mainly by VEGF. The expressions of VEGF and MVD may be two of reference predictors for biological behaviors of breast carcinoma The occurrence and progression of breast cancer might be correlated with the expression of VEGF. The VEGF-targeting antiangiogenic therapy is expected to become a new therapeutic modality for C-erbB-2 positive patients.

[Expression of vascular endothelial growth factor in different breast tissues and clinical significance thereof].

OBJECTIVE: To investigate the differences in the expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD) count in breast benign affection, breast atypical hyperplasia, and breast carcinoma in situ and to clarify the association of VEGF expression and MVD with the clinicopathological features of these diseases. METHODS: Immunohistochemistry (SP-method) was used to examine the expression of VEGF and MVD count in 100 samples of breast benign affection (including 35 cases of breast fibroid tumor, 35 cases of breast cystic hyperplasia, and 30 cases of intraductal papilloma), and 15 samples of breast atypical hyperplasia, and 25 samples of breast carcinoma in situ, obtained during operation. RESULTS: The positive rate of VEGF of the breast carcinoma in situ group was 56% , significantly higher than hose of the breast benign affection and breast atypical hyperplasia groups (22% and 33% respectively, P < 0.05). However, there was no significant differences in positive rate of VEGF among breast fibroid tumor, breast cystic hyperplasia, and intraductal papilloma (all P > 0.05). The MVD value of the breast carcinoma in situ group was 20.1 +/- 6.1, significantly higher than those of the breast benign affection group and breast atypical hyperplasia groups (14.3 +/- 3. 5 and 18.5 +/- 3.6 respectively, both P < 0.05). There was no significant differences in MVD value among breast fibroid tumor, breast cystic hyperplasia, and intraductal papilloma (all P > 0.05). CONCLUSION: In breast tumors, angiogenesis is probably mediated mainly by VEGF. The occurrence and progression of breast cancer may be related with the expression of VEGF.