Digital Fusion Research Articles

Comparison of Galaxy and Unix tools for analyzing the exome sequencing data from syndactyly abnormalities

Syndactyly is a congenital limb abnormality, which manifests as the fusion of digits due to incomplete separation during embryonic development, and its pathogenesis involves intricate genetic and molecular processes. Since Exome sequencing has gained widespread utilization as an invaluable tool for exploring genetic disorders during prenatal development, the Bioinformatic platforms, such as GALAXY and UNIX, play a central role in the analysis process of exome sequencing data, facilitating precise identification and interpretation of genetic variations linked to congenital abnormalities. In this study, we conducted a comparative analysis of exome sequencing data from a 1.5-year-old syndactyly patient using two platforms: GALAXY and UNIX. The UNIX platform identified a total of 275,572 variants, and the GALAXY platform identified 140,291 variants when compared with the Grch38/hg38 reference genome. A comparative analysis identified 126,848 common variants between the platforms. After filtration with the 200 syndactyly-related genes, 1,345 variants were remained. The distribution of these 1,345 variants spans the entirety of the patient's genome, with focal concentrations observed on specific chromosomes including chromosomes 2, 4, and 11. Concurrently, within the top 200 genes implicated in syndactyly, the genes FRAS1, CACNA1C, GLI2, and NOTCH1 exhibit the highest frequency of variants. These data emphasized the impact of the chosen analytical platform on genetic variation detection in congenital limb abnormalities, provided critical insights into the selection of bioinformatic tools for optimizing exome sequencing workflows in the context of limb malformations, contributed to advancements in genetic research and diagnostic methodologies.

Can the Digital Economy Reduce the Rural-Urban Income Gap?

Currently, the Chinese government is considering two major strategies, namely, developing the digital economy and achieving common prosperity, to address regional development imbalances. Using panel data from 276 Chinese cities spanning from 2011 to 2019, the article first employs the entropy method to measure China’s digital economy development, digital fusion application, and Internet accessibility. Subsequently, the paper evaluates the influence of the digital economy on regional development imbalances, focusing on the rural-urban income gap. The results show a significant reduction in the rural-urban income gap due to digital economy development. Notably, digital fusion applications have a greater impact on reducing the rural-urban income gap than Internet accessibility. In addition, a heterogeneity analysis reveals that the influence of the digital economy on the rural-urban income gap is only reflected in the eastern and western regions, with a more substantial effect observed in the western region. This study, to some extent, helps Chinese government officials distinguish the diverse impacts of different dimensions and regional variations in digital economies on the rural-urban income gap. Such insights can guide the government in strategically advancing digital economy development to accelerate the mitigation of regional disparities and achieve sustainable economic development.

Digital Inclusive Finance Helps Developing Countries Narrow the Urban-rural Income Gap Analysis——Taking China as an Example

With the rapid development of digital technology, finance, and technology integration today, a new type of large-scale financial digitization has emerged, increasing the breadth and depth of services, increasing the comfort of the financial services sector, and enabling residents to participate equally in the financial system and obtain necessary financial resources. Extensive digital financing has enabled information exchange and reduced costs. It can promote better management. The concept of digital fusion funding is an innovation in the development of traditional financing. This is a modern development vision focusing on the interests of the group. Their honesty and tolerance are of great importance to achieve social equality. Many studies have shown that the development of digital economic integration may effectively assist developing countries to reduce the revenue gap in the village. China is the largest developing country with the world's largest population. For example, China can summarize how the integration of digital economy affects urban-rural income gaps, identify problems and signs of experience in developing countries.

Research on the transformation and innovation of visual art design form based on digital fusion technology

Abstract This paper constructs a three-dimensional object visual perception space using digital fusion technology to enhance the impact of art design works. A large amount of homogeneous or different visual art design information collected is fused, and data processing and fusion methods are used to reduce redundant data, establish a reasonable knowledge base to explain the information and derive the maximum support degree. The mean square error is calculated according to the adaptive weighted data fusion, and the trust degree function and likelihood function are introduced to obtain the total trust degree of visual art design innovation types. The results show that the beauty indexes become nonlinear, the fitted correlation indices are all greater than 70%, and the digital fusion technology can prompt the artworks to be more outstanding in visual effects.

Visibility of Multisensor Digital Fusion Technology in Public Art Design under Complex Environments

Application of multisensor digital fusion technology in public art design in complex environments is deliberated to make public art design develop better. First, the more advanced sensor fusion technology is introduced into public art design, and the basic principle and system composition of multisensor fusion technology are analysed. The application of multisensor fusion technology in the field of public art is deeply analysed from multiple angles. Second, the visibility algorithm in public art design based on a fuzzy neural network (FNN) is studied, and the corresponding model is proposed. Finally, the proposed model is tested. The test results show that the root mean squared error of the model is 0.0261, the network has a good fitting effect on the output value, the similarity between the model output value and the real value is high, the fitting effect is good, the model is accurate and effective, and the identification accuracy is achieved. Moreover, the corresponding example model is proposed. The visibility development level of public art design in a region in the next 14 years is predicted. The algorithm proposed provides some ideas for the application of multisensor digital fusion technology in public art design.

Readability and Quality Assessment of Online Materials for Syndactyly Release.

Background:Syndactyly is one of the most common congenital hand malformations, involving an abnormal fusion of digits and with treatment varying according to its complexity. The internet has become a primary source of information for both families and patients with congenital hand anomalies. The purpose of this study was to evaluate both the readability and quality of available web content for syndactyly, using validated instruments.Methods:Two independent reviewers conducted searches for “Syndactyly” using three of the largest online search engines: Bing, Google, and Yahoo. The top 10 websites for each search engine, along with any webpage within one click of the parent website, were analyzed. Readability was assessed using seven established quantitative tests. The quality of the web pages was analyzed using the Discern questionnaire and handbook.Results:A total of 15 websites were included in the analysis. The average readability of all websites was equivalent to comprehension at a grade 11.3 level. The average Flesch reading ease score was 49.3 out of 100, which is considered difficult to read. Quality was assessed using Discern, a brief questionnaire consisting of 16 questions with five points attributed per question. The mean quality score using Discern was 33.3 points out of a maximum of 80 points.Conclusions:Online materials pertaining to the treatment of syndactyly far exceed the recommended sixth-grade reading level, and lack in terms of quality and comprehensiveness of information. Health care professionals should be cognizant of the paucity of available online information and provide patients with more appropriate resources.

Analysis of the Application Value of X-Ray Digital Tomographic Fusion Technique in Urinary System Diseases.

Objective To explore the application value of the X-ray digital tomographic fusion technique in the diagnosis of urinary system diseases. Methods 500 patients with suspected urinary diseases in our hospital were examined by three methods: X-ray digital tomographic fusion imaging (DTS), intravenous pyelography (IVP), and abdominal plain film (KUB), and the image quality before and after tomographic fusion was objectively evaluated. The image quality could be divided into three grades: excellent, good, and poor. Results The image excellent rate of DTS (88%) was higher than that of IVP (27.5%). The sensitivity of DTS in the diagnosis of renal cyst and space occupying of the bladder was higher than that of IVP (P < 0.05). The accuracy rate of DTS in the diagnosis of urinary calculi was 93.33%, higher than 63.3% of KUB (P < 0.001). The accuracy rate of DTS in the diagnosis of ureteral stricture was 90%, higher than 65% of IVP (P=0.03). The accuracy of DTS in the diagnosis of hydronephrosis was higher than that of IVP and KUB (P < 0.05). Conclusion In the examination of urinary system-related diseases, high-definition images can be obtained by timely using sectional fusion technology. Compared with conventional IVP, space occupying lesions such as the bladder and kidney can be displayed more clearly with the help of the tomographic fusion technique, which is helpful to improve the possibility of finding lesions and is of great significance in clinical application.

Novel HOXD13 variants in syndactyly type 1b and type 1c, and a new spectrum of TP63-related disorders.

Syndactyly is the most common limb defect depicting the bony and/or cutaneous fusion of digits. Syndactyly can be of various types depending on the digits involved in the fusion. To date, eight syndactyly-associated genes have been reported, of which HOXD13 and GJA1 have been explored in a few syndactyly but most of them have unknown underlying genetics. In the present study HOXD13, GJA1 and TP63 genes have been screened by resequencing in 24 unrelated sporadic cases with various syndactyly. The screening revealed two pathogenic HOXD13 variants, NM_000523:c.500 A > G [p.(Y167C)], and NM_000523:c.961 A > C [p.(T321P)] in syndactyly type 1b and type 1c, respectively. This is the first report to identify HOXD13 pathogenic variant in syndactyly type 1b and third report in syndactyly type 1c pathogenesis. Furthermore, this study also reports a TP63 pathogenic variant, NM_003722:c.953 G > A [p.(R318H)] in Ectrodactyly andCleft lip and palate (ECLP). In conclusion, the current study expands the clinical spectrum of HOXD13 and TP63-related disorders.

Clinical value of digital tomographic fusion imaging in the diagnosis of avascular necrosis of the femoral head in adults

BackgroundTo explore the clinical significance of digital tomographic fusion imaging in the diagnosis of avascular disease of the femoral head in adults.MethodsEighty-two adult patients with avascular necrosis of the femoral head confirmed by MRI in the department of orthopedics of our hospital were studied retrospectively. The related signs of adult avascular necrosis of the femoral head were diagnosed by digital tomographic fusion imaging, and the detection rates of digital X-ray (DR) and digital tomosynthesis (DTS) were compared to clarify the clinical value of digital tomographic fusion imaging in the diagnosis of adult avascular necrosis of the femoral head.ResultsDTS detected DR and 78 cases identified 55 cases. Taking the results of CT/MRI as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of DR and DTS in the diagnosis of ANFH were calculated. There was a significant difference in the detection rate between the two methods (P < 0.05).ConclusionThe digital tomographic fusion imaging technique has the advantages of high detection rate and excellent image quality, is economical, and is worth popularizing. For those with negative X-rays, DTS diagnosis and CT or/and MRI can avoid unnecessary CT and MRI examinations, which is helpful to reduce the waste of medical resources.

The five digits of the giraffe metatarsal

AbstractEvolution has shaped the limbs of hoofed animals in specific ways. In artiodactyls, it is the common assumption that the metatarsal is composed of the fusion of digits III and IV, whereas the other three digits have been lost or are highly reduced. However, evidence from the fossil record and internal morphology of the metatarsal challenges these assumptions. Furthermore, only a few taxonomic groups have been analysed. In giraffes, we discovered that all five digits are present in the adult metatarsal and are highly fused and modified rather than lost. We examined high-resolution micro-computed tomography scans of the metatarsals of two mid and late Miocene giraffid fossils and the extant giraffe and okapi. In all the Giraffidae analysed, we found a combination of four morphologies: (1) four articular facets; (2) four or, in most cases, five separate medullary cavities internally; (3) a clear, small digit I; and (4) in the two fossil taxa of unknown genus, the presence of external elongated grooves where the fusions of digits II and V have taken place. Giraffa and Okapia, the extant Giraffidae, show a difference from all the extinct taxa in having more flattened digits tightly packed together, suggesting convergent highly fused digits despite divergent ecologies and locomotion. These discoveries provide evidence that enhances our understanding of how bones fuse and call into question current hypotheses of digit loss.

디지털 패브리케이션을 위한 디지털 융합 디자인 프로세스 합리화 과정에 관한 연구

디지털 패브리케이션을 위한 디지털 융합 디자인 프로세스 합리화 과정에 관한 연구

Development of digital breast tomosynthesis and diffuse optical tomography fusion imaging for breast cancer detection

Diffuse optical tomography (DOT) non-invasively measures the functional characteristics of breast lesions using near infrared light to probe tissue optical properties. This study aimed to evaluate a new digital breast tomosynthesis (DBT)/DOT fusion imaging technique and obtain preliminary data for breast cancer detection. Twenty-eight women were prospectively enrolled and underwent both DBT and DOT examinations. DBT/DOT fusion imaging was created after acquisition of both examinations. Two breast radiologists analyzed DBT and DOT images independently, and then finally evaluated the fusion images. The diagnostic performance of each reading session was compared and interobserver agreement was assessed. The technical success rate was 96.4%, with one failure due to an error during DOT data storage. Among the 27 women finally included in the analysis, 13 had breast cancer. The areas under the receiver operating characteristic curve (AUCs) for DBT were 0.783 and 0.854 for readers 1 and 2, respectively. DOT showed comparable diagnostic performance to DBT for both readers. The AUCs were significantly improved (P = 0.004) when the DBT/DOT fusion images were used. Interobserver agreements were highest for the DBT/DOT fusion images. In conclusion, this study suggests that DBT/DOT fusion imaging technique appears to be a promising tool for breast cancer diagnosis.

Behavioural effects of extracellular matrix protein Fras1 depletion in the mouse.

Fras1 is an extracellular protein of the basement membranes that surround embryonic epithelia, choroid plexuses and meninges in foetal mouse brain. Depletion of Fras1 in knockout mice results in sub-epidermal blistering and fusion of eyelids and digits as well as malformation of lungs and kidneys. Mutations in the human counterpart FRAS1 are responsible for the Fraser Syndrome with clinical manifestations similar to the murine phenotype. In addition, brain deformities or mental impairments have occasionally been reported in patients with Fraser Syndrome. In the present study, we explored the possible involvement of Fras1 in brain function, analysing its expression pattern in mouse brain and investigating aspects of Fras1-/- mice behaviour, related to the function of brain regions expressing Fras1. Transcripts were detected in choroid plexuses and in certain brain regions including cortical, hippocampal and amygdalar areas in juvenile mice. Behavioural tests revealed that Fras1-/- mice exhibit impaired egocentric spatial memory, aberrant olfactory learning and memory, markedly reduced fear memory in an auditory fear conditioning task, as well as reduced anxiety expression in open field and elevated plus maze tests. Moreover, the extracellular matrix organization has been severely affected in cortical and subcortical areas as demonstrated by Wisteria floribunda agglutinin immunolabelling. The widespread detection of Fras1 transcripts in the brain of both pre- and postnatal mice, as well as the behavioural and cellular disturbances exhibited by Fras1-/- adult mice provide evidence for the involvement of Fras1 in brain organization and function.

Epithelial Migration and Non-adhesive Periderm Are Required for Digit Separation during Mammalian Development.

The fusion of digits or toes, syndactyly, can be part of complex syndromes, including van der Woude syndrome. A subset of van der Woude cases is caused by dominant-negative mutations in the epithelial transcription factor Grainyhead like-3 (GRHL3), and Grhl3-/-mice have soft-tissue syndactyly. Although impaired interdigital cell death of mesenchymal cells causes syndactyly in multiple genetic mutants, Grhl3-/- embryos had normal interdigital cell death, suggesting alternative mechanisms for syndactyly. We found that in digit separation, the overlying epidermis forms a migrating interdigital epithelial tongue (IET) when the epithelium invaginates to separate the digits. Normally, the non-adhesive surface periderm allows the IET to bifurcate as the digits separate. In contrast, in Grhl3-/- embryos, the IET moves normally between the digits but fails to bifurcate because of abnormal adhesion of the periderm. Our study identifies epidermal developmental processes required for digit separation.

Platform tilt stabilisation using inertial measurement unit sensor

This paper aims to develop a low cost two-axis pan-tilt platform stabilisation setup using a low-cost inertial measurement unit (IMU) sensor, utilise elegant and widely used sensor fusion and control algorithm, and demonstrate the performance of such a system. The IMU sensor and the other components for the two-axis platform setup are selected initially based on the design calculations and the platform stabiliser setup is then designed and manufactured in accordance with the selected components. To perform platform stabilisation, reliable pan-tilt angular estimates are required from the IMU sensor. For this purpose, techniques such as sensor bias removal, digital low pass filter (DLPF) and sensor fusion algorithms are deployed considering the robustness of their performance in the real-time embedded hardware. First-order impulse response (FIR) filter is chosen as the DLPF algorithm and the complementary filter (CF) is chosen as the sensor fusion algorithm as these are widely recognised for their need of very less computational power. Finally, the pan-tilt stabilisation is performed by two separate PID servo control tuned using Zeigler-Nichols manual tuning rules and finally the performance of the control system in tracking the angular estimates is finally studied.

Research of “double desserts” seismic prediction method for tight sandstone - Taking Linxing block on the east edge of Ordos Basin as an example

The determination of the sweet spot of tight sandstone reservoir is the primary problem in the exploration and development of tight sandstone reservoir. Practice has proved that the prediction of reservoir spatial pore characteristics, thickness distribution and oil and gas potential (i.e. geological sweet spot) of tight sandstone reservoir can not meet the demand of exploration and development of tight sandstone reservoir. In view of the requirements of tight sandstone fracturing engineering, it is also necessary to analyze the engineering field of the reservoir. In this paper, based on seismic data preprocessing and petrophysical analysis, thin reservoir quantitative characterization and AVO fluid prediction are used to evaluate the tight reservoir. At the same time, combining with the fracture analysis method of FMI imaging logging, pre stack fracture description and brittleness prediction, the “engineering sweet spot” prediction is carried out. Finally, the multi-attribute RGB digital fusion visualization research method is used to comprehensively evaluate the tight reservoir. The practice shows that the research method has guiding significance for the exploration and development of tight reservoir.

Convergence and digital fusion lead to competitive differentiation

PurposeOrganizations are consistently seeking innovative strategies and novel pathways to enhance business processes and create differentiation. The global business ecosystem is changing and there is growing demand for multi-modal digital technologies, big data consolidation and data analytics to harness a cost-competitive agile system. Technological convergence and integration of digital systems is one of the preferred methodologies that facilitates new and effective workflows and revives business processes. The progressive interlinking of digital technologies with business operations leads to the convergence and blending of management disciplines, devices and applications. The growing inconsistencies in managerial understanding regarding the benefits of convergence prompts a comprehensive examination of digital convergence pathways, identifying the impacts on converging entities and business objectives. The State bank of India (SBI) mega-merger case study was selected to investigate the pragmatic framework of digital convergence and to understand the impacts on interlinked entities such as: business operations, strategic management, project team that support value creation and competitive differentiation. The purpose of this paper is to focus on the phenomena of techno-fusion of emerging technologies creating new opportunities, business models and unique strategies for global banking and financial service organizations.Design/methodology/approachThis study applies the qualitative, inductive research method using critical reflection of before and after the implementation of convergence and digital integration strategies. The SBI case study employs this research strategy based on the premise that banks must stay agile and highly responsive to the changing environment to enhance its value proposition and competitive differentiation objectives. The study methodology incorporates cooperative inquiry and multiple levels of analysis using data collection techniques of exhaustive review of archives, informal interviews, questionnaires and observations to identify the synergistic process improvement pathway. The study is grounded on the concept that the convergence of diverse business pathways involves innovative and interlinked project, strategic and information technology (IT) workflows that results in open innovative systems.FindingsThe studies identify that organizational innovation and creative solutions are a result of ecosystem turbulence, environmental force diversity, competitive pressure and the need for differentiation. Organizations that harness the power of digital fusion and convergence of management, systems and data generate a competitive advantage. The technological convergence strategy pulls multiple business and technology processes (project, strategic, IT, Cloud, AI and business process management) at the organizational, divisional or functional level generating new opportunities and threats, new business models and unique growth strategies for global banking and financial services organizations. Organizations that fully integrate techno-fusion of business and digital strategies produce synergistic effects and enhance adaptability, innovation and resiliency in the face of competitive challenges.Research limitations/implicationsAdditional areas that can be explored further as an extension of this study are listed below: identifying factors to improve the speed of convergence; the current results are limited to large size organizations where formal management and technology functions are distinctive. Similar studies on smaller organizations are warranted.Originality/valueThis study focuses on the evolving field of technology innovation, which is increasingly being intertwined with business operations. Innovative digital technology is enabling the convergence of the disciplines of management, digital devices and applications. This facilitates the creation of a pragmatic framework that supports convergence of business operations, strategic management and digital fusion which leads to value creation and competitive differentiation. The techno-fusion of emerging technologies and digital strategies generates new opportunities and threats, new business models and unique growth strategies for organizations.

Clinical application of 3D MRI in diagnosis and treatment of brachial plexus and subclavian artery compression by tumors

Objective To explore the diagnostic advantages and clinical application value of 3D MRI neurovascular fusion technique in brachial plexus with subclavian artery lesions caused by tumor compression. Methods From December 2014 to December 2017, 5 patients were treated, including 2 cases of breast cancer metastasis, 2 cases of schwannoma and 1 case of lung cancer metastasis. The pathological changes of brachial plexus and subclavian artery caused by tumor compression were preliminarily considered by clinical examination, electromyography, ultrasound and CT. All the patients underwent three-dimensional reconstruction using 3D MRI neurovascular fusion technique. The abnormal condition of brachial plexus and subclavian artery was determined according to three-dimensional anatomical model, and the treatment plan was worked out. Results Three-dimensional reconstruction and digital fusion were performed in 5 patients with tumors and anatomical structures of brachial plexus and subclavian artery. The reconstructed images of blood vessels and nerves were well displayed, and the treatment plan was formulated on the basis of these images. There were 4 cases of operation and 1 case of conservative treatment. The intraoperative manifestations of the patients were consistent with the imaging manifestations, and the therapeutic effect reached the expected goal. The patients performed conservative treatment can timely understand the condition and choose other treatment options. Conclusion 3D MRI can clearly and vividly display the structure of the tumors, such as the brachial plexus and the subclavian artery, and provide the imaging basis for diagnosis and treatment. This technique can be further studied and applied. Key words: Brachial plexus; Neoplasms; 3D MRI; Subclavian artery

A novel insertion and deletion mutation in the BHLHA9 underlies polydactyly and mesoaxial synostotic syndactyly with phalangeal reduction

Mesoaxial syndactyly is characterized by fusion of the central digits. The disorder segregates in autosomal recessive pattern and mapped on human chromosome 17p13.3. Homozygous missense mutations in the BHLHA9 have been reported to cause mesoaxial synostotic syndactyly with phalangeal reduction (MSSD).In the present study, we have investigated a family segregating mesoaxial synostotic syndactyly with phalangeal reduction (MSSD) in autosomal recessive manner. Genotyping using microsatellite markers followed by Sanger sequencing revealed a homozygous deletion and insertion mutation (NM_001164405: c.252_270delinsGCA; p.(Phe85Glufs*108)) in the BHLHA9 gene in affected individuals of the family. This study reports the first frameshift mutation in the BHLHA9 causing mesoaxial synostotic syndactyly and phalangeal reduction.

Abstract P2-03-07: Digital image analysis of Ki67 in hot spots is superior to alternative proliferation associated markers in breast cancer

Abstract INTRODUCTION Proliferative activity is one of the most important prognostic parameters in cancer. During the pathological examination of breast tumors, it is routinely evaluated by a count of the number of mitoses. Adding immunohistochemical stains of the nuclear protein Ki67 provides extra prognostic and predictive information. However, the currently used methods for both of these evaluations battle imperfections, primarily in reproducibility. In this study, we make an equally broad and detailed evaluation of mitoses, Ki67 and the more recently described Phosphohistone H3 (PHH3) in primary breast cancer using digital image analysis (DIA). Furthermore, we aim to investigate the prognostic and predictive value of proliferation-associated biomarkers in breast cancer stromal cells in relation to patient outcome. MATERIALS AND METHODS Two cohorts of primary breast cancer specimens (total n=297) with clinicopathological data including &amp;gt;10 years survival data, were sectioned and stained for Ki67, PHH3 and pancytokeratin (CKMNF116) and all glass slides were digitally scanned at x20. The DIA software used was the Visiopharm Integrator System (VIS) by Visiopharm A/S, Hoersholm, Denmark. VIS operates by a 'digital fusion' method that automatically excludes non-epithelial tissue restricting the analysis of the biomarkers (Ki67 and PHH3) to CKMNF116 positive cells. Both manual and DIA scores were compared for sensitivity and specificity for the gene expression based Luminal B versus A subtype, for high versus low transcriptomic grade as well as for their prognostic value in terms of Cox regression hazard ratios and breast cancer specific and overall survival. Further, we investigated whether the expression of Ki67 in the tumors' hot spots, invasive edges or as an average across all regions should be assessed for maximum power in relation to these outcomes. In addition, by inverting the DIA algorithm run by the VIS on the same cohorts, the expression of Ki67 and PHH3 was evaluated in the tumor stromal compartment. RESULTS Regardless of tumor region, DIA of Ki67 outperformed the other markers in sensitivity and specificity for gene expression subtypes and transcriptomic grade. In contrast to mitotic counts, tumors with high expression of Ki67 as defined by DIA, had significantly increased hazard ratio for all-cause mortality within 10 years from diagnosis. DIA of Ki67 was superior to manual Ki67 and PHH3 evaluations as well as to mitotic counts in terms of separation of patients with poor versus relatively good survival. Finally, we replaced the manual mitotic counts with DIA of Ki67 in hot spots as the marker for proliferation when determining histological grade. This increased the differences in estimated mean overall survival between the highest and lowest grades and added significantly more prognostic information to the classic Nottingham histological grade. CONCLUSIONS We conclude that digital image analysis of Ki67 in hot spots should be suggested as the marker of choice for proliferative activity in breast cancer. Citation Format: Robertson S, Stålhammar G, Wedlund L, Gholizadeh S, Lippert M, Rantaleinen M, Bergh J, Hartman J. Digital image analysis of Ki67 in hot spots is superior to alternative proliferation associated markers in breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-03-07.