Reference Criteria Research Articles

The diagnosis performance of convolutional neural network in the detection of pulmonary nodules: a systematic review and meta-analysis.

Pulmonary nodules are an early imaging indication of lung cancer, and early detection of pulmonary nodules can improve the prognosis of lung cancer. As one of the applications of machine learning, the convolutional neural network (CNN) applied to computed tomography (CT) imaging data improves the accuracy of diagnosis, but the results could be more consistent. To evaluate the diagnostic performance of CNN in assisting in detecting pulmonary nodules in CT images. PubMed, Cochrane Library, Web of Science, Elsevier, CNKI and Wanfang databases were systematically retrieved before 30 April 2023. Two reviewers searched and checked the full text of articles that might meet the criteria. The reference criteria are joint diagnoses by experienced physicians. The pooled sensitivity, specificity and the area under the summary receiver operating characteristic curve (AUC) were calculated by a random-effects model. Meta-regression analysis was performed to explore potential sources of heterogeneity. Twenty-six studies were included in this meta-analysis, involving 2,391,702 regions of interest, comprising segmented images with a few wide pixels. The combined sensitivity and specificity values of the CNN model in detecting pulmonary nodules were 0.93 and 0.95, respectively. The pooled diagnostic odds ratio was 291. The AUC was 0.98. There was heterogeneity in sensitivity and specificity among the studies. The results suggested that data sources, pretreatment methods, reconstruction slice thickness, population source and locality might contribute to the heterogeneity of these eligible studies. The CNN model can be a valuable diagnostic tool with high accuracy in detecting pulmonary nodules.

Head-to-Head Comparison of 18 F-FDG and 68 Ga-FAPI-04 PET/CT for Radiological Evaluation of Cervical Cancer.

We aimed to compare the potential value of 68 Ga-FAPI-04 and 18 F-FDG PET/CT in primary cervical cancer and lymph node metastases. Patients with cervical cancer underwent both 68 Ga-FAPI-04 and 18 F-FDG PET/CT. Histopathology and follow-up CT or MRI results (at least 3 months of follow-up) were used as reference criteria. Paired-sample t test was used to compare the SUV max of 18 F-FDG and 68 Ga-FAPI-04 PET/CT for cervical cancer primary lesions and metastatic lymph nodes. A total of 35 patients with a mean age of 53 ± 11 years (range, 30-76 years) were included. The detection rate of both tracers for primary tumors was 100%. There was no significant correlation between 18 F-FDG and 68 Ga-FAPI-04 for SUV max (14.5 ± 5.7 vs 15.1 ± 6.2; P = 0.645). In addition, the detection rates of 68 Ga-FAPI-04 and 18 F-FDG for lymph node metastasis were 100% and 98%, respectively. No significant difference was found in SUV max between 18 F-FDG and 68 Ga-FAPI-04 groups (7.6 ± 4.0 vs 7.0 ± 3.5; P = 0.572). Twelve false-positive lymph nodes were detected in 8 patients with 18 F-FDG PET/CT, none of which were developed on 68 Ga-FAPI-04 PET/CT. 68 Ga-FAPI-04 PET/CT has a high tracer rate for the diagnosis of primary cervical cancer and lymph node metastases. Moreover, 68 Ga-FAPI-04 PET/CT also showed good results in distinguishing metastatic lymph nodes from reactive lymph nodes of cervical cancer.

Assessment of the performance of the body mass index in diagnosing obesity in community-dwelling older adults in Latin American and Caribbean countries

BackgroundThe body mass index (BMI) ≥30 kg/m2 is the universally accepted cut-off point for defining obesity; however, its accuracy in classifying obesity in older adults is poorly understood. ObjectivesTo assess the performance of the BMI cut-off point ≥30 kg/m2 in classifying obesity in older adults, using the fat mass index (FMI) and fat mass percentage (FM%) as reference criteria; and to establish region- and sex-specific BMI-based cut-off points to classify obesity in older adults. MethodsThe present study is a secondary analysis derived from a cross-sectional project that included a sample of 1463 older adults from ten Latin American and Caribbean countries. Volunteers underwent total body water measurements using the deuterium dilution technique to determine FMI and FM%. Accuracy of the BMI and derived cutoff points was assessed by the area under the receiver operating characteristic curve (AUC). ResultsThe BMI cut-off point ≥30 kg/m2 had low sensitivity for classifying obesity in these older adults compared to the FMI and FM%. The AUC values for the optimal BMI-derived cut-off points showed an acceptable-to-outstanding discriminatory capacity in diagnosing obesity defined by the FMI. There was also a better balance between sensitivity and specificity than with the values obtained by a BMI ≥30 kg/m2 in older subjects in both regions. ConclusionThe BMI cut-off point ≥30 kg/m2 had poor sensitivity for accurately diagnosing obesity in older adults from two regions. The region- and sex-specific BMI-derived cut-off points for defining obesity using the FMI are more accurate in classifying obesity in older men and women subjects from both regions.

Spanish version of the self-care self-efficacy scale: A validation study in community-dwelling older adults with chronic multimorbidity

ObjectiveTo test the psychometric properties of the Spanish version of the Self-Care Self-Efficacy Scale (SCSES-Sp) in community-dwelling older adults with chronic multimorbidity. MethodsA sample of 1013 community-dwelling older adults with chronic multimorbidity participated in an observational cross-sectional study that was carried out in 3 phases. ResultsConfirmatory factor analysis showed that the SCSES-Sp has 4 dimensions: "self-efficacy in self-care behaviours based on clinical knowledge", "self-efficacy in self-care maintenance", "self-efficacy in self-care monitoring", and "self-efficacy in self-care management". A panel of independent experts considered the content of the SCSES-Sp valid. Convergent validity analysis showed moderate-strong correlations between all of the SCSES-Sp's dimensions and the reference criteria chosen. Reliability was good for the SCSES-Sp and all its dimensions. Test-retest reliability analysis showed that the SCSES-Sp was temporally stable. ConclusionsThe SCSES-Sp is a valid and reliable tool to assess self-efficacy in self-care in Spanish-speaking, community-dwelling older adults with chronic multimorbidity.

Diagnostic performance of SARC-F and SARC-CalF in screening for sarcopenia in older adults in Northern Brazil

To compare the performance of SARC-F and SARC-CalF as screening tools for sarcopenia. Cross-sectional study with a convenience sample of 312 community-dwelling older people. Sarcopenia was defined as low handgrip strength (HGS) or low gait speed (GS ≤ 0.8 m/s). HGS was measured by dynamometry and GS by the 4-m walking speed test. For HGS, six criteria (C) were used to identify sarcopenia in men/women: CI: < 27 kg/16 kg; CII: < 35.5 kg/20.0 kg; CIII: grip over body mass index < 1.05/< 0.79; CIV: grip strength over total body fat < 1.66/< 0.65; CV: grip over bodyweight < 0.45/< 0.34; CVI: < 27 kg/16 kg and low skeletal muscle mass index (SMMI); CI and CVI defined according to the European Working Group on sarcopenia in older people and the rest according to the sarcopenia definition and outcomes Consortium. For sarcopenia screening, the SARC-F (≥ 4 points) and the SARC-CalF (≥ 11 points) were used. The kappa analysis revealed no agreement between the SARC-F and the various criteria for the identification of sarcopenia in men. The same lack of agreement was observed in women with some exceptions: CI = 0.161 ± 0.074, p = 0.020; GS = 0.209 ± 0.076, p = 0.003. Concerning the Cohen’s kappa between the SARC-Calf and the reference criteria of sarcopenia, the following coefficients were observed as significant for women: CI = 0.201 ± 0.069, p = 0.003; CII = 0.186 ± 0.064, p = 0.005; GS = 0.273 ± 0.068, p = 0.0001; and for men: CII = 0.139 ± 0.053, p = 0.021; GS = 0.223 ± 0.099, p = 0.011. ROC curves revealed the SARC-Calf with acceptable discrimination and reasonable sarcopenia predictive capacity considering a cutoff value of 10.5 in both men (AUC: 67.5%, p = 0.022; Se = 52.9%; Sp = 76.8%) and women (AUC: 72.4%, p < 0.001; Se = 63%; Sp = 68.5%) concerning GS. The SARC-CalF performed better than the SARC-F for screening sarcopenia in the population ≥ 60 years of age in the Amazonas, measured through walking slowness.

Fish welfare during slaughter: the European Council Regulation 1099/09 application.

The Treaty of Lisbon states that animals are sentient beings. Fish species show physiological differences from terrestrial animals and are slaughtered and killed in a very different context. Many existing commercial killing methods expose fish to extensive suffering over a prolonged period of time, and some of the slaughtering practices they experience can cause pain and distress. This study highlights the limited feasibility of European Council Regulation 1099/09 requirements on welfare when killing cephalopods and crustaceans. Sentience is the animal's capacity to have positive (comfort, excitement) and negative (pain, anxiety, distress, or harm) feelings. Considerable evidence is now showing that the major commercial fish species, including cephalopods and crustaceans, possess complex neurological substrates supporting pain sensitivity and conscious experiences. In the legislation applied to scientific procedures, the concept of sentience in these species is important. Therefore, it would be appropriate to acknowledge current scientific evidence and establish reference criteria for fish welfare. For the welfare of fish species during slaughter, European Council Regulation 1099/09 applicability is limited. Fish welfare during slaughter is more than just an ethical problem. According to the One-Health approach, food safety should also include the concept of sentience for fish welfare. Pending studies that dispel all doubt, the precautionary principle of European Council Regulation 178/04 remains valid and should be applied to fish welfare.

Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project)

ObjectivesNo consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on...

THE STUDENTS’ RESPONSES IN IMPLEMENTING LEARNING MEDIA INNOVATION DIGITAL LITERACY BASED ON LOCAL WISDOM FOR ONLINE CLASS TO IMPROVE LISTENING AND WRITING SKILLS AT INFORMATION SYSTEM EDUCATIONAL PROGRAM OF ITB STIKOM BALI

The product of Digital Literacy as a Learning Media Innovation for Online Class to Improve Listening and Writing skill of Students in information systems education program at ITB STIKOM Bali has been accomplished, and this research is the continuous of that research especially in the implementation part. Researcher would like to know the effectiveness of the listening product that have been developed. Data was collected by means of documentation, interviews, and questionnaires. The data collected was analyzed quantitatively to determine the average score, where the average score was categorized based on the evaluation table of reference criteria and qualitatively as a description of the score results obtained. The results from the users’ judgement evaluation got the mean score in the aspect content, language, and presentation was 3,6 which belonged to the very good category. The mean score based on the graphic aspect was 3,6 which belonged the very good category. From the students’ perception, the mean score was 3,75 which belonged the very good category. It showed that the media developed by researcher was very good and appropriate used for improving listening skill of students in information systems education program at ITB STIKOM Bali.

Accuracy of Sensor-Based Measurement of Clinically Relevant Motor Activities in Daily Life of Children With Mobility Impairments

ObjectiveThis study aimed to determine the accuracy of 3 sensor configurations and corresponding algorithms deriving clinically relevant outcomes of everyday life motor activities in children undergoing rehabilitation. These outcomes were identified in 2 preceding studies assessing the needs of pediatric rehabilitation. The first algorithm estimates the duration of lying, sitting, and standing positions and the number of sit-to-stand transitions with data from a trunk and a thigh sensor. The second algorithm detects active and passive wheeling periods with data from a wrist and a wheelchair sensor. The third algorithm detects free and assisted walking periods and estimates the covered altitude change during stair climbing with data from a single ankle sensor and a sensor placed on walking aids. DesignThe participants performed a semi-structured activity circuit while wearing inertial sensors on both wrists, the sternum, and the thigh and shank of the less-affected side. The circuit included watching a movie, playing, cycling, drinking, and moving around between facilities. Video recordings, which 2 independent researchers labeled, served as reference criteria to determine the algorithms’ performance. SettingIn-patient rehabilitation center. ParticipantsThirty-one children and adolescents with mobility impairments who were able to walk or use a manual wheelchair for household distances (N=31). InterventionsNot applicable. Main Outcome Measure(s)The algorithms’ activity classification accuracies. ResultsThe activity classification accuracy was 97% for the posture detection algorithm, 96% for the wheeling detection algorithm, and 93% for the walking detection algorithm. Conclusion(s)The 3 sensor configurations and corresponding algorithms presented in this study revealed accurate measurements of everyday life motor activities in children with mobility impairments. To follow-up on this promising results, the sensor systems needs to be tested in long-term measurements outside the clinic before using the system to determine the children's motor performance in their habitual environment for clinical and scientific purposes.

Validation of an accelerometer system for measuring physical activity and sedentary behavior in healthy children and adolescents

The study aims to assess the concurrent validity of the SENS motion® accelerometer system for device-based measurement of physical activity and sedentary behavior in healthy children and adolescents. Thirty-six healthy children and adolescents (mean ± standard deviation (SD) age, 10.2 ± 2.3 years) were fitted with three SENS sensors while performing standardized activities including walking, fast walking, sitting/lying, and arm movements. Data from the sensors were compared with video observations (reference criteria). The agreement between SENS motion® and observation was analyzed using Student’s t-test and illustrated in Bland–Altman plots. The concurrent validity was further evaluated using intraclass correlation coefficient (ICC) and was expressed as standard error of measurement (SEM) and minimal detectable change (MDC). Strong agreement was found between SENS and observation for walking time, sedentary time, and lying time. In contrast, moderate agreement was observed for number of steps, sitting time, and time with and without arm movement. ICC2.1 values were overall moderate to excellent (0.5–0.94), with correspondingly low SEM% for walking time, sedentary time, lying time, and time with arm movement (2–9%). An acceptable SEM% level was reached for both steps and sitting time (11% and 12%). For fast walking time, the results showed a weak agreement between the measurement methods, and the ICC value was poor.Conclusion: SENS motion® seems valid for detecting physical activity and sedentary behavior in healthy children and adolescents with strong agreement and moderate to excellent ICC values. Furthermore, the explorative results on arm movements seem promising.What is Known:• Inactivity and sedentary behavior follow an increasing trend among children and adolescents.• SENS motion®seems to be valid for measuring physical activity and sedentary behavior in adults and elderly patients.What is New:• SENS motion®seems valid with strong agreement between video observations and SENS measurement, and ICC values are moderate to excellent when measuring physical activity and sedentary behavior in healthy children and adolescents.• SENS motion®seems promising for detection of arm movements.

Establishing Geomorphic Reference Criteria for Design of River Diversions Around Mine Pits in the Pilbara, Western Australia

The poor condition of river diversion channels can prevent mining companies from relinquishing their mine to the government after mining has ceased. Many regions lack a locally derived template for integrating appropriate geomorphic and hydraulic conditions from unmodified river channels into river diversion designs to help guide post-mining closure activities. Establishing baseline geomorphic reference criteria for unmodified catchments can guide restoration efforts to allow recovery and stability of the fluvial system. Design-wise, channels should be built so that flow conditions are able to move sediment, but not high enough to accelerate erosion in the channel. We used natural headwater channels to inform a regional guide for geomorphic criteria for artificial channels constructed in the Pilbara, Western Australia. We provide guideline hydraulic criteria for specific channel types, including velocity, stream power, and bed shear stress values for five key channel types: alluvial single thread (≥ cobble) and single thread (sand), bedrock/confined channel sections, island-barform channels, and heavily vegetated channels.

Accuracy of Point-of-Care Blood Glucometers in Neonates and Critically Ill Adults

Inpatient glycemic management has become a common issue because of the increasing number of hospitalized patients with hyperglycemia. Point-of-care devices can enable timely inpatient glucose monitoring, which may lead to better outcomes. The accuracy of point-of-care testing in various clinical scenarios has been questioned, particularly in neonates and critically ill patients. This study aimed to evaluate the accuracy of the CONTOUR PLUS and CONTOUR PLUS ONE glucometers (new wireless systems that link to a smart mobile device) when used as point-of-care devices for blood glucose monitoring in neonates and critically ill adults in inpatient settings. This cross-sectional study was conducted at a medical center in central Taiwan and enrolled patients admitted to the neonatal intensive care unit, sick child room, or respiratory intensive care unit between November 2020 and April 2021. Neonates with suspected infection or abnormal blood coagulation and adults who had abnormal blood coagulation, were pregnant, had received organ transplants, or had undergone massive blood transfusions were excluded. The accuracy of the glucometers was determined based on the following criteria of the International Organization for Standardization (ISO) standard: 15197:2013. Overall, 114 neonates (mean age, 4.2 days [range, 0-28 days]; 65 boys [57.0%]) and 106 hospitalized critically ill adults (mean age, 68.2 years [range, 27-94 years]; 72 men [67.9%]) were enrolled in this study. The glucose values obtained with each glucometer had good precision, and all findings met the reference criteria of the within-lot results. All measurements of the neonates' venous blood by each glucometer met the accuracy criteria specified by ISO standard 15197:2013. Furthermore, 98.1% and 97.2% of the arterial blood glucose measurements for critically ill adults obtained with CONTOUR PLUS and CONTOUR PLUS ONE met the accuracy criteria, respectively. Both glucose management systems met the accuracy criteria for venous blood from neonates and arterial blood from critically ill adults. Thus, the use of these 2 point-of-care devices in inpatient settings, including for neonates and critically ill adults, can be recommended to minimize limitations associated with the clinical application of point-of-care testing in glucose management. The wireless connection may play a role in the subsequent development of institution-wide virtual glycemic management under the supervision of a team of endocrinologists.

Assessing Diatom Community Dynamics in a Recovering Agricultural Stream in Middle Georgia, USA

Streams play vital roles in surrounding communities and provide essential ecosystem services. The protection of streams is important, they are legally protected under the Clean Water Act, and they can be monitored through the continuous analyses of biological data, such as algal or other aquatic communities. The goals of this study were to analyze the long-term recovery of Tobler Creek, a recovering agricultural stream on the site of a National Historic Landmark, and yield comparisons to a local low-impact stream, Murder Creek, located within the Oconee National Forest. In 2011, Tobler Creek exceeded reference criteria values for total phosphorus (TP) but met the nitrate nitrogen criteria. With an 11-year recovery period, Tobler Creek met both nutrient reference criteria. In 2022, periphyton samples were collected according to standard protocols, confirming that diatoms are the dominant algal group in the community. With recovery, Tobler Creek showed an increase in diatom species richness (χ2 = 116.11, df = 5, p &lt; 0.01) but this was significantly lower than the values documented in Murder Creek. The multi-metric index (MMI), calculated using diatom community analysis to estimate ecological health, indicated that Tobler Creek experienced degradation from 2011 to 2022 (χ2 = 55.97, df = 5, p &lt; 0.05) and is below the regional 25th percentile. The percentage of sediment-tolerant taxa (surirelloid, naviculoid, and nitzschoid) was significantly higher in Tobler Creek in 2022 (χ2 = 500.96, df = 5, p &lt; 0.01) compared to Murder Creek in 2022 (t = −4.67, df = 10, p &lt; 0.01). Despite a reduction in nutrients given the 42-year recovery period, the diatom community in Tobler Creek was significantly different than other regional protected streams. Ecological degradation of the habitat was likely driven by sedimentation due to run-off in the recovering agriculture stream. These findings highlight the importance of protecting water quality, as the recovery of nutrients can be a decades-long process overlayed with many potentially new stressors influencing aquatic organisms.

Implementation of Islamic Religious Education (PAI) Learning in the Formation of Religious Character and Social Concern Attitudes

This study uses a qualitative approach with a descriptive analysis method. (1) in-depth interviews carried out with data collection techniques, (2) participatory observation, and (3) documentation. The data analysis process starts with data collection, editing (sorting), and checking the validity of the data. To check the validity of the data, the researchers used the data triangulation method. The results of this study indicate that: 1) The religious character of students at SMA Manggala Sakti Solokuro: The students have strong faith, devotion to Allah SWT, have strong faith, adhere to Islamic law, the students have a noble character, and have good character. As for Social Care: Devotion, help, kinship, caring, cooperation, and tolerance. 2) Implementation of PAI learning in the Formation of religious character and social care at SMA Manggala Sakti Solokuro, planning in the form of syllabus, socialization, lesson plans, implementation of Islamic Religious Education (PAI) learning in shaping religious character and social care at SMA Manggala Sakti Solokuro through 2 ways, namely intracurricular and extracurricular, evaluation with authentic assessment, assessment of reference criteria, reporting of learning outcomes. 3) Factors supporting the implementation of PAI learning in shaping religious character and social awareness include: prayer room, Islamic library, loudspeakers, culture of shaking hands with teachers before entering school, strong encouragement from the teacher council, availability of the Qur'an, teaching aids and LCD in the classroom. each class, there is an on-site evaluation. While the inhibiting factors include: student association outside school, different student backgrounds, environmental factors that are less supportive, the absence of a mosque, and friends' association

Vanderbilt Mini-PROM-Breast for Breast Reconstruction: A Short-Form, Patient-Reported Outcomes Measure.

Breast reconstruction procedures are among the most commonly performed plastic surgery operations. Although there are well-validated patient-reported outcomes measures (PROMs) for breast reconstruction, there are several patient-, provider-, and service-level barriers to their implementation in routine clinical settings. Therefore, we developed a short-form PROM to evaluate breast reconstruction outcomes. Using a mixed-methods approach, the Vanderbilt Mini-PROM-Breast (VMP-B) was constructed and validated to assess patient-reported outcomes from breast reconstruction. Classic test theory methods were used to evaluate acceptability, reliability, and validity. External validation was subsequently performed using the BREAST-Q as a reference standard. The VMP-B is a 16-item instrument composed of three domains: quality of life, body image, and breast satisfaction. Psychometric properties including acceptability, reliability, and validity exceeded reference criteria. When tested with 104 patients, the authors found significant benefits of breast reconstruction on quality of life, body image, and breast satisfaction. These results were associated with sizeable effect sizes (g) (g = 0.421, g = 0.520, and g = 1.25) demonstrative of clinically meaningful results. When tested concurrently in 70 patients, the VMP-B and the BREAST-Q showed similar results, exhibiting excellent convergent validity. The VMP-B is a validated short-form PROM that reliably assesses breast reconstruction outcomes. As a short form, the VMP-B decreases both patient and provider burden, which allows for routine, point-of-care collection of breast reconstruction outcomes.

Влияние профессиональной деятельности сотрудников органов внутренних дел на стрессоустойчивость и психофизиологические процессы организма

The specific features of the activity of ATS employees have a significant impact on the personal and psychophysiological characteristics of individuals and can lead to the development of maladaptive States. Employees subject to emotional instability, chronic emotional stress causes changes in the personality structure, manifested in the strengthening of accentuation, deviant behavior, the occurrence of professional deformation. The study was conducted among the employees of the internal Affairs bodies, in the amount of 708 people sent to the Center for psychological diagnosis, for the purpose of psychoprophylactic examination. When assessing the reserves of mental and psychophysiological stability of employees, the reference criterion was the length of service in the internal Affairs bodies. The following psychodiagnostic methods were used: lüscher color test, the method of assessing the overall intellectual development of the “CAT”, standardized multifactorial method of personality research “Smith”. These methods made it possible to diagnose the presence or absence of signs of socio-mental maladjustment, the presence of accentuations and negative personal characteristics, the level of intellectual productivity. According to researches it is established that the period of service in law-enforcement bodies from 6 to 10 years is critical when there is a critical accumulation of emotional tension, and as a result — psychological mechanisms of protection of an organism weaken, owing to it functional violations in a state of health increase, psychosomatic diseases are formed. The objective of this study was to identify the characteristics of the personality of employees of the internal Affairs bodies, which are more exposed to the development of the state of maladjustment in the process of official activity. As these factors, the stability of the emotional sphere and the stability of the functional reserves of the body were considered.

The Role of Social Awareness in Growth and Development in Early Childhood

Social awareness of early childhood is the awareness and ability of a child to socialize or interact with other people in a social context in a certain way that is acceptable. Early childhood is also referred to as the golden age, because at that age, children's physical and motor abilities develop and grow very quickly. Children begin to be sensitive to receiving stimulation. Therefore, social awareness of early childhood must be optimally developed. This study aims to collect various references related to social awareness in early childhood. This research is a literacy study, where articles are obtained through the DOAJ (Directory of Open Access Journals) website, Academia Edu, Google Classroom, and ScienceDirect. The reference criteria used are references published between 2005-2022. Based on various references that have been collected, social awareness has an important role in the life of the child itself. This is because social awareness in early childhood can affect their further development.

Abstract P6-02-05: Prevalence of non-BRCA germline pathogenic variants in Mexican women with breast cancer referred for genetic cancer risk assessment

Abstract Background: The prevalence of germline pathogenic variants in Mexican women with breast cancer who met the reference criteria for genetic cancer risk assessment (GCRA) has been previously reported as close to 20%. However, information regarding the spectrum of gPVs in genes other than BRCA in this population is limited. Methods: This prospective study included Mexican women who were diagnosed with BC and met international criteria for GCRA. Participants were enrolled in the Clinical Cancer Genomics Community Research Network (CCGCRN) registry and at two referral breast cancer centers in Mexico, the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City and at the Hospital Zambrano Hellion TecSalud, Monterrey. Participants underwent multigene panel testing (MGPT) for 37 cancer susceptibility genes. For this analysis, only the results of pathogenic and likely pathogenic variants in the index cases were reported. The demographic and molecular characteristics of the variants are described here. Results: From August 2017 to September 2021, 1020 Mexican women with BC underwent MGPT, with a median age at diagnosis of 41 y (range 20-86), of whom 206 (20.2%) were carriers. 208 gPVs were identified with BRCA1/2 representing 70% (145/208) of the gPVs (BRCA1 n=89, BRCA2 n=56). 63 (30%) of gPVs were identified in genes other than BRCA (CHEK2 n=21, PALB2 n=13, TP53 n=7, RAD51C n=5, ATM n=4, NF1 n=3, PTEN n=2, MUTYH homozygous n=2, RAD50 n=1, BRIP1 n=1, CDH1 n=1, NBN n=1, MSH2 n=1 and MSH6 n=1). The recurrent variants previously proposed as founders in the Hispanic population were frequent among those identified in their respective genes: CHEK2 c.707T&amp;gt;C 81% (17/21), PALB2 c.2167_2168delAT 46% (6/13) and BRCA1 del(exons 9-12) 18% (16/89). As a group, the 4 most frequent genes where gPVs were identified (BRCA1, BRCA2, CHEK2 and PALB2) represented 86% (179/208) of the positive results. Conclusion: Among the variants identified in this population of Mexican women with BC, the proportion of gPVs in genes other than BRCA was significant (about 1 out of 3 pts), which justifies the use of MGPT in the assessment of our population. However, a tailored panel (sequencing of BRCA1/BRCA2/CHEK2/PALB2 and MLPA for BRCA1) could be proposed in areas of Mexico with limited medical resources, including the analysis of other genes in selected patients according to clinical suspicion and family history of cancer. Citation Format: Yanin Chavarri-Guerra, Cynthia Villareal Garza, Jose Luis Rodriguez-Olivares, Dione Aguilar-y Mendez, Gregorio Quintero-Beulo, Francisco Gutierrez-Delgado, Josef Herzog, Stephen Gruber. Prevalence of non-BRCA germline pathogenic variants in Mexican women with breast cancer referred for genetic cancer risk assessment [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-02-05.

The Chain of Custody in the Era of Modern Forensics: From the Classic Procedures for Gathering Evidence to the New Challenges Related to Digital Data

The purpose of this work is to renew the interest and attention for the chain of custody in forensic medicine, its establishment and maintenance, protecting the integrity and validity of evidence as well as to analyze how over time the establishment of the chain of custody and the collection of evidence has evolved also in function of the advent of technology and the use of electronic devices connected to the network. The analysis of the various aspects of the chain of custody demonstrates how necessary it is for the professional figures involved in the phases of the investigation (especially those who manage the evidence and who have, therefore, designated the assignment) to know the procedures to follow, trace the movement and the handling of objects subjected to seizure, also for the purposes of toxicological and/or histological investigations. The knowledge of interferences or complications helps to reduce errors and safeguard the validity of the evidence, assuring the proceeding judicial authority that the evidence is authentic and that it is, in other words, the same evidence seized at the scene of the crime. Furthermore, the issue is particularly felt today, with the recent need to guarantee the originality of digital data. Following a careful review and analysis of the literature currently available in this regard, it is worth adding that further efforts are needed to formulate internationally validated guidelines, harmonizing the different reference criteria in forensic science and medical areas, given the current absence of good international practices valid in the field and applicable both in the case of physical evidence and in the case of seizure of digital evidence.

Spatial distribution differences of cholinesterase in healthy Chinese under the influence of geographical environmental factors.

The main targets of this were to screen the factors that may influence the distribution of cholinesterase (CHE) reference value in healthy people, and further explored the geographical distribution differences of CHE reference value in China. In this study, we collected the CHE data of 17,601 healthy people from 173 cities in China to analyse the correlation between CHE and 22 geography secondary indexes through spearman regression analysis. Six indexes with significant correlation were extracted, and a ridge regression model was built, and the country's urban CHE reference value of healthy Chinese was predicted. By using the disjunctive kriging method, we obtained the geographical distribution of CHE reference values for healthy people in China. The reference value of CHE for healthy Chinese was significantly correlated with the 6 secondary indexes, namely, latitude (°), altitude (m), annual average temperature (°C), annual average relative humidity (%) and annual precipitation (mm), and topsoil sand gravel percentage (% wt). The geographical distribution of CHE values of healthy Chinese showed a trend of being higher in southeast China and lower in northwest. This study lays a foundation for further research on the mechanism of different influencing factors on the reference value of CHE index. A ridge regression model composed of significant influencing factors has been established to provide the basis for formulating reference criteria for the treatment factors of the liver damage diseases and livercancer using CHE reference values in different regions.