Unbound^(28)O,the heaviest oxygen isotope observed:a cutting-edge probe for testing nuclear models

The beyond-dripline oxygen isotopes^(27,28)O were recently observed at RIKEN,and were found to be unbound decaying into^(24)O by emitting neutrons.The unbound feature of the heaviest oxygen isotope,^(28)O,provides an excellent test for stateof-the-art nuclear models.The atomic nucleus is a self-organized quantum manybody system comprising specific numbers of protons Z and neutrons N.

Electrochemical biosensors for point-of-care testing

Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings.

Failure characterization of fully grouted rock bolts under triaxial testing

Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic stress conditions.Under these conditions,it is assumed that the intermediate principal stress(σ_(2))equals the minimum principal stress(σ_(3)).This assumption overlooks the potential variations in magnitudes of in situ stress conditions along all three directions near an underground opening where a rock bolt is installed.In this study,a series of push tests was meticulously conducted under triaxial conditions.These tests involved applying non-uniform confining stresses(σ_(2)≠σ_(3))to cubic specimens,aiming to unveil the previously overlooked influence of intermediate principal stresses on the strength properties of rock bolts.The results show that as the confining stresses increase from zero to higher levels,the pre-failure behavior changes from linear to nonlinear forms,resulting in an increase in initial stiffness from 2.08 kN/mm to 32.51 kN/mm.The load-displacement curves further illuminate distinct post-failure behavior at elevated levels of confining stresses,characterized by enhanced stiffness.Notably,the peak load capacity ranged from 27.9 kN to 46.5 kN as confining stresses advanced from σ_(2)=σ_(3)=0 to σ_(2)=20 MPa and σ_(3)=10 MPa.Additionally,the outcomes highlight an influence of confining stress on the lateral deformation of samples.Lower levels of confinement prompt overall dilation in lateral deformation,while higher confinements maintain a state of shrinkage.Furthermore,diverse failure modes have been identified,intricately tied to the arrangement of confining stresses.Lower confinements tend to induce a splitting mode of failure,whereas higher loads bring about a shift towards a pure interfacial shear-off and shear-crushed failure mechanism.

C-CORE:Clustering by Code Representation to Prioritize Test Cases in Compiler Testing

Edge devices,due to their limited computational and storage resources,often require the use of compilers for program optimization.Therefore,ensuring the security and reliability of these compilers is of paramount importance in the emerging field of edge AI.One widely used testing method for this purpose is fuzz testing,which detects bugs by inputting random test cases into the target program.However,this process consumes significant time and resources.To improve the efficiency of compiler fuzz testing,it is common practice to utilize test case prioritization techniques.Some researchers use machine learning to predict the code coverage of test cases,aiming to maximize the test capability for the target compiler by increasing the overall predicted coverage of the test cases.Nevertheless,these methods can only forecast the code coverage of the compiler at a specific optimization level,potentially missing many optimization-related bugs.In this paper,we introduce C-CORE(short for Clustering by Code Representation),the first framework to prioritize test cases according to their code representations,which are derived directly from the source codes.This approach avoids being limited to specific compiler states and extends to a broader range of compiler bugs.Specifically,we first train a scaled pre-trained programming language model to capture as many common features as possible from the test cases generated by a fuzzer.Using this pre-trained model,we then train two downstream models:one for predicting the likelihood of triggering a bug and another for identifying code representations associated with bugs.Subsequently,we cluster the test cases according to their code representations and select the highest-scoring test case from each cluster as the high-quality test case.This reduction in redundant testing cases leads to time savings.Comprehensive evaluation results reveal that code representations are better at distinguishing test capabilities,and C-CORE significantly enhances testing efficiency.Across four datasets,C-CORE increases the average of the percentage of faults detected(APFD)value by 0.16 to 0.31 and reduces test time by over 50% in 46% of cases.When compared to the best results from approaches using predicted code coverage,C-CORE improves the APFD value by 1.1% to 12.3% and achieves an overall time-saving of 159.1%.

Efficient Penetration Testing Path Planning Based on Reinforcement Learning with Episodic Memory

Intelligent penetration testing is of great significance for the improvement of the security of information systems,and the critical issue is the planning of penetration test paths.In view of the difficulty for attackers to obtain complete network information in realistic network scenarios,Reinforcement Learning(RL)is a promising solution to discover the optimal penetration path under incomplete information about the target network.Existing RL-based methods are challenged by the sizeable discrete action space,which leads to difficulties in the convergence.Moreover,most methods still rely on experts’knowledge.To address these issues,this paper proposes a penetration path planning method based on reinforcement learning with episodic memory.First,the penetration testing problem is formally described in terms of reinforcement learning.To speed up the training process without specific prior knowledge,the proposed algorithm introduces episodic memory to store experienced advantageous strategies for the first time.Furthermore,the method offers an exploration strategy based on episodic memory to guide the agents in learning.The design makes full use of historical experience to achieve the purpose of reducing blind exploration and improving planning efficiency.Ultimately,comparison experiments are carried out with the existing RL-based methods.The results reveal that the proposed method has better convergence performance.The running time is reduced by more than 20%.

SARS-CoV-2 Pooled Testing Methodology for PCR Testing Applied in Private Laboratory in Armenia

Since the beginning of COVID-19 pandemics many countries were facing challenges with testing capacity recourse limitations. Throughout the waves of the pandemic countries were trying to address the existing constrains exploring solutions to increase the testing capacity with more cost-effective approaches. Pooled methodology was one of the methods which many have validated and used. It is evident that in case of pooled sample testing the sensitivity becomes lower, however the variation highly depends on the pool size as well as the incidence rate at the certain point. Armenia as well as many other countries has adopted regulations for mandatory COVID-19 PCR testing for all the travelers. Current study aimed to explore the efficiency of COVID-19 pooled PCR testing for nasopharyngeal swabs of individuals with no symptoms in a time period with good epidemiological state of the infection. Nasopharingeal swab samples from individuals were collected. The manual extraction of RNAs of samples was performed after pooling up to 5 samples. The pools with Cycle Threshold (CT) of < 37 were considered positive and were retested individually. In total 28,015 samples were grouped in 667 pools of which 57 were positive. The total number of positive samples was 65. The median difference (CT-pool–CT samples) was 2.4 (ranging from–3.0 to 8.9). The correlation of CT of pools and positive samples was positive. The correlation coefficient r = 0.84, P < 0.000, 95% CI range 0.7423 to 0.9243). The total economic saving when using pools compared to the individual testing was 72%. The minor difference between CT values of pools and samples can be explained by the dilution effect in the pool. However, the positive correlation between the values as well as the amount of cost saving demonstrate that pooling on nasopharyngeal samples for COVID-19 PCR testing can be a good method for efficient screening with significant resource saving. One of the most important advantages of the proposed method is the fact that samples are pooled prior extraction, which avoids the possibilities with misinterpretation of IC due to low yield of RNA in the extraction process.

Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

Assessing the Spatial Equality of COVID Testing Sites Maintaining Zero COVID Policy

Rapid and timely testing is essential to minimize the COVID-19 spread. Decision makers and policy planners need to determine the equal distribution and accessibility of testing sites. This study mainly examines the spatial equality of COVID-19 testing sites that maintain a zero COVID policy in Guangzhou City. The study has identified the spatial disparities of COVID testing sites, characteristics of testing locations, and accessibility. The study has obtained information on COVID testing sites in Guangzhou City and population data. Point pattern analyses, Euclidian distance and allocation, and network analyses are the main methods used to achieve the research objectives, and 1183 total COVID testing sites can be recognized in Guangzhou City. Results revealed that spatial disparities could be noticed over the study area. Testing locations of Guangzhou City are highly clustered. The most significant testing sites are located in Haizhu District, which has the third largest population. The highest population density can be identified in Yuexiu District. However, only 94 testing sites are located there. According to all the results, higher disparities can be identified, and a lack of testing sites is located in the north part of the study area. Some people in the northern part have to travel more than 10 km to reach a testing site. Finally, this paper suggests increasing the number of testing sites in the north and south parts of the study area and keeping the same distribution, considering the area, total population, and population density. This kind of research will be helpful to decision-makers in making proper decisions to maintain a zero COVID policy.

Effectiveness of Co-Testing in Cervical Cancer Screening Program in Macao SAR

Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.

Cautionary Remarks When Testing Agreement between Two Raters for Continuous Scale Measurements: A Tutorial in Clinical Epidemiology with Implementation Using R

Background: When continuous scale measurements are available, agreements between two measuring devices are assessed both graphically and analytically. In clinical investigations, Bland and Altman proposed plotting subject-wise differences between raters against subject-wise averages. In order to scientifically assess agreement, Bartko recommended combining the graphical approach with the statistical analytic procedure suggested by Bradley and Blackwood. The advantage of using this approach is that it enables significance testing and sample size estimation. We noted that the direct use of the results of the regression is misleading and we provide a correction in this regard. Methods: Graphical and linear models are used to assess agreements for continuous scale measurements. We demonstrate that software linear regression results should not be readily used and we provided correct analytic procedures. The degrees of freedom of the F-statistics are incorrectly reported, and we propose methods to overcome this problem by introducing the correct analytic form of the F statistic. Methods for sample size estimation using R-functions are also given. Results: We believe that the tutorial and the R-codes are useful tools for testing and estimating agreement between two rating protocols for continuous scale measurements. The interested reader may use the codes and apply them to their available data when the issue of agreement between two raters is the subject of interest.

Large-scale model testing of high-pressure grouting reinforcement for bedding slope with rapid-setting polyurethane

Bedding slope is a typical heterogeneous slope consisting of different soil/rock layers and is likely to slide along the weakest interface.Conventional slope protection methods for bedding slopes,such as retaining walls,stabilizing piles,and anchors,are time-consuming and labor-and energy-intensive.This study proposes an innovative polymer grout method to improve the bearing capacity and reduce the displacement of bedding slopes.A series of large-scale model tests were carried out to verify the effectiveness of polymer grout in protecting bedding slopes.Specifically,load-displacement relationships and failure patterns were analyzed for different testing slopes with various dosages of polymer.Results show the great potential of polymer grout in improving bearing capacity,reducing settlement,and protecting slopes from being crushed under shearing.The polymer-treated slopes remained structurally intact,while the untreated slope exhibited considerable damage when subjected to loads surpassing the bearing capacity.It is also found that polymer-cemented soils concentrate around the injection pipe,forming a fan-shaped sheet-like structure.This study proves the improvement of polymer grouting for bedding slope treatment and will contribute to the development of a fast method to protect bedding slopes from landslides.

Optimality of Group Testing with Differential Misclassification

Group testing is a method that can be used to estimate the prevalence of rare infectious diseases,which can effectively save time and reduce costs compared to the method of random sampling.However,previous literature only demonstrated the optimality of group testing strategy while estimating prevalence under some strong assumptions.This article weakens the assumption of misclassification rate in the previous literature,considers the misclassification rate of the infected samples as a differentiable function of the pool size,and explores some optimal properties of group testing for estimating prevalence in the presence of differential misclassification conforming to this assumption.This article theoretically demonstrates that the group testing strategy performs better than the sample by sample procedure in estimating disease prevalence when the total number of sample pools is given or the size of the test population is determined.Numerical simulation experiments were conducted to evaluate the performance of group tests in estimating prevalence in the presence of dilution effect.

Evaluation of Interferon-Gamma Release Assay Testing and Tuberculin Skin Test for Early Diagnosis of Tuberculosis in Children and Adolescents

Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.

Detection of internal crack growth in polyethylene pipe using guided wave ultrasonic testing

Despite the success of guided wave ultrasonic inspection for internal defect detection in steel pipes,its application on polyethylene(PE)pipe remains relatively unexplored.The growth of internal cracks in PE pipe severely affects its pressure-holding capacity,hence the early detection of internal cracks is crucial for effective pipeline maintenance strategies.This study extends the scope of guided wave-based ultrasonic testing to detect the growth of internal cracks in a natural gas distribution PE pipe.Laboratory experiments and a finite element model were planned to study the wave-crack interaction at different stages of axially oriented internal crack growth with a piezoceramic transducer-based setup arranged in a pitch-catch configuration.Mode dispersion analysis supplemented with preliminary experiments was performed to isolate the optimal inspection frequency,leading to the selection of the T(0,1)mode at 50-kHz for the investigation.A transmission index based on the energy of the T(0,1)mode was developed to trace the extent of simulated crack growth.The findings revealed an inverse linear correlation between the transmission index and the crack depth for crack growth beyond 20%crack depth.

Stability and accuracy of central difference method for real-time dynamic substructure testing considering mass participation coefficient

For real-time dynamic substructure testing(RTDST),the influence of the inertia force of fluid specimens on the stability and accuracy of the integration algorithms has never been investigated.Therefore,this study proposes to investigate the stability and accuracy of the central difference method(CDM)for RTDST considering the specimen mass participation coefficient.First,the theory of the CDM for RTDST is presented.Next,the stability and accuracy of the CDM for RTDST considering the specimen mass participation coefficient are investigated.Finally,numerical simulations and experimental tests are conducted for verifying the effectiveness of the method.The study indicates that the stability of the algorithm is affected by the mass participation coefficient of the specimen,and the stability limit first increases and then decreases as the mass participation coefficient increases.In most cases,the mass participation coefficient will increase the stability limit of the algorithm,but in specific circumstances,the algorithm may lose its stability.The stability and accuracy of the CDM considering the mass participation coefficient are verified by numerical simulations and experimental tests on a three-story frame structure with a tuned liquid damper.

Testing method of rock structural plane using digital drilling

The rock mass consists of rock blocks and structural planes,which can reduce its integrity and strength.Therefore,accurately obtaining the characteristics of the rock mass structural plane is a prerequisite for evaluating stability and designing supports in underground engineering.Currently,there are no effective testing methods for the characteristic parameters of the rock mass structural plane in underground engineering.The paper presents the digital drilling technology as a new testing method of rock mass structural planes.Flawed rock specimens with cracks of varying widths and angles were used to simulate the rock mass structural planes,and the multifunctional rock mass digital drilling test system was employed to carry out the digital drilling tests.The analysis focuses on the variation laws of drilling parameters,such as drilling pressure and drilling torque,affected by the characteristics of prefabricated cracks,and clarifies the degradation mechanism of rock equivalent compressive strength.Additionally,an identification model for the characteristic parameters of rock mass structural planes during drilling is established.The test results indicate that the average difference of the characteristics of prefabricated cracks identified by the equivalent compressive strength is 2.45°and 0.82 mm,respectively.The identification model while drilling is verified to be correct due to the high identification accuracy.Based on this,a method for testing the characteristic parameters of the surrounding rock structural plane while drilling is proposed.The research offers a theoretical and methodological foundation for precise in situ identification of structural planes of the surrounding rock in underground engineering.

Determination of Material Parameters of EVA Foam under Uniaxial Compressive Testing Using Hyperelastic Models

The objective of this research was to determine the mechanical parameter from EVA foam and also investigate its behavior by using Blatz-Ko,Neo-Hookean,Mooney model and experimental test.The physical characteristic of EVA foam was also evaluated by scanning electron microscopy(SEM).The results show that Blatz-Ko and Neo-Hookean model can fit the curve at 5%and 8%strain,respectively.The Mooney model can fit the curve at 50%strain.The modulus of rigidity evaluated from Mooney model is 0.0814±0.0027 MPa.The structure of EVA foam from SEM image shows that EVA structure is a closed cell with homogeneous porous structure.From the result,it is found that Mooney model can adjust the data better than other models.This model can be applied for mechanical response prediction of EVA foam and also for reference value in engineering application.

Effectiveness of colonoscopy,immune fecal occult blood testing,and risk-graded screening strategies in colorectal cancer screening

BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.

Analysis of English Testing Based on Reliability Theory in Language Testing-Taking the English Midterm Test for the First Grade of a Middle School in Hangzhou as an Example

Based on the reliability theory in language testing,this study analyzes the midterm English test of a first grade class in Hangzhou using SPSS software.We will analyze the overall structure and reliability of the test paper,and use cloze as a representative of objective questions to calculate their difficulty and discrimination,in order to explore the quality of the questions and the mastery of the knowledge learned by students.The purpose of this analysis and research is to improve the quality of exam questions and help teachers get useful information from exam results,thereby improving teaching quality.

Implications of genetic testing and informed consent before and after genetic testing in individuals with cancer

Recent advancements in next generation sequencing have allowed for genetic information become more readily available in the clinical setting for those affected by cancer and by treating clinicians.Given the lack of access to geneticists,medical oncologists and other treating physicians have begun ordering and interpreting genetic tests for individuals with cancer through the process of"mainstreaming".While this process has allowed for quicker access to genetic tests,the process of"mainstreaming"has also brought several challenges including the dissemination of variants of unknown significance results,ordering of appropriate tests,and accurate interpretation of genetic results with appropriate followup testing and interventions.In this editorial,we seek to explore the process of informed consent of individuals before obtaining genetic testing and offer potential solutions to optimize the informed consent process including categorization of results as well as a layered consent model.