The medical licensing examination debate

National licensing examinations are typically large‐scale examinations taken early in a career or near the point of graduation, and, importantly, success is required to subsequently be able to practice. They are becoming increasingly popular as a method of quality assurance in the medical workforce, but debate about their contribution to patient safety and the improvement of healthcare outcomes continues. A systematic review of the national licensing examination literature demonstrates that there is disagreement between assessment experts about the strengths and challenges of licensing examinations. This is characterized by a trans‐Atlantic divide between the dominance of psychometric reliability assurance in North America and the wider interpretations of validity, to include consequences, in Europe. We conclude that the debate might benefit from refocusing to what a national licensing examination should assess: to achieve a balance between assessing a breadth of skills and the capacity for such skills in practice, and focusing less on reproducibility.     

A State Census of Unsubmitted Sexual Assault Kits: Comparing Forensic DNA Testing Outcomes by Geographic and Population Density Characteristics*

A growing number of U.S. cities and states have large numbers of unsubmitted sexual assault kits (SAKs) in police property facilities. Prior research conducted in large urban cities has found that testing these kits yields a sizable number of DNA profiles that meet FBI eligibility for upload to the national criminal DNA database CODIS (Combined DNA Index System) and uploaded profiles return a substantial number of matches to existing criminal profiles in CODIS. It is unknown whether these findings are unique to large urban cities with high crime rates. The purpose of current study was to document forensic testing outcomes from a state census of previously unsubmitted SAKs, which included large urban–suburban centers, as well as smaller cities and rural counties. We inventoried all previously unsubmitted SAKs in Michigan (N = 3422 SAKs) and submitted all kits for forensic DNA testing. A total of n = 1239 SAKs had a DNA profile that met eligibility for upload into CODIS (36.2% unconditional, 56.5% conditional CODIS eligible rate) and n = 585 SAKs yielded a CODIS Hit (17.1% unconditional, 47.2% conditional CODIS hit rate). These rates are consistent with studies from urban areas suggesting approximately half of SAKs tested yield a CODIS profile and approximately half of those uploaded profiles yield a hit. We compared SAK forensic testing outcomes by geographic and population density characteristics, and although rates were often higher in larger metropolitan areas, the obtained rates in micropolitan and rural areas suggest testing is warranted in smaller jurisdictions as well.     

Validation of presumptive tests for non-human blood using Kastle Meyer and Hemastix reagents

Kastle Meyer and Hemastix reagents are presumptive tests commonly used in forensic casework for the detection of blood, and their suitability has been reviewed in numerous publications. However, studies to date have focused on the validation of these tests on human blood alone, and no published work has looked at the sensitivity, specificity and effect on DNA analysis when using these reagents to presumptively test for animal blood. The aim of this study was to validate the two reagents for use with animal blood, and compare their performance in order to choose the best test based on the circumstances in wildlife crime investigation.The sensitivity, specificity, stability and robustness of the methods were assessed by experiments with dilutions of animal blood (from 1:4 to 1:65536) using direct and indirect (rub) tests, potential interfering substances, blood sources from different species and aged blood. The effects of the two reagents on subsequent DNA analysis were also investigated.During the direct tests, Kastle Meyer showed a higher sensitivity, detecting blood down to a dilution of 1:16,384, one order of magnitude lower than Hemastix. However during the rub test, Hemastix showed a higher sensitivity, detecting blood down to a dilution of 1:64 on porous materials while Kastle Meyer was positive only down to a dilution of 1:16. Moreover, when using the same swab for presumptive testing and DNA extraction, Hemastix testing allowed amplification of a sufficient amount of DNA for species identification at its limit of sensitivity on porous materials (1:64) while Kastle Meyer inhibited most amplification of DNA at its less sensitive limit of 1:16 dilution. On the other hand, Hemastix showed a much lower specificity, producing false positive results when exposed to tomato, potato, rust, avian uric acid, bleach and sink rot, while Kastle Meyer only produced a faint positive reaction from potato. Both tests performed equally well detecting fresh blood of different animal species. The stability test gave comparable results among the tests except for aged fish blood stains, where the Kastle Meyer test performed poorly.Owing to its ease of use, higher sensitivity, and lack of interference with downstream DNA analysis, and despite its reduced specificity compared to Kastle Meyer, the Hemastix method is more appropriate for use in wildlife crime investigations. Positive results would always be confirmed with DNA analysis and the low interference of the reagent will allow the use of a single swab for presumptive testing and DNA sampling.     

广东汉族DXS10011和DXS8377单体型

目的调查DX10011和DXS8377两个X染色体STR在广东汉族男性群体中的遗传多态性。方法DNA样本来自广东汉族男性无关个体,PCR后用聚丙烯酰胺凝胶电泳和银染法进行DNA分型。结果在113名个体中,DXS10011和DXS8377分别检出20和12个等位基因。DXS10011-DXS8377共有72种不同的单体型,最多见的单体型只出现了3次。在没有母亲时,DXS10011-DXS8377的女孩的非父排除率为0.9588。在83个孩子为女孩的三联体家系和29个有两个孩子的家系中,DXS10011和DXS8377均表现为共显性连锁遗传,且没有发现突变。结论本数据表明DXS10011和DXS8377在复杂的亲权鉴定中可提供高的遗传多态性信息。     

电子数据司法鉴定能力验证的设计与分析——以2021年电子数据功能性鉴定为例

电子数据鉴定作为司法程序中的重要环节,对于确保鉴定流程的规范性和鉴定意见的正确性,以及维护司法公正具有重要意义。针对电子数据司法鉴定实验室,能力验证是一种有效的质量控制与改进手段。电子数据功能性鉴定作为电子数据鉴定的重要组成部分,有必要利用能力验证进行质量控制。通过梳理2021年电子数据功能性鉴定能力验证(2021SF-CNAS 034)结果,阐述电子数据功能性鉴定过程中应注意的相关事项,分析国内该领域行业及地域的发展现状、参加机构的鉴定结果准确性以及鉴定方法和鉴定工具的使用情况,进一步探讨目前该领域能力验证存在的问题,总结出可采取的相应措施,并对该领域的未来发展方向进行了展望。     

国家综改区“先行先试权”的法律结构分析

国家综合配套改革试验区的先行先试是一种特殊的制度创新机制。这种＂先行先试＂授权在形式上的显著特点是政策性授权而不是法律授权。但在社会主义法治国家建设的过程中,必须研究＂先行先试＂的法律属性及其法制化问题。本文主要分析＂先行先试＂的法律特征和＂先行先试权＂的法律结构。     

D6S1043和D12S391基因座在亲权鉴定中的应用

目的研究D6S1043和D12S391基因座在亲权关系鉴定案件中的应用价值。方法应用荧光标记复合扩增系统对日常检案中所收集的192名汉族无关个体血样DNA进行PCR扩增,用ABI3100-Avant遗传分析仪对扩增产物进行毛细管电泳,用GeneMapperv3.2软件进行基因分型,统计分析D6S1043和D12S391基因座的多态信息。结果在D6S1043和D12S391基因座分别发现12个等位基因,它们在中国汉族人群中的个体识别能力分别为0.9656和0.9510,二联体非父排除率分别为0.573和0.510,三联体非父排除率分别为0.731和0.679。结论D6S1043和D12S391基因座具有高度多态性,在亲权鉴定中具有重要应用价值。     

Military genomic testing: proportionality,expected benefits,and the connection between genotypes and phenotypes

Mehlman and Li offer a framework for approaching the bioethical issues raised by the military use of genomics that is compellingly grounded in both the contemporary civilian and military ethics of medical research, arguing that military commanders must be bound by the two principles of paternalism and proportionality. I agree fully. But I argue here that this is a much higher bar than we may fully realize. Just as the principle of proportionality relies upon a thorough assessment of harms caused and military advantage gained, the use of genomic research, on Mehlman and Li''s view, will require an accurate understanding of the connection between genotypes and phenotypes – accurate enough to ameliorate the risk undertaken by our armed forces in being subject to such research. Recent conceptual work in evolutionary theory and the philosophy of biology, however, renders it doubtful that such knowledge is forthcoming. The complexity of the relationship between genotypic factors and realized traits (the so-called ‘G→P map’) makes the estimation of potential military advantage, as well as potential harm to our troops, incredibly challenging. Such fundamental conceptual challenges call into question our ability to ever satisfactorily satisfy the demands of a sufficiently rigorous ethical standard.     

REALITY IS. . . . A RESPONSE TO MARTINDALE,TIPPINS, BEN‐PORATH,AUSTIN, AND WITTMANN

This article is written as a response to the Martindale et al. critique of the Ackerman and Pritzl (2011) child custody evaluation practices article. The Martindale et al. critique focuses on a small portion of the overall results regarding test usage and suggests that the entire article is “flawed and deficient.” However, their critique engages in confirmatory bias and exaggerated statements and ignores the overall value of the article in general. A more broad‐based explanation of the results is provided herein.     

Empirical testing of estimated DNA frequencies

Direct empirical testing of forensic DNA micro-probabilities has proved difficult. Substantial support for the population genetic models on which these micro-probabilities are based has come from powerful but indirect means. However for many people empirical testing rather than models remains the ideal.Following the example set by Weir and Evett we report here a large-scale empirical test of a population genetic model incorporating substructure and relatedness. Given that all models represent simplifications of reality the fit of observed and prediction is remarkable and gives substantial support to the reliability of current methods.