Outcomes of clinical utility in amyloid-PET studies: state of art and future perspectives

Purpose To review how outcomes of clinical utility are operationalized in current amyloid-PET validation studies, to prepare for formal assessment of clinical utility of amyloid-PET-based diagnosis. Methods Systematic review of amyloid-PET research studies published up to April 2020 that included outcomes of clinical utility. We extracted and analyzed (a) outcome categories, (b) their definition, and (c) their methods of assessment. Results Thirty-two studies were eligible. (a) Outcome categories were clinician-centered (found in 25/32 studies, 78%), patient-/caregiver-centered (in 9/32 studies, 28%), and health economics-centered (5/32, 16%). (b) Definition: Outcomes were mainly defined by clinical researchers; only the ABIDE study expressly included stakeholders in group discussions. Clinician-centered outcomes mainly consisted of incremental diagnostic value (25/32, 78%) and change in patient management (17/32, 53%); patient-/caregiver-centered outcomes considered distress after amyloid-pet-based diagnosis disclosure (8/32, 25%), including quantified burden of procedure for patients’ outcomes (n = 8) (1/8, 12.5%), impact of disclosure of results (6/8, 75%), and psychological implications of biomarker-based diagnosis (75%); and health economics outcomes focused on costs to achieve a high-confidence etiological diagnosis (5/32, 16%) and impact on quality of life (1/32, 3%). (c) Assessment: all outcome categories were operationalized inconsistently across studies, employing 26 different tools without formal rationale for selection. Conclusion Current studies validating amyloid-PET already assessed outcomes for clinical utility, although non-clinician-based outcomes were inconsistent. A wider participation of stakeholders may help produce a more thorough and systematic definition and assessment of outcomes of clinical utility and help collect evidence informing decisions on reimbursement of amyloid-PET.

Analysis of the commercialization from the Enem by the three schools better ranked in 2015 from the city of São Paulo. Abstract

This work discusses the use of the ENEM ranking by a group of private schools in the city of São Paulo for commercial purposes and explcity through the data obtained from Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (INEP), how the families are led to look for these schools because of the disclosure of results with criteria and deficit of information, starting an "intellectual auction" for the search for scholarships to attend high school. It is well-known that the students' dispute between private schools in São Paulo has been fierce over the years and the transitions made by them tend to happen at the end of the last grade of Elementary School II (9th Year), so, after having done all training in an institution, in the final portion of their preparation, students tend to look for specialized entrance schools and better ranked in the ENEM. We observed that these elements end up distorting the real breadth of the school function that starts to adopt measures to keep its students and just prepare for the entrance exam.

Ethical, Legal and Social Implications of Susceptibility Genetic Testing for Late-Onset Neurodegenerative Diseases

Over the last decade, advances in our understanding about the genetic architecture of complex traits and common diseases, have increased our ability to perform susceptibility genetic testing for diseases in asymptomatic individuals. These technological developments raise complex ethical, legal and social considerations. Here we discuss a series of ethical issues associated with susceptibility genetic testing for Alzheimer's and Parkinson's disease. These include, amongst others, informed consent, disclosure of results and unexpected findings, mandatory screening, privacy and confidentiality, and stigma and genetic discrimination. As knowledge of the genetic basis of these diseases continues growing, and as genetic testing becomes more widespread, we anticipate that it will become increasingly important for scientists and clinicians to engage in the conversation about the ethical, social and policy implications of these technologies.

FATORES INFLUENCIADORES DA ADOÇÃO DE UM MÉTODO DE COSTING NA PERSPECTIVA DE PROFISSIONAIS EM CONTABILIDADE COM ATUAÇÃO NO SETOR INDUSTRIAL

<p>Os métodos de custeio são responsáveis por definir a forma pela qual os custos são apropriados aos seus portadores finais e possuem forte relevância na obtenção das informações gerenciais necessárias para os aspectos decisórios, na mensuração de estoques e na evidenciação dos resultados. Dessa forma, o período de adoção de um método de custeio é uma fase à qual uma entidade deve realizar análise detalhada dos objetivos pertinentes, buscando atender às necessidades dos diversos setores de forma eficiente e eficaz. Nesse sentido, o objetivo com esta pesquisa foi identificar os fatores que influenciam a adoção de um método de custeio nas empresas do setor industrial. A pesquisa possui natureza descritiva e quantitativa; a coleta de dados ocorreu por meio de um questionário eletrônico aplicado a 175 profissionais de contabilidade atuantes no setor industrial. Os resultados mostram que os fatores influenciadores da adoção de um método de custeio, em ordem de influência; são competitividade, gerenciamento, controle, legalidade, planejamento, apropriação, supervisão, comparabilidade, confiabilidade e precisão.</p><p>Palavras-chave: Método de custeio. Contabilidade de custos. Adoção de um método.</p><p> </p><p align="center"><strong><em>Factors influencing the adoption of a cost method in professional perspective in accounting with operations in the industrial sector</em></strong></p><p align="center"><em>Abstract</em></p><p> <strong></strong></p><p><em>The costing methods are responsible for defining the way in which the costs are appropriate to their final carriers and have strong relevance in obtaining the management information necessary for decision-making aspects, in the measurement of inventories and in the disclosure of results. In this way, the period of adoption of a costing method is a stage at which an entity should perform detailed analysis of the relevant objectives, seeking to meet the needs of the many sectors efficiently and effectively. Accordingly, the objective with this research was to identify the factors influencing the adoption of a costing method in industrial companies. The research has descriptive and quantitative nature, the data was collected through an electronic questionnaire applied to 175 accounting professionals working in the industrial sector. The results show that the factors influencing the adoption of a costing method, in order of influence, are competitiveness, management, governance, legality, planning, ownership, supervision, comparability, reliability and accuracy.</em></p><p><em>Keywords: Costing method. Costing accounting. </em><em>Adoption of a method.</em></p>

Patients' Choices for Return of Exome Sequencing Results to Relatives in the Event of Their Death

The incorporation of exome and genome sequencing into research and clinical practice raises the possibility of providing a range of genomic results to relatives in the event of the death of the research participant or patient. Genomic data can be of direct relevance to the medical care of relatives. However, some test subjects (e.g., cancer patients) are at higher risk of dying before they receive their test results and thus may not be able to share useful information with family members. We created an Institutional Review Board (IRB)-approved document with talking points on the possibility of disclosure of results to family members after an individual’s death to discuss during the informed consent process for genomic testing with participants in a study of exome sequencing in the context of familial colorectal cancer/polyposis.

Managing incidental findings and disclosure of results in a paediatric research cohort – the LIFE Child Study cohort

To assess the frequency of incidental findings (IFs) in the population-based “Leipzig Research Centre for Civilization Diseases (LIFE) Child Study” within 1 year.From July 2011 to June 2012, 969 children participated in the study. The IFs were analysed with respect to age, gender, type of examination and clinical action taken.The IFs were detected in 63 participants (6.5%), including five children who presented with two IFs simultaneously. Eleven children received a new, hence previously unknown, clinical diagnosis. Alternatively, 18 IFs could not be confirmed or were of a transient and self-limiting condition. The frequency of IFs varied widely depending on the type of examination, but did not differ by gender.Although IFs were common events, there was no finding with a profound clinical impact on the subject’s life. Our current IF management protocol may be useful in creating management plans for other cohort studies.