Testes genéticos de venda direta ao consumidor : questões ético-legais no mercado português

RESUMO - As descobertas realizadas na área da genética levaram ao desenvolvimento de aplicações práticas, entre as quais se destacam os testes genéticos, cujas aplicações em saúde tiveram um impacto considerável na prática clínica. Uma das consequências deste desenvolvimento foi o nascimento de um novo mercado na área da saúde, o mercado dos Testes Genéticos de Venda Direta ao Consumidor (TGVDC). Este mercado está associado a questões do foro ético e legal muito específicas e importantes. Através da realização do presente trabalho de projeto pretende-se analisar e discutir as principais questões éticas e legais suscitadas pelos TGVDC, com maior enfoque no mercado português e na aplicação do enquadramento ético-legal em vigor em Portugal. No que toca à metodologia, no âmbito do presente trabalho de projeto, realizou-se uma análise da literatura científica e ético-legal do tema em estudo. Posteriormente realizou-se uma entrevista exploratória, a uma personalidade de reconhecido mérito na área da genética humana, a fim de compreender quais as principais questões suscitadas pelo mercado de TGVDC. Seguidamente realizou-se um mapeamento das entidades que operam no mercado de TGVDC, seguido de um inquérito a essas mesmas entidades, a fim de avaliar as características do serviço oferecido em Portugal e a aplicação do regime normativo ético-legal em vigor. Verificou-se, como era expectável, que o mercado português de TGVDC apresenta reduzida dimensão quando comparado com outros mercados a nível internacional, designadamente o mercado norte-americano que é, claramente, o mais desenvolvido nesta área. Os resultados obtidos apontaram ainda, no que toca à realidade portuguesa, para a pertinência de questões discutidas na literatura analisada. Em suma, apesar das limitações inerentes à realização de um projeto pioneiro e ambicioso num curto espaço de tempo, as conclusões deste trabalho permitem extrair conclusões importantes acerca do mercado português de TGVDC, sob a perspetiva ético-legal, bem como efetuar recomendações importantes para futuros estudos nesta área.

Structure du temps de travail des infirmières de santé publique: effets de l'âge des patients, de la nature des prestations fournies et du lieu du contact. [Structure of work times of public health nurses: effect of the age of patients, nature of care given and location of contact].

In the framework of health services research sponsored by the Swiss National Science Foundation, a research was undertaken of the activity of the large majority of the public health nurses working in the Swiss cantons of Vaud and Fribourg (total population 700,000). During one week, 130 nurses gathered, with a specially devised instrument, data on 4165 patient visits. Studying the duration of the contacts, one has distinguished contact duration per se (DC), duration of the travel time preceding the contact (DD), and total duration in relation with the contact (DTC-addition of the first two). It was noted that the three durations increased significantly with patient age (as regard travel time, this is explained by the higher proportion of home visits in higher age groups, as compared with visits at a health center). Examined according to location of the visit, contact duration per se (without travel) is higher for visits at home and in nursing homes than for those taking place at a health center. Looked at in respect to the care given (technical care, or basic nursing care, or both simultaneously), our data show that the provision of basic nursing care (alone or with technical care) doubles contact duration (from 20 to 42-45'). The analyses according to patient age shows that, at an advanced age (beyond 80 years particularly), there is an important increase of the visits where both types of care are given. However, contact duration per se shows a significant raise with age only for the group "technical care only"; it can be demonstrated that this is due to the fact that older patients require more complex technical acts (e.g., bladder care, as compared with simpler acts such as injection). A model of the relationships between patient age and contact duration is proposed: it is because of the increase in the proportions of home visits, of visits including basic nursing care, and of more complex technical acts that older persons require more of the working time of public health nurses.

Towards a better energy efficiency through a systems approach in an industrial forklift

The purpose of this study is to improve the potential energy recovery to electric energy in an electrohydraulic forklift system. The initial achieved result for energy saving ratio after structural optimization is 40 %. Component optimization is applied to the tested drive which consists of a DTC controlled electric servo motor directly running a reversible hydraulic pump. According to the study the energy efficiency and the energy recovery from the electro-hydraulic forklift system can be increased by 11 % units. New ideas and directions of further research were obtained during the study.

Providing Genetic Testing Through the Private Sector: A View From Canada

Genetic testing technologies are rapidly moving from the research laboratory to the market place. Very little scholarship considers the implications of private genetic testing for a public health care system such as Canada’s. It is critical to consider how and if these tests should be marketed to, and purchased by, the public. It is also imperative to evaluate the extent to which genetic tests are or should be included in Canada’s public health care system, and the impact of allowing a two-tiered system for genetic testing. A series of threshold tests are presented as ways of clarifying whether a genetic test is morally appropriate, effective and safe, efficient and appropriate for public funding and whether private purchase poses special problems and requires further regulation. These thresholds also identify the research questions around which professional, public and policy debate must be sustained: What is a morally acceptable goal for genetic services? What are the appropriate benefits? What are the risks? When is it acceptable that services are not funded under health care? And how can the harms of private access be managed?

Régulation de la division asymétrique chez C. elegans

La division asymétrique est essentielle pour générer la diversité au cours du développement et permet aussi de réguler la balance entre renouvellement et différenciation des cellules souches chez l’adulte. Dans ces deux cas de figure, elle dépend respectivement d’une polarité intrinsèque ou d’une polarité extrinsèque. C. elegans est un excellent modèle pour étudier les mécanismes cellulaires et moléculaires de la division asymétrique in vivo. Chez l’embryon, le maintien d’un axe de polarité antéro-postérieur dépend des protéines PAR conservées et localisées de façon asymétrique en deux groupes mutuellement exclusifs; le groupe antérieur avec PAR-3, PAR-6, PKC-3 et le groupe postérieur avec PAR-2 et PAR-1. L’absence d’une protéine PAR entraine une perte de polarité et une létalité embryonnaire. Lors d’un crible par ARN interférence mené par Jean-Claude Labbé pour identifier les suppresseurs de la létalité associée à la perte de PAR-2, deux cyclines de type B, CYB-2.1 et CYB-2.2 ont été trouvées. J’ai déterminé que CYB-2.1 et CYB-2.2 interviennent dans la polarité sans perturber le cycle cellulaire et agissent vraisemblablement avec leur kinase associée, CDK-1, pour stabiliser les niveaux protéiques de PAR-6. Ces travaux permettent de mieux définir les liens étroits entre polarité et cycle cellulaire. La lignée germinale de C. elegans est un excellent modèle pour étudier les divisions des cellules souches germinales in vivo. Par contre, l’absence d’orientation préférentielle de ces divisions laisse envisager que la complexité morphologique de la niche pourrait engendrer une diversité d’axe possible. J’ai étudié la régulation morphologique de cette niche, une unique cellule somatique appelée distal tip cell (DTC), qui arborise de longues extensions au stade adulte. Mes résultats préliminaires favorisent un modèle dans lequel les cellules souches et progéniteurs germinaux (CSPG) supportent la formation de ces extensions. Enfin, j’ai obtenu des conditions favorables à l’étude de la division asymétrique extrinsèque dans ce modèle, en simplifiant l’architecture de la niche dans des conditions qui préservent les divisions cellulaires des cellules souches. Mes travaux ont permis de mieux comprendre les liens unissant les différents processus biologiques impliqués dans la division asymétrique, d’une part par l’étude du rôle qu’y jouent des régulateurs clés du cycle cellulaire au cours du développement et d’autre part par la caractérisation d’une communication bidirectionnelle entre la niche et les cellules souches chez l’adulte.

Poster examples from Web Science

These posters illustrate a range of activities and research topics

3-5-man chess: Maximals and mzugs

This article reports the combined results of several initiatives in creating and surveying complete suites of endgame tables (EGTs) to the Depth to Mate (DTM) and Depth to Conversion (DTC) metrics. Data on percentage results, maximals and mutual zugzwangs, mzugs, has been filed and made available on the web, as have the DTM EGTs.

Chess endgame news

A report of the new Bourzutschky/Konoval chess endgame depth record of DTC = 330 moves, and of the progress of the Kryukov peer-group to disseminate Nalimov's DTM EGTs. The question of data integrity and assurance is raised.

Chess endgame news

News that Bourzutschky confirms there is no sub-7-man pawnless zugzwang, and that Bourzutschky and Konoval are generating DTC EGTs with a new program. News also of Kristensen's work on EGTs using OBDDs, Ordered Binary Decision Diagrams.

3-5-Man chess data

This reports the work of Karrer and Wirth in identifying percentage results and, respectively, the Depth to Mate (DTM) and Depth to Conversion (DTC) data in all 2-5-man chess endgames.

Chess endgame knowledge advances

This review of recent developments starts with the publication of Harold van der Heijden's Study Database Edition IV, John Nunn's second trilogy on the endgame, and a range of endgame tables (EGTs) to the DTC, DTZ and DTZ50 metrics. It then summarises data-mining work by Eiko Bleicher and Guy Haworth in 2010. This used CQL and pgn2fen to find some 3,000 EGT-faulted studies in the database above, and the Type A (value-critical) and Type B-DTM (DTM-depth-critical) zugzwangs in the mainlines of those studies. The same technique was used to mine Chessbase's BIG DATABASE 2010 to identify Type A/B zugzwangs, and to identify the pattern of value-concession and DTM-depth concession in sub-7-man play.

Metal-directed assembly of large dinuclear copper(II) dithiocarbamate macrocyclic complexes

The synthesis of a range of dinuclear Cu(II) dithiocarbamate (dtc)-based macrocycles and their characterisation are described. By carefully tuning the size of the aromatic spacer, cavities of different dimensions can be designed. The length and flexibility of the chosen spacer group dictates the intermetallic distance and hence the degree of communication between the two metal centres as evidenced by electrochemical and EPR experiments. This is illustrated by crystallographic evidence that show the macrocycles can host guests (such as CH2Cl2) or can fold and form unexpected Cu(I) dtc clusters.

Western Chess: Endgame data

This spreadsheet contains key data about that part of the endgame of Western Chess for which Endgame Tables (EGTs) have been generated by computer. It is derived from the EGT work since 1969 of Thomas Ströhlein, Ken Thompson, Christopher Wirth, Eugene Nalimov, Marc Bourzutschky, John Tamplin and Yakov Konoval. The data includes %s of wins, draws and losses (wtm and btm), the maximum and average depths of win under various metrics (DTC = Depth to Conversion, DTM = Depth to Mate, DTZ = Depth to Conversion or Pawn-push), and examples of positions of maximum depth. It is essentially about sub-7-man Chess but is updated as news comes in of 7-man EGT computations.

Six-man Oracle Survey, 1

This is a list in GBR order of existing 6-man endgame tables (EGTs) created by Nalimov (DTM, Distance to Mate) or Thompson (DTC, Distance to Conversion).

Increased implantation and pregnancy rates obtained by placing the tip of the transfer catheter in the central area of the endometrial cavity

The influence of endometrial cavity length (ECL) on implantation and pregnancy rates after 400 embryo transfers was studied prospectively in a population with the indication of IVF/intracytoplasmic sperm injection (ICSI). The tip of the transfer catheter was placed above or below the half point of the ECL in a randomized manner. Two analyses were performed: (i) absolute position (AP); embryo transfers were divided into three groups according to the distance between the end of the fundal endometrial surface and the catheter tip (DTC - distance tip catheter): AP 1 (n = 212), 10-15 mm; AP 2 (n = 158), 16-20 mm; and AP 3 (n = 30), ≥21 mm. (ii) relative position (RP) - embryo transfers were divided into four groups according to their RP [RP = (DTC/ECL) × 100]: RP 1 (n = 23), ≤40%; RP 2 (n = 177), 41-50%; RP 3 (n = 117), 51-60%; and RP 4 (n = 83), ≥61%. Analysis based on relative distance revealed significantly higher implantation and pregnancy rates (P < 0.05) in more central areas of the ECL. However, analysis based on absolute position did not reveal any difference. In conclusion, the present results demonstrated that implantation and pregnancy rates are influenced by the site of embryo transfer, with better results being obtained when the catheter tip is positioned close to the middle area of the endometrial cavity. In this respect, previous analysis of the ECL is the fundamental step in establishing the ideal site for embryo transfers.