Valor preditivo positivo das categorias 3, 4 e 5 do Breast Imaging Reporting and Data System (BI-RADS®)

OBJETIVO: O objetivo deste trabalho foi avaliar o BI-RADS® como fator preditivo de suspeição de malignidade em lesões mamárias não palpáveis nas categorias 3, 4 e 5, correlacionando as mamografias com os resultados histopatológicos através do cálculo do valor preditivo positivo do exame mamográfico. MATERIAIS E MÉTODOS: Trezentas e setenta e uma pacientes encaminhadas a um serviço de referência em tratamento de câncer em Teresina, PI, para realização de exames histopatológicos em mama no período de julho de 2005 a março de 2008, por terem mamografia de categorias 3, 4 ou 5, tiveram seus exames revisados. Das 371 pacientes, 265 foram submetidas a biópsia por agulha grossa e 106, a marcação pré-cirúrgica. RESULTADOS: Em relação às mamografias, 11,32% foram classificadas como categoria 3, 76,28% como categoria 4 e 12,4% como categoria 5. Os resultados histológicos demonstraram 24% de exames positivos para malignidade. Os valores preditivos positivos das categorias 3, 4 e 5 foram, respectivamente, de 7,14%, 16,96% e 82,61%. Foram calculados os valores preditivos positivos, separadamente, para as biópsias percutâneas (7,14%, 15,76%, 76,47%) e para as marcações pré-cirúrgicas (7,14%, 20%, 100%). CONCLUSÃO: Achados malignos foram subestimados pelo laudo radiológico e houve superestimação de achados benignos, o que resultou na realização desnecessária de alguns procedimentos invasivos.

Impact of reclassifying noninvasive follicular variant of papillary thyroid carcinoma on the risk of malignancy in The Bethesda System for Reporting Thyroid Cytopathology.

BACKGROUND: Recent discussions have focused on redefining noninvasive follicular variant of papillary thyroid carcinoma (NI-FVPTC) as a neoplasm rather than a carcinoma. This study assesses the potential impact of such a reclassification on the implied risk of malignancy (ROM) for the diagnostic categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). METHODS: The study consisted of consecutive fine-needle aspiration biopsy (FNAB) cases collected between January 1, 2013 and June 30, 2014 from 5 academic institutions. Demographic information, cytology diagnoses, and surgical pathology follow-up were recorded. The ROM was calculated with and without NI-FVPTC and was presented as a range: all cases (ie, overall risk of malignancy [OROM]) versus those with surgical follow-up only. RESULTS: The FNAB cohort consisted of 6943 thyroid nodules representing 5179 women and 1409 men with an average age of 54 years (range, 9-94 years). The combined average ROM and OROM for the diagnostic categories of TBSRTC were as follows: nondiagnostic, 4.4% to 25.3%; benign, 0.9% to 9.3%; atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 12.1% to 31.2%; follicular neoplasm (FN), 21.8% to 33.2%; suspicious for malignancy (SM), 62.1% to 82.6%; and malignant, 75.9% to 99.1%. The impact of reclassifying NI-FVPTC on the ROM and OROM was most pronounced and statistically significant in the 3 indeterminate categories: the AUS/FLUS category had a decrease of 5.2% to 13.6%, the FN category had a decrease of 9.9% to 15.1%, and the SM category had a decrease of 17.6% to 23.4% (P < .05), whereas the benign and malignant categories had decreases of 0.3% to 3.5% and 2.5% to 3.3%, respectfully. The trend of the effect on the ROM and OROM was similar for all 5 institutions. CONCLUSIONS: The results from this multi-institutional cohort indicate that the reclassification of NI-FVPTC will have a significant impact on the ROM for the 3 indeterminate categories of TBSRTC. Cancer Cytopathol 2016;124:181-187. © 2015 American Cancer Society.

Positive predictive values of Breast Imaging Reporting and Data System (BI-RADS®) categories 3, 4 and 5 in breast lesions submitted to percutaneous biopsy

Objective To evaluate the BI-RADS as a predictive factor of suspicion for malignancy in breast lesions by correlating radiological with histological results and calculating the positive predictive value for categories 3, 4 and 5 in a breast cancer reference center in the city of São Paulo. Materials and Methods Retrospective, analytical and cross-sectional study including 725 patients with mammographic and/or sonographic findings classified as BI-RADS categories 3, 4 and 5 who were referred to the authors' institution to undergo percutaneous biopsy. The tests results were reviewed and the positive predictive value was calculated by means of a specific mathematical equation. Results Positive predictive values found for categories 3, 4 and 5 were respectively the following: 0.74%, 33.08% and 92.95%, for cases submitted to ultrasound-guided biopsy, and 0.00%, 14.90% and 100% for cases submitted to stereotactic biopsy. Conclusion The present study demonstrated high suspicion for malignancy in lesions classified as category 5 and low risk for category 3. As regards category 4, the need for systematic biopsies was observed.

Methodology used in studies reporting chronic kidney disease prevalence : a systematic literature review.

BACKGROUND: Many publications report the prevalence of chronic kidney disease (CKD) in the general population. Comparisons across studies are hampered as CKD prevalence estimations are influenced by study population characteristics and laboratory methods. METHODS: For this systematic review, two researchers independently searched PubMed, MEDLINE and EMBASE to identify all original research articles that were published between 1 January 2003 and 1 November 2014 reporting the prevalence of CKD in the European adult general population. Data on study methodology and reporting of CKD prevalence results were independently extracted by two researchers. RESULTS: We identified 82 eligible publications and included 48 publications of individual studies for the data extraction. There was considerable variation in population sample selection. The majority of studies did not report the sampling frame used, and the response ranged from 10 to 87%. With regard to the assessment of kidney function, 67% used a Jaffe assay, whereas 13% used the enzymatic assay for creatinine determination. Isotope dilution mass spectrometry calibration was used in 29%. The CKD-EPI (52%) and MDRD (75%) equations were most often used to estimate glomerular filtration rate (GFR). CKD was defined as estimated GFR (eGFR) <60 mL/min/1.73 m(2) in 92% of studies. Urinary markers of CKD were assessed in 60% of the studies. CKD prevalence was reported by sex and age strata in 54 and 50% of the studies, respectively. In publications with a primary objective of reporting CKD prevalence, 39% reported a 95% confidence interval. CONCLUSIONS: The findings from this systematic review showed considerable variation in methods for sampling the general population and assessment of kidney function across studies reporting CKD prevalence. These results are utilized to provide recommendations to help optimize both the design and the reporting of future CKD prevalence studies, which will enhance comparability of study results.

Entrepreneurial Initiative Selling Within Organizations: Towards a More Comprehensive Motivational Framework

We develop and test a motivational framework to explain the intensity with which individuals sell entrepreneurial initiatives within their organizations. Initiative selling efforts may be driven by several factors that hitherto have not been given full consideration: initiative characteristics, individuals' anticipation of rewards, and their level of dissatisfaction. On the basis of a survey in a mail service firm of 192 managers who proposed an entrepreneurial initiative, we find that individuals' reported intensity of their selling efforts with respect to that initiative is greater when they (1) believe that the organizational benefits of the initiative are high, (2) perceive that the initiative is consistent with current organizational practices (although this effect is weak), (3) believe that their immediate organizational environment provides extrinsic rewards for initiatives, and (4) are satisfied with the current organizational situation. These findings extend previous expectancy theory-based explanations of initiative selling (by considering the roles of initiative characteristics and that of initiative valence for the proponent) and show the role of satisfaction as an important motivational driver for initiative selling.

Incumbent audit firm-provided tax services and the clients with low financial reporting quality

This study investigates whether incumbent audit firm-provided tax services enhance or impair the likelihood of acknowledging client companies’ low financial reporting quality. In particular, we examine the association between tax-related fees and the likelihood of timely restatements, and internal control weakness disclosures among a sample of US companies that all have misstatements in financial information. The empirical findings indicate that companies paying higher tax-related fees are less likely to disclose SOX 404 internal control weakness disclosures, implying that underlying control problems are unacknowledged when incumbent audit firm provided tax-related fees are higher. However, the findings suggest that just providing both audit and tax-related services does not have an impact on audit quality per se, but rather it is the magnitude of the tax-related fees in particular that counts. We also find some evidence suggesting that companies paying higher tax-related fees have higher likelihood of restatement lags, whereas companies paying smaller tax-related fees to their audit firm restate financial statements in a timelier manner. Overall, the findings suggest that audit scrutiny of client companies with low quality financial reporting is weaker when the magnitude of tax-related fees is higher.

Web-based corporate social responsibility reporting

Due to concerns regarding globalisation and sustainable development, corporate social responsibility (CSR) is topical in the business context and in the field of accounting. The main objective of this study was to review previous academic literature in the field of CSR reporting and develop an insight into CSR reporting in the Web-based environment. The main purpose was to find out what Web-based CSR reporting is like and how companies are utilising the Internet to communicate on responsibility issues. I did not, however, collect empirical research data but limited my study into theoretical and descriptive examination. In order to create an insight into Web-based reporting, I examined the development, motives and current practices of CSR reporting. I concluded that the Internet is a unique, interactive communication channel that is used differently compared with annual reports. The amount of companies engaging in Web-based CSR reporting is increasing and the reporting practices in terms of e.g. content and accessibility of information vary. I also concluded that many companies have not yet discovered the true potential of the Web as an interactive communication medium.

Ympäristöasioiden hallinnan kehittäminen elintarviketeollisuuden yrityksessä

Ympäristöjärjestelmät auttavat organisaatioiden toiminnan ympäristövaikutuksien hallinnassa. ISO 14001 -standardi antaa yritykselle työkalun ympäristöjärjestelmän rakentamiseen, ylläpitämiseen ja kehittämiseen. Ympäristöjärjestelmälle voidaan hakea ulkopuolisen tarkastajan myöntämä hyväksyntä eli sertifikaatti, jota sidosryhmät voivat vaatia osoitukseksi ympäristöasioiden hoidosta. Sidosryhmien kasvava ympäristökiinnostus lisää yrityksien paineita kehittää ympäristöraportointiaan. Yrityksen yhteiskuntavastuuseen sisältyvien taloudellisen, sosiaalisen ja ympäristövastuun raportointiin kehitetty kansainvälinen GRI-raportointiohjeisto on saavuttanut yleisesti hyväksytyn raportointiviitekehyksen aseman ja sitä voidaan hyödyntää myös pelkän ympäristövastuun raportoinnissa. Tässä diplomityössä tarkastellaan yrityksen ympäristöasioiden hallintaa ja ympäristöraportointia. Tavoitteena on suunnitella ja osittain toteuttaa elintarviketeollisuuden yritykselle ISO 14001 -standardin mukainen ympäristöjärjestelmä. Toisena tavoitteena on suunnitella yrityksen ympäristöraportoinnin aloittamista ja antaa GRI-ohjeiston pohjalta ehdotus asioista, joita yrityksen ympäristöraportti voisi raportoinnin alkuvaiheessa sisältää. Työn lopussa annetaan ehdotus jatkotoimenpiteistä, joilla ympäristöjärjestelmä saadaan sertifiointivalmiiksi ja miten ympäristöraportointiprosessia voidaan edistää.

Evaluation of plant growth-promoting and bioprotecting rhizobacteria on wheat crop

Experiments were carried out under laboratory, growth chamber, and field conditions to evaluate the effect of Plant growth-promoting and bioprotecting rhizobacteria (PGPBR) seed treatment on seed pathogens, seed germination, plant growth, and grain yield of wheat (Triticum aestivum). Most of the PGPBR strongly reduced the recovery of the pathogens from infected wheat seeds. All treatments, except the chemical iprodione + thiram, significantly promoted plant growth over the nontreated control. Psudomonas putida biotype A (11) and P. agglomerans (14) showed the greatest effects. Field experiments, carried out at two locations, indicated that all treatments, except P. chlororaphis (42), significantly increased seedling emergence of wheat . In Pato Branco, PR, P. putida biotype A (11) and P. putida biotype B (44) presented the best results, both being superior to fungal biological and chemical treatments. In Passo Fundo P. putida biotype A (11) and P. putida biotype B (17 and 44) significantly improved yield over the nontreated control. Yield increases of these three PGPBR were similar to the chemical treatment iprodione + thiram. In Pato Branco, P. putida biotype A (11) and P. putida biotype B (17), as well as the chemical treatment, provided significant increase over the nontreated control. Yield increases by the PGPBR varied from 18% to 22% in Passo Fundo and from 27% to 28% in Pato Branco.