New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Information asymmetry and co-creation in health care services

With the aim of addressing a gap in service research on co-creation in health care, this study discusses the problem of information asymmetry in the service provider–user relationship by adopting the Viable Systems Approach. We develop a three-step interpretative framework to support the understanding of the health service relationship by going beyond the traditional information asymmetry view towards a framework capable of examining the human side of service interaction. Using the case of the Italian Health System, we discuss whether and how the problem of information asymmetry affects the health care provider–user co-creation relationship. Our findings open up a wider view of information asymmetry, suggesting a shift in focus from information sharing to interpretation schemes sharing, all the way up to values sharing, offering new insights for co-creation in health care