GRADE Evidence to Decision (EtD) frameworks : A systematic and transparent approach to making well-informed healthcare choices. 1. Introduction

Funding: Work on this article has been partially funded by the European Commission FP7 Program (grant agreement 258583) as part of the DECIDE project. Sole responsibility lies with the authors; the European Commission is not responsible for any use that may be made of the information contained therein.Peer reviewedPublisher PD

A comparative evaluation of PDQ-Evidence

BACKGROUND: A strategy for minimising the time and obstacles to accessing systematic reviews of health system evidence is to collect them in a freely available database and make them easy to find through a simple ‘Google-style’ search interface. PDQ-Evidence was developed in this way. The objective of this study was to compare PDQ-Evidence to six other databases, namely Cochrane Library, EVIPNet VHL, Google Scholar, Health Systems Evidence, PubMed and Trip. METHODS: We recruited healthcare policy-makers, managers and health researchers in low-, middle- and highincome countries. Participants selected one of six pre-determined questions. They searched for a systematic review that addressed the chosen question and one question of their own in PDQ-Evidence and in two of the other six databases which they would normally have searched. We randomly allocated participants to search PDQ-Evidence first or to search the two other databases first. The primary outcomes were whether a systematic review was found and the time taken to find it. Secondary outcomes were perceived ease of use and perceived time spent searching. We asked open-ended questions about PDQ-Evidence, including likes, dislikes, challenges and suggestions for improvements. RESULTS: A total of 89 people from 21 countries completed the study; 83 were included in the primary analyses and 6 were excluded because of data errors that could not be corrected. Most participants chose PubMed and Cochrane Library as the other two databases. Participants were more likely to find a systematic review using PDQ-Evidence than using Cochrane Library or PubMed for the pre-defined questions. For their own questions, this difference was not found. Overall, it took slightly less time to find a systematic review using PDQ-Evidence. Participants perceived that it took less time, and most participants perceived PDQ-Evidence to be slightly easier to use than the two other databases. However, there were conflicting views about the design of PDQ-Evidence. CONCLUSIONS: PDQ-Evidence is at least as efficient as other databases for finding health system evidence. However, using PDQ-Evidence is not intuitive for some people

Using the COMMVAC taxonomy to map vaccination communication interventions in Mozambique

Improved communication about childhood vaccination is fundamental to increasing vaccine uptake in low-income countries. Mozambique, with 64% of children fully vaccinated, uses a range of communication interventions to promote uptake of childhood immunisation.; Using a taxonomy developed by the 'Communicate to Vaccinate' (COMMVAC) project, the study aims to identify and classify the existing communication interventions for vaccination in Mozambique and to find the gaps.; We used a qualitative research approach to identify the range of communication interventions used in Mozambique. In-depth semi-structured interviews were carried out with key purposively selected personnel at national level and relevant documents were collected and analysed. These data were complemented with observations of communication during routine vaccination and campaigns in Nampula province. We used the COMMVAC taxonomy, which organises vaccination communication intervention according to its intended purpose and the population targeted, to map both routine and campaign interventions.; We identified interventions used in campaign and routine vaccination, or in both, fitting five of the seven taxonomy purposes, with informing or educating community members predominating. We did not identify any interventions that aimed to provide support or facilitate decision-making. There were interventions for all main target groups, although fewer for health providers. Overlap occurred: for example, interventions often targeted both parents and community members.; We consider that the predominant focus on informing and educating community members is appropriate in the Mozambican context, where there is a high level of illiteracy and poor knowledge of the reasons for vaccination. We recommend increasing interventions for health providers, in particular training them in better communication for vaccination. The taxonomy was useful for identifying gaps, but needs to be more user-friendly if it is to be employed as a tool by health service managers

Optimización del ángulo de inclinación de una torre de un puente atirantado.

Los puentes son de vital importancia en la sociedad ya que han permitido que muchas ciudades aumenten y desarrollen de manera notable la movilización o transporte lo que agilita el comercio y fomenta el turismo. La construcción de un puente brinda a una población una herramienta o alternativa vial para su acceso o salida de manera más rápida. En el Ecuador existen un sinnúmero de puentes que han permitido al país desarrollarse mejor. Ejemplo de ello es el Puente de la Unidad Nacional, el cual conecta Guayaquil con Samborondón y Durán. Antes de su construcción el transporte de vehículos, personas y mercadería dependía de gabarras y pequeños botes lo cual limitaba el desarrollo de dichas poblaciones. Actualmente, y gracias al puente, la vía a Samborondón se ha convertido en una zona “exclusiva” de alto potencial residencial y comercial. Además de ello el Puente de la Unidad Nacional ha permitido que se desarrolle toda una red vial que conecta a las provincias del sur de Ecuador con el Puerto Principal. En los últimos años, la red vial de todo el país experimentado un gran crecimiento. Para ello ha sido necesaria la construcción de cientos de puentes alrededor de todo el país. En algunos casos, estos proyectos viales han tenido que enfrentar dificultades de tipo topográfico, hidráulico, geotécnico e incluso económico, que han limitado la construcción de puentes convencionales y han permitido implementar nuevas soluciones. Uno de estos casos es el del Puente sobre el Río Napo, el cual no permitía la construcción de pilas sobre el río debido a la socavación que este produciría, por lo que se optó por un puente atirantado

Estudio de la dinámica mitocondrial en el músculo esquelético de un modelo animal de Esclerosis Lateral Amiotrófica

La esclerosis lateral amiotrófica (ELA) es una enfermedad neurodegenerativa que provoca la pérdida progresiva de motoneuronas superiores e inferiores, conduciendo a la parálisis y atrofia muscular y, en última instancia, al fallecimiento del paciente. Aunque los mecanismos subyacentes no se comprenden completamente, se ha sugerido que la disfunción mitocondrial desempeña un papel crucial. Aunque numerosos estudios han investigado esta alteración en el sistema nervioso, se sabe menos acerca de cómo afecta esta disfunción a la fisiología del músculo esquelético.El objetivo de este trabajo es estudiar la dinámica mitocondrial en el músculo esquelético del modelo animal de ELA SOD1G93A, mecanismo que se encarga de mantener la morfología y funcionalidad de la red mitocondrial celular. Para ello, se estudió la expresión génica y proteica de las principales moléculas involucradas en los mecanismos de la dinámica mitocondrial. Además, se comprobaron a nivel transcriptómico la existencia de alteraciones musculares y mitocondriales en el músculo esquelético del modelo.Los resultados revelan una desregulación de la dinámica mitocondrial y mostraron una hiperactivación de las moléculas responsables de la fisión mitocondrial en el músculo esquelético del modelo de ELA SOD1G93A. Estos hallazgos sugieren que esta disfunción mitocondrial podría contribuir a la progresión de la enfermedad, empeorando la patogenia de la ELA. Además, plantean la posibilidad de que la dinámica mitocondrial pueda ser un objetivo terapéutico para el tratamiento de la enfermedad.<br /

Challenges of evidence synthesis during the 2020 COVID pandemic: a scoping review

Aim:: The objectives of this scoping review are to identify the challenges to conducting evidence synthesis during the COVID-19 pandemic and to propose some recommendations addressing the identified gaps. Methods:: A scoping review methodology was followed to map the literature published on the challenges and solutions of conducting evidence synthesis using the Joanna Briggs Methodology of performing scoping review. We searched several databases from the start of the Pandemic in December 2019 until 10th June 2021. Results:: A total of 28 publications was included in the review. The challenges cited in the included studies have been categorised into four distinct but interconnected themes including: upstream, Evidence synthesis, downstream and contextual challenges. These challenges have been further refined into issues with primary studies, databases, team capacity, process, resources, and context. Several proposals to improve the above challenges included: transparency in primary studies registration and reporting, establishment of online platforms that enables collaboration, data sharing and searching, the use of computable evidence and coordination of efforts at an international level. Conclusion:: This review has highlighted the importance of including artificial intelligence, a framework for international collaboration and a sustained funding model to address many of the shortcomings and ensure we are ready for similar challenges in the future. © 2021 Elsevier Inc

Orange and lemon peel powders as a bioelement source

The purpose of this paper was to evaluate the concentration of some bioelements from citrus peel powder. Peels powder was obtained by drying and grinding citrus peels as a by-product resulting after the preparation of some natural juices. The results obtained by atomic absorption spectrometry of Na, K, Ca, Mg, Fe, Mn, Zn and Cu, shows that the powders taken into the study contain important amounts of essential mineral elements, especially Ca and K (159-182 mg/100g, respectively 211-218 mg/100g) and also appreciable contents of Mg (15.3-23.4 mg/100g), Fe (18.1-34.1 mg/100g), Zn (9.34-11.8 mg/100g), Na (8.75-12.8 mg/100g), Cu (1.27-3.71 mg/100g) and Mn (1.32-2.03 mg/100g). The concentration of the analyzed mineral bioelements shows, in general, the following decreasing trend: K> Ca> Fe> Mg> Zn> Na> Cu> Mn