Assessment Of Adequacy Research Articles

Practice Variation in Establishing the Adequacy of Beta-Blockers as an Antiarrhythmic Agent in School-Aged Children and Adolescents

BackgroundBeta-blockers (BBs) are commonly prescribed to manage arrhythmias in children and adolescents without any standardised approach to establish BB adequacy. We invited all Canadian pediatric cardiologists to participate in an anonymous survey to understand practice variation in the assessment of BB adequacy in school-aged children and adolescents with arrhythmia or the potential for arrhythmia. MethodsAn electronic survey approved by the Institutional Ethics Board was distributed by e-mail to 96 Canadian pediatric cardiologists who had been active in practice for at least 1 year. Incomplete surveys were excluded. ResultsForty-one cardiologists (43%) responded to all questions in the survey. Thirteen cardiologists (32%) reported always assessing BB adequacy, 17 (41%) did so only for specific arrhythmias, and 11 (27%) reported never performing such an assessment. A total of 19 cardiologists (46%) and 18 cardiologists (44%) reported using Holter monitoring and exercise testing, respectively, to assess beta receptor blockade adequacy. Thirteen cardiologists (32%) considered BB therapy adequate if Holter demonstrated a 20% decrease in heart rate (HR) from baseline, and 10 respondents (24%) defined adequate BB therapy using exercise testing as a 20% decrease in maximal HR or blood pressure from baseline. ConclusionDespite wide variation in practice, Holter monitoring and exercise testing are commonly used methods to measure the adequacy of BB therapy. There are no standard criteria, but the majority (56%) reported using a 20% decrease in HR or blood pressure from the pretreatment state as a criterion for adequate BB therapy in children and adolescents with arrhythmia or the potential for arrhythmia.

Effects of excessive or restricted phosphorus and calcium intake during early life on markers of bone architecture and composition in pigs.

Sufficient supply of pigs with calcium (Ca) and phosphorus (P) is essential for animal health and welfare during the growth period. However, the P content in animal manure is considered as a cause of massive environmental problems in soil and aquatic ecosystems. To complement previous findings, the objective of this study is the investigation of effects of a reduced and increased Ca and P supplementation on bone mineralization and bone structure compared with the current dietary recommendation. Another aim is to find possible serum markers that would allow the assessment of adequacy of P supply for bone health during growth. The result validated that the recommended Ca and P supply is sufficient, without the addition of microbial phytases. However, addition of P has no further beneficial effects on bone stability, while P supplementation below the recommended level affects bone development and growth performance. Reduced P levels have consequences for cancellous bone density and trabecular architecture. Further fine-tuning of the P supply in conjunction with an appropriate Ca supply will contribute to a reduction in P waste and associated environmental impact while maintaining animal health and welfare.

A prospective assessment of adequacy of orthopaedic emergency medicine consultations: The experience at an academic level I trauma center

Background: This study sought to determine the diagnostic accuracy, consultation appropriateness, and effectiveness of management of orthopaedic conditions in an emergency setting. Methods: A prospective, blinded analysis of all orthopaedic consults by emergency medicine providers at our institutional level I trauma center was conducted between May 1, 2016 and Jun 30, 2016. Providers were blinded to eliminate Hawthorne effect bias. Direct orthopaedic transfers and general surgery trauma consults were excluded. The accuracy of the initial diagnosis, effectiveness of management by the emergency medicine physician, and ultimately, consult appropriateness were evaluated. Results: The emergency department received 239 consecutive consults over the 2-month period. Of these 38.5% (92/239) were inaccurate due to nonspecific consults (14.6%; 35/239), incomplete information with missed injuries (12.6%; 30/239), grossly incorrect diagnosis (11.3%; 27/239), or use of incorrect terminology (5.9%; 14/239). Inaccurate diagnoses led to a significant change in orthopaedic management in 73.9% (68/239) of patients. Of the open injuries, 30.8% (4/13) were incorrectly called “closed.” Antibiotics were not initiated prior to orthopaedic consultation for open fractures in 61.5% (8/13) of patients. Initial work-up was incomplete in 25.5% (61/239), affecting management in 44.3% (27/61) of cases; 56.9% (136/239) of consults required acute orthopaedic intervention in the emergency department setting. Conclusions: In this study a significant number of patients presenting to a level one trauma center referred for orthopaedic consultation by emergency medicine providers were initially misdiagnosed and suboptimally managed. This may have a significant impact on patient morbidity and mortality. Orthopaedic consultants must be vigilant and apply due diligence to ensure that emergency patients receive proper and thorough evaluation and treatment. Level of Evidence: Level IV.

An Assessment of Renta Dignidad's Adequacy to Prevent Poverty in Bolivia

The elderly population in developing countries is often left without access to traditional pension plans due to participation in the informal economy. To remedy this, non-contributory pension schemes are being implemented by policy makers worldwide. Bolivia, one of Latin America’s poorest nations, has successfully implemented the non-contributory pension policy Renta Dignidad. This paper analyzes the economic impacts of Renta Dignidad on gender, language, and household specific subsamples of Bolivia’s population.

Validation of the RumiWatch Converter V0.7.4.5 classification accuracy for the automatic monitoring of behavioural characteristics in dairy cows

ABSTRACTThe objective of the present study was to validate the accuracy of algorithms, implemented in the currently available RumiWatch Converter (RWC) version V0.7.4.5 of the RumiWatch System (RWS), for the classification of behavioural characteristics from jaw and head movements which are monitored by a noseband halter comprising a pressure sensor and a triaxial accelerometer. The accurate classification of behavioural characteristics in different time resolutions is critical for the usage of the RWS for scientific and practical purposes as chewing behaviour provides essential indicators for the assessment of diet adequacy in dairy cows. To validate the RWC V0.7.4.5 classification accuracy for behavioural characteristics of rumination, eating, drinking, other activity and ruminating chews per bolus by direct observation as reference method, 14 dairy cows participated in the trial. Concordance between the consolidated 1-min and 1-h classification results was assessed. The RWC V0.7.4.5 classified only rumination and ruminating chews per bolus precisely, whereas an algorithm optimisation for the classification of eating, drinking and other activity is required. Additionally, classification results from the 1-min and 1-h time summaries were not in agreement with each other except for rumination.

Assessment of Nutritional Status and Macronutrients Adequacy of Traumatic Brain Injury Patients Attending Tertiary Health Care in Oman

Assessment of Nutritional Status and Macronutrients Adequacy of Traumatic Brain Injury Patients Attending Tertiary Health Care in Oman

Reserves of Generating Capacity for Perspective Planning of Development of the Unified Energy System of Russia

Determination of reserves of generating capacity is one of the main tasks in planning the future development of electric power systems. There are many problems that affect the rational level of redundancy of generating capacities in Russian power industry. Modern changes in the Russian electric power industry concerning the level of redundancy of generating capacity in the long-term planning of the development of the Unified Power System (UPS) of Russia are analyzed in the article. The optimization problem of determining the necessary reserves of generating capacity in the power system, based on the assessment of adequacy, taking into account the modern features of the development of the UPS of Russia is presented. The results of assessing the adequacy of the UPS of Russia at the level of 2022 and the value of the optimized reserves of generating capacity in the UPS of Russia are showed in the final part.

Comparison between sphincter pharyngoplasty and a rolled pharyngeal myomucosal flap surgery for management of velopharyngeal incompetence

Background Surgical techniques for velopharyngeal incompetence are directed at creating more favorable structure or function of the velopharyngeal mechanism to achieve an appropriate blend of oronasal resonance and eliminate nasal air emission. Purpose This study aimed to compare the functional outcome of sphincter pharyngoplasty and a rolled superiorly based myomucosal pharyngeal flap for surgical treatment of velopharyngeal incompetence. Patients and methods This study was conducted on a total number of 20 patients (11 male and nine9 female) with velopharyngeal insufficiency (VPI) with age ranging between 8 and 20 years. Patients were divided into two equal random groups according to the surgical technique used for correction of VPI. Group 1 comprised 10 patients with VPI were managed by sphincter pharyngoplasty and; group 2 comprised 10 patients with VPI were managed by a rolled superiorly based pharyngeal myomucosal flap. Perceptual evaluation of voice and nasopharyngoscopy were used for preoperative and postoperative assessment of velopharyngeal adequacy. Results Postoperative clinical evaluation for hypernasality revealed improvement of hypernasility in both patients group. Mean nasalance scores obtained in the postoperative evaluation revealed that both groups presented mean nasalance scores significantly lower than those obtained before surgery. Conclusion Sphincter pharyngoplasty and a rolled pharyngeal flap surgery were efficient in reducing hypernasality for treatment of VPI.

Nutritional Ecology of the Southern Green Stink Bug <i>Nezara viridula</i> (Hemiptera: Pentatomidae) on Selected Varieties of Cowpea and Tomato

Cowpea, Vigna unguiculata (L.) Walp. (Fabales: Fabaceae), and tomato, Solanum lycopersicum L. (Solanales: Solanaceae), are two economically important crops in the southern United States. The southern green stink bug, Nezara viridula (L.) (Hemiptera: Pentatomidae) is a highly polyphagous pest that attacks a wide range of crops including cowpea and tomato causing a reduction in yield and produce quality. Considering the damage and the associated losses in cowpea and tomato production by this and other pests, as well as the demand for reduced use of pesticides, there is a need to cultivate varieties that are resistant to N. viridula. One key indicator of resistance is host nutritional availability and adequacy. This study evaluated the effect of two selected varieties of cowpea and tomato on the growth and development of N. viridula under laboratory conditions as a first step towards the assessment of nutritional adequacy of both crops. We carried out feeding experiments to compare food utilization and suitability by various life stages of N. viridula. The food substrates tested included fresh immature cowpea pods, fresh cowpea seeds, dry cowpea seeds and newly ripened tomato fruits. Overall, mean nymphal mortality was less when reared on cowpea (63.7±2.9%) than tomato (83.0±1.8%). Nymphs required less time to complete development on cowpea (27.8±2.8d) than on tomato (45.0±3.9d). Fresh body weight at adult emergence was greater on cowpea (132.3±12.1mg) than tomato (83.9±1.5mg). Consumption index (CI) and growth rate (GR) were higher on cowpea (CI: 22.0 ±1.3; GR: 2.1±0.3) than tomato (CI: 8.7±1.4; GR: 0.9±0.1). Collectively, these results suggest that cowpea provided a more suitable nutritional substrate for nymphal development. Many small vegetable growers cultivate both crops.

Effect of branched chain amino acid supplementation on dialysis adequacy and nutritional parameters in hemodialysis patients.

Malnutrition in hemodialysis (HD) patients is caused by deficient nutrient and protein intake and has a negative impact on patient outcomes. The assessment of dialysis adequacy in these patients depends to a large extent on the calculation of urea clearance using dialyzer clearance of urea (K) multiplied by the duration of the dialysis treatment (t, in minutes) divided by the volume of distribution of urea in the body (V, in mL); Kt/V. This study aims to detect the effect of branched-chain amino acid (BCAA) supplementation on Kt/V and other nutritional parameters such as serum albumin as well as body mass index. Forty-six patients from the HD Unit of Mostafa Mahmoud Hospital were included in this study. Daily intake of BCAA was continued for three months. At the start of the study, before the intervention, and at the end of the 3rd month, we measured serum albumin, valine, leucine, iso-leucine, and Kt/V. Analysis of data was performed using paired and independent t-test. We found that BCAA has a highly significant effect on increasing the level of albumin, leucine, isoleucine, valine, and Kt/V in HD patients (P <0.001) (Paired t-test). BCAA supplements could be used in this patient population to improve dialysis adequacy and outcome.

Assessment of adequacy of tools and measures applied by enterprises for production process improvement

ABSTRACT The article presents a new approach to assess improvement actions performed in production enterprises. The evaluation criterion is adequacy of diagnostic tools that were used as improvement measures. Three aspects of improvements have been analysed: nature of problems that are the starting point for undertaking a project, types of tools used to identify problems, and types of measures introduced. Data obtained from completed projects is processed and verified statistically with use of the so-called maturity matrix. The presented methodology may be helpful in taking actions aimed at increasing effectiveness of improvement activities in an enterprise.

Beyond patency: Functional assessment of adequacy using internal mammary artery grafting to the left anterior descending artery

Arterial graft physiology influences the long-term outcome of coronary artery bypass grafting (CABG). We studied factors that can affect the overall resistance to flow using internal mammary artery grafting to the left anterior descending artery. This was a prospective, nonrandomized observational study of 100 consecutive patients who underwent elective on-pump isolated or combined valve surgery and CABG. Coronary stenoses were assessed using conventional and quantitative coronary angiography assessment. The flow and pulsatility index (PI) of the grafts were assessed by transit-time flowmetry during cardioplegic arrest and at the end of the operation. Fractional polynomials were used to explore linearity, followed by multivariable regression analysis. Univariate analysis demonstrated higher flows at the end of the operation in patients who had higher flows with the cross-clamp on (P < .001), in males (P = .004), in patients with a low PI at the end of the operation (P = .04), and in patients with a larger size of the recipient artery (P = .005). Multivariable regression analysis showed that the graft flow at the end of the operation was significantly associated with the mean flow with the cross-clamp on (P < .001), sex (P = .003), and PI at the end of the operation (P = .003). Concomitant valve surgery did not influence flows. Male patients had 18 mL/min higher flow. The graft flow at the end of the operation can be determined by the flow with the cross-clamp on, the PI with the cross-clamp off and coronary artery. We reported differences in the graft flows between sexes, and for first the time, we introduced the concepts of "adequate flow" and "resistance-to-forward-flow" for patent coronary grafts.

Forming a мetodology for transforming a model as the basis for expanding its informativeness

A problem on building the methodology for transforming the implicit form of a model has been stated and solved, which improves the efficiency of replacing complex nonlinear forms of mathematical models to reducing them to a recurrent sequence in the form of analytical expressions that allow quick express calculations. New explicit forms of the models have been proposed that make it possible to use recurrent sequences for representing a solution to the problem and forming an error estimation expression, as well as and additional information. Given the fact that for many attributes the solution and an error estimation are critical, the analyticity of expressions reveals new properties and possibilities. Based on such factors as authenticity, accuracy, depth, materiality and completeness, the adequacy of the model is represented by a single analytical expression that would make it possible in future to simplify the process of comparison through the use of quantitative methods. Representation of transformations, according to which the connection between the error of two consecutive approximations and dependence on the approximation number was established, is predetermined by the necessity to analyze convergence dynamics based on the iteration number. Another variant, not less important, which can characterize the dynamics of convergence is the connection between an error of the first approximation and the arbitrary approximation. Based on the overall expansion of the implicit form of the model and the mean value theorem, the relationship between the two consecutive errors or norms has been established. It is demonstrated that if the error or a norm of error are assigned, the estimates for the first and second derivatives would make it possible to determine the boundary number of the iteration starting from which the error is less than the assigned one. An example has been given for deriving an estimation for the general model of the magnitude of a maximally possible error, the boundary number of the iteration, starting from which the error acquires a value less than the assigned one. A comprehensive analytical assessment of adequacy based on a single expression has also been derived. Representation of informational attributes in the quantitative form is predetermined by new opportunities that would emerge due to the obtained tools for quantitative analysis. Numerical modelling has been performed; the character of dynamics of new informational indicators and attributes has been examined. The data given for nine iterations demonstrate efficiency and completeness of information to perform a quick analysis and draw a conclusion. Based on the dynamics of quantitative attributes for a relative error, as well as new ones, proposed based on the results from implementing the model transformation methodology, it has been shown that the possibilities emerge to run a quick analysis and draw a conclusion. It was demonstrated that the introduced attributes expand the informativeness of the methodology implementation for the further representation of a nonlinear model in the form of a recurrent sequence

SCREW ROLLING OF PIPES IN A FOUR-HIGH ROLLING MILL

A model of four-high screw rolling mill was developed and manufactured with the help of additive technologies. The work rolls are installed: the main ones – by cup-shaped scheme and auxiliary – by mushroom scheme with an angle of rolling of ±7 degrees, with an unregulated feed angle of 15 degrees. The main and auxiliary rolls have a barrel length of 70 mm. Diameter of the main rolls in pinching is 50 mm, of auxiliary rolls – 36 mm. At the exit in cross section of the tube outlet from the rolls, their diameters are almost the same and are 72 mm. Each of the four rolls is driven by an individual drive with a 100 W motor-reducer and a rotational speed of 60 rpm by a mushroom scheme and of 83 rpm by a cup-shaped one, which minimizes the divergence of peripheral speeds in the deformation zone at different roll diameters. On the developed model of four-high rolling mill, rolling of liners from plasticine with a diameter of 25 mm with a wall thickness of 7.5 was carried out; 5.5 and 3.5 mm, corresponding to the ratio of diameter to wall thickness 3; 5 and 8. Pipe rolling was carried out on floating mandrels with diameters of 9, 13 and 17 mm. After rolling, measurements of the diameter and wall thickness of the pipes were carried out in 5 cross sections that were equally spaced from each other. In each cross section, the diameter was measured at 5, and the wall thickness at 10 points. The finite element method has been used to simulate the process of rolling these pipes in the QForm program. Assessment of the model adequacy was carried out by comparing the size of pipes and their accuracy after rolling with the results of computer simulation. When rolling at a four-high rolling mill, the wall thickness is significantly reduced.

Information technologies and management of transport systems development of the approach to assessing adaptation of the intersection transport model

In the work the authors touch upon the main approaches to assessment of adequacy of modeling of the transport system. They study the main parameters which can be used during assessment of adequacy of a transport model. The object of the research is a process of movement of vehicles at controlled intersections. The subject of the research is the technique of assessment of adequacy of the transport model using certain parameters of traffic flow (intensity, delays, motion speed, queue length). During the research the authors have developed the algorithm of assessment of adequacy of a certain parameter modeling.

Assessment of Hemodialysis Adequacy in Patients with End Stage Renal Disease in a Military Hospital of Dhaka, Bangladesh

Introduction: The burden of kidney disease patients requiring renal replacement therapy is increasing day by day. Hemodialysis (HD) constitutes the most common form of renal replacement therapy (RRT) worldwide. Determining the adequacy of hemodialysis, Urea kinetic modeling (UKM) is an important tool for this. The aim of this study was to determine hemodialysis adequacy by UKM.&#x0D; Material &amp; Methods: A total 137 patients were sampled in dialysis center of Combined Military Hospital (CMH) Dhaka. This was a cross sectional study. Data were collected from predialysis, postdialysis and next predialysis blood sample. Mean of adequacy parameters like single pool Kt/V (spKt/V), urea reduction ratio (URR), time average concentration of urea (TACurea) and normalized protein catabolic rate (NPCR) were calculated and compared between twice and thrice per week hemodialysis groups. Also compared adequacy variables between groups who achieved cutoff values and who did not achieve it.&#x0D; Results: One hundred (72.99%) patients were on 8 hours/week and 37 (27%) were on 12 hours/week hemodialysis session. Only 21(21%) and 16(43%) could achieve spKt/V cut off value among 8 hour and 12 hours group respectively. Eighty (58.39%) patients had URR &lt; 65% in this study. Blood flow e+250 ml/ min group had significantly better dialysis adequacy than blood flow &lt;250ml/min group, URR (81.31± 10.21 vs. 54.51 ± 11.52 and p-value &lt;0.001), spKt/V (1.99 ± 0.41 vs. 1.41 ± 0.31 pvalue&lt; 0.001) Thrice weekly hemodialysis group achieved better adequacy than twice weekly group.&#x0D; Conclusion: Frequency and blood flow of dialysis are strongly associated with adequacy of hemodialysis as evidenced by spKt/V and URR value. So to achieve hemodialysis adequacy, increasing the frequency of dialysis from two to three sessions per week is recommended.&#x0D; J Bangladesh Coll Phys Surg 2019; 37(4): 169-174

Can models for long-term decarbonization policies guarantee security of power supply? A perspective from gas and power sector coupling

The assessment of adequacy and security of the energy system requires the detailed knowledge of physical and operational characteristics. In contrast, studies concerning energy transitions employ stylized models that oftentimes ignore the technical properties but have a lasting influence on long-term energy policies. This paper investigates the gap between energy system planning and operational models by linking these two perspectives: (1) a long-term investment model with low spatial resolution and high level of aggregation, and (2) a spatially resolved system security model that captures the interdependences between the backbone of the electric power sector, i.e., the electricity and the gas infrastructure. We assess EU decarbonization pathways of the electricity sector towards 2050 by integrating the investment decisions of the long-term planning model and the safety performance of the resulting system operations via the security assessment model. In a large RES deployment scenario, we investigate two flexibility options: gas power plants and cross-country transmission expansion. Using the integrated model, we analyze how the adequacy and security of supply under extreme short-term operational conditions impact the long-term planning of the energy system and the investment decision-making. We provide country specific recommendations for UK. Results indicate weaknesses in the gas-electricity system and suggest improvements on capacity allocation.

Functional group based marine ecosystem assessment for the Bay of Biscay via elasticity analysis.

The transitory and long-term elasticities of the Bay of Biscay ecosystem to density-independent and density-dependent influences were estimated within a state space model that accounted for both process and observation uncertainties. A functional group based model for the Bay of Biscay fish ecosystem was fit to time series obtained from scientific survey and commercial catch and effort data. The observation model parameters correspond to the unknown catchabilities and observation error variances that vary across the commercial fisheries and fishery-independent scientific surveys. The process model used a Gompertz form of density dependence, which is commonly used for the analysis of multivariate ecological time series, with unknown time-varying fishing mortalities. Elasticity analysis showed that the process model parameters are directly interpretable in terms of one-year look-ahead prediction elasticities, which measure the proportional response of a functional group in the next year given a proportional change to a variable or parameter in the current year. The density dependent parameters were also shown to define the elasticities of the long term means or quantiles of the functional groups to changes in fishing pressure. Evidence for the importance of indirect effects, mediated by density dependence, in determining the ecosystem response of the Bay of Biscay to changes in fishing pressure is presented. The state space model performed favourably in an assessment of model adequacy that compared observations of catch per unit effort against cross-validation predictive densities blocked by year.

Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk.

Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55–75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3–1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia.

Examining the role of funders in ensuring value and reducing waste in research: An organizational case-study of the Patient-Centered Outcomes Research Institute

International experts have recommended actions that funders can take to improve the value of research investments. They state that self-assessment and public sharing are the basis for accountability and improvement. We examined our policies and practice to determine the extent to which the Patient-Centered Outcomes Research Institute's (PCORI) policies and practices as a research funder align with international best practice recommendations.A self-audit of current policies and practice against 17 recommendations and 35 sub-recommendations representing five major stages of research production, based on adapted methods used for self-assessment by another funder, was performed.Fit of existing PCORI policies and practices with 35 sub-recommendations, qualitative assessment of adequacy (area of strength; area of partial strength; area of growth; not applicable) for 17 recommendations for five stages of research production was assessed.Of the 17 recommendations, 15 were applicable to PCORI's research mission and focus. PCORI has policies and practices in place for all elements of six recommendations ("area of strength") and policies that address each element but with some still in active development for three ("area of partial strength"). PCORI is partially addressing six of the 15 relevant recommendations ("area of growth").Areas for growth include making study protocols publicly available, improving policies on data sharing, and enhancing collaboration with other funders to reduce redundant funding.A voluntary consortium of international funders is underway to encourage further progress, including additional self-assessment and public sharing for accountability.These findings indicate PCORI has undertaken efforts to align its funding practices with international recommendations to ensure the value of public dollars invested in research. Further efforts will likely require additional coordination and collaboration between funders and stakeholders.