National strategies for knowledge translation in health policy-making: A scoping review of grey literature.

BACKGROUND AND OBJECTIVES: Without strategic actions in its support, the translation of scientific research evidence into health policy is often absent or delayed. This review systematically maps and assesses national-level strategic documents in the field of knowledge translation (KT) for health policy, and develops a practical template that can support Evidence-informed Policy Network (EVIPNet) Europe countries in producing national strategies for evidence-informed policy-making. METHODS: Websites of organizations with strategic responsibilities in KT were electronically searched, on the basis of pre-defined criteria, in July-August 2017, and an updated search was carried out in April-June 2021. We included national strategies or elements of national strategies that dealt with KT activities, as well as similar strategies of individual institutions with a national policy focus. Two reviewers screened the strategies for inclusion. Data were analysed using qualitative content analysis. RESULTS: A total of 65 unique documents were identified, of which 17 were eligible and analysed for their structure and content. Of the 17, 1 document was a national health KT action plan and 6 documents were institution-level KT strategies. The remaining 10 strategies, which were also included were 2 national health strategies, 5 national health research strategies and 3 national KT strategies (not specific to the field of health alone). In all, 13 structural elements and 7 major themes of health policy KT strategies were identified from the included documents. CONCLUSION: KT in health policy, as emerged from the national strategies that our mapping identified, is based on the production and accessibility of policy-relevant research, its packaging for policy-making and the activities related to knowledge exchange. KT strategies may play different roles in the complex and context-specific process of policy-making. Our findings show that the main ideas of health-specific evidence-informed policy literature appear in these strategies, but their effectiveness depends on the way stakeholders use them. Specific knowledge-brokering institutions and organizational capacity, advocacy about the use of evidence, and close collaboration and co-decision-making with key stakeholders are essential in furthering the policy uptake of research results.

Development Perspectives for Curative Technologies in Primary Demyelinating Disorders of the Central Nervous System with Neuromyelitis Optica Spectrum Disorder (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) at the Forefront.

Primary demyelinating disorders of the central nervous system (CNS) include multiple sclerosis and the orphan conditions neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein IgG-associated disease (MOGAD). Curative technologies under development aim to selectively block autoimmune reactions against specific autoantigens while preserving the responsiveness of the immune system to other antigens. Our analysis focused on target patient selection for such developments, carefully considering the relevant clinical, regulatory, and market-related aspects. We found that the selection of patients with orphan conditions as target populations offers several advantages. Treatments for orphan conditions are associated with limited production capacity, qualify for regulatory incentives, and may require significantly shorter and lower-scale clinical programs. Furthermore, they may meet a higher acceptable cost-effectiveness threshold in order to compensate for the low numbers of patients to be treated. Finally, curative technologies targeting orphan indications could enter less competitive markets with lower risk of generic price erosion and would benefit from additional market protection measures available only for orphan products. These advantages position orphan conditions and subgroups as the most attractive target indications among primary demyelinating disorders of the CNS. The authors believe that after successful proof-of-principle demonstrations in orphan conditions, broader autoimmune patient populations may also benefit from the success of these pioneering developments.

Taxonomic diversity and environmental tolerance of cultivable extremophilic bacteria from a high-altitude meltwater pond on Ojos del Salado (Chile).

Earth harbors unique environments where only microorganisms adapted to extreme conditions, known as extremophiles, can survive. This study focused on a high-altitude meltwater pond, located in the Puna de Atacama, Dry Andes. The extremophilic bacteria of this habitat must adapt to a range of extremities, including cold and dry climate, high UV radiation, high daily temperature fluctuations, low-nutrient availability, and negative water balance. This study aimed to explore the taxonomic diversity of cultivable extremophilic bacteria from sediment samples of a desiccated, high-altitude, meltwater pond using media with different organic matter contents and different incubation temperatures. Based on the 16S rRNA gene sequence analysis, the isolates were identified as members of the phyla Actinobacteria, Proteobacteria, and Firmicutes. The most abundant genera were Arthrobacter and Pseudoarthrobacter. The isolates had oligocarbophilic and psychrotrophic properties, suggesting that they have adapted to the extreme environmental parameters of their natural habitats. The results indicate a positive correlation between nutrient concentration and temperature tolerance.

Assessing phenotypic variation and plasticity of endemic gastropods from thermal water refugia using complex morphometric techniques: A case study of Lake Pețea melanopsids.

Understanding the underlying reasons for phenotypic plasticity and resulting morphological disparity is one of the key topics of evolutionary research. The phenotypic plasticity of extant and fossil melanopsids has been widely documented. Yet millennial-resolution, well-dated records from small aquatic habitats harboring endemics are scarce. The thermal spring-fed Lake Pețea is an ice age refugia harboring a unique endemic warm-water fauna. Subfossil melanopsids display incredible morphological variability from smooth to keeled, elongated to ribbed, shouldered forms. Numerous morphotypes have been considered as individual taxa with a fluent succession from the smooth elongated to the ribbed, shouldered types. This study presents an extensive morphometric analysis of subfossil melanopsids (ca. 3500 specimens) derived from stratified samples with an independent chronology. The aim was to separate morphotypes for investigations of temporal morphological disparity. Our results challenge the widely accepted hypothesis that proposes the evolution of shouldered, compressed, ribbed shells through a two-step process from smooth elongated spindle-shaped shells. Instead, it suggests that the subfossil shells belong to two distinct taxa present throughout the available stratigraphic data. The main components of shape variation, shape globularity, and shell coiling seem allometry-related. Ribs, striation, and keels appear randomly. High-spired spindle-shaped forms were considered to represent specimens of Microcolpia daudebartii hazayi. Bulkier low-spired and shouldered specimens represent phenotypes of Mi. parreyssii parreyssii. The collective and random distribution of morphotypes from the early stages of the lake's history also refutes the idea of a continuous transformation of the elongated forms into compressed, shouldered ones. Rather points to multiple events and environmental stimuli triggering development. Melanopsids appear in Late Glacial horizons, with Theodoxus prevostianus preferring temperatures above 23°C which may indicate the subordinate presence of hot water microhabitats in cooler waters.

Technical note: Phantom-based evaluation of CBCT dose calculation accuracy for use in adaptive radiotherapy.

BACKGROUND: High-quality 3D-anatomy of the day is needed for treatment plan adaptation in radiotherapy. For online x-ray-based CBCT workflows, one approach is to create a synthetic CT or to utilize a fan-beam CT with corresponding registrations. The former potentially introduces uncertainties in the dose calculation if deformable image registration is used. The latter can introduce burden and complexity to the process, the facility, and the patient. PURPOSE: Using the CBCT of the day, acquired on the treatment device, for direct dose calculation and plan adaptation can overcome these limitations. This study aims to assess the accuracy of the calculated dose on the CBCT scans acquired on a Halcyon linear accelerator equipped with HyperSight. METHODS: HyperSight's new CBCT reconstruction algorithm includes improvements in scatter correction, HU calibration of the imager, and beam shape adaptation. Furthermore, HyperSight introduced a new x-ray detector. To show the effect of the implemented improvements, gamma comparisons of 2%/2 mm, 2%/1 mm, and 1%/1 mm were made between the dose distribution in phantoms calculated on the CBCT reconstructions and the simulation CT scans, considering this the standard of care. The resulting gamma passing rates were compared to those obtained with the Halcyon 3.0 reconstruction and hardware without HyperSight's technologies. Various anatomical phantoms for dosimetric evaluations on brain, head and neck, lung, breast, and prostate cases have been used in this study. RESULTS: The overall results demonstrated that HyperSight outperformed the Halcyon 3.0 version. Based on the gamma analysis, the calculated dose using HyperSight was closer to the CT scan-based doses than the calculated dose using iCBCT Halcyon 3.0 for most cases. Over all plans and gamma criteria, Halcyon 3.0 achieved an average passing rate of 92.9%, whereas HyperSight achieved 98.1%. CONCLUSION: Using HyperSight CBCT images for direct dose calculation, for example, in (online) plan adaptation, seems feasible for the investigated cases.

Automated and observer based light field indicator edge evaluation in diagnostic X-ray equipment

Abstract Introduction To analyze edge detection and optical contrast calculation of light field-indicators used in X-ray via automated- and observer-based methods, and comparison with current standard approaches, which do not give exact definition for light field edge determination. Methods Automated light sensor array was used to measure the penumbra zone of the edge in the standard X-ray equipment, while trained and naïve human observers were asked to mark the light field edge according to their own determination. Different interpretations of the contrast were then calculated and compared. Results In contrast to automated measurements of edge definition and detection, measurements by human observers showed large inter-observer variation independent of their training with X-ray equipment. Different contrast calculations considering the different edge definitions gave very different contrast values. Conclusion As the main conclusion, we propose a more exact edge definition of the X-ray light field, corresponding well to the average human observer's edge determination. The new edge definition method with automated systems would reduce human variability in edge determination. Such errors could potentially affect the approval of X-ray equipment, and also increase the radiation dose. The automated measurement based on human observers' edge definition and the corresponding contrast calculation may lead to a more precise light field calibration, which enables reduced irradiation doses on radiology patients.