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This manual on improving transparency, integrity, and accountability in water supply and sanitation is the result of a partnership between the World Bank Institute (WBI) and transparency international (TI). It was developed under the open and participatory government program at the municipal level (known by its Spanish acronym as the GAP Municipal Program). This manual can help: 1) increase the involvement of civil society by engaging all stakeholders in setting water supply and sanitation priorities and monitoring performance, including reducing opportunities for corruption; 2) increase the contributions of water supply and sanitation services to poverty reduction by increasing the quality and coverage of service to poorer communities on an equitable basis; 3) promote the financial sustainability of water and sanitation service delivery organizations, thereby increasing the confidence of consumers, civil society organizations, and other stakeholders in those institutions' ability to expand improve service; and 4) raise ethical standards among all stakeholders, especially service delivery organizations, thereby instilling a sense of public service throughout these organizations.

Recent European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS) guidelines highlighted some concerns about the randomized clinical trials (RCTs) comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) for aortic stenosis. Quantification of these biases has not been previously performed. To assess whether randomization protects RCTs comparing TAVI and SAVR from biases other than nonrandom allocation. A systematic review of the literature between January 1, 2007, and June 6, 2022, on MEDLINE, Embase, and Cochrane Central Register of Controlled Trials was performed. Specialist websites were also checked for unpublished data. The study included RCTs with random allocation to TAVI or SAVR with a maximum 5-year follow-up. Data extraction was performed by 2 independent investigators following the PRISMA guidelines. A random-effects meta-analysis was used for quantifying pooled rates and differential rates between treatments of deviation from random assigned treatment (DAT), loss to follow-up, and receipt of additional treatments. The primary outcomes were the proportion of DAT, loss to follow-up, and patients who were provided additional treatments and myocardial revascularization, together with their ratio between treatments. The measures were the pooled overall proportion of the primary outcomes and the risk ratio (RR) in the TAVI vs SAVR groups. The search identified 8 eligible trials including 8849 participants randomly assigned to undergo TAVI (n = 4458) or SAVR (n = 4391). The pooled proportion of DAT among the sample was 4.2% (95% CI, 3.0%-5.6%), favoring TAVI (pooled RR vs SAVR, 0.16; 95% CI, 0.08-0.36; P < .001). The pooled proportion of loss to follow-up was 4.8% (95% CI, 2.7%-7.3%). Meta-regression showed a significant association between the proportion of participants lost to follow-up and follow-up time (slope, 0.042; 95% CI, 0.017-0.066; P < .001). There was an imbalance of loss to follow-up favoring TAVI (RR, 0.39; 95% CI, 0.28-0.55; P < .001). The pooled proportion of patients who had additional procedures was 10.4% (95% CI, 4.4%-18.5%): 4.6% (95% CI, 1.5%-9.3%) in the TAVI group and 16.5% (95% CI, 7.5%-28.1%) in the SAVR group (RR, 0.27; 95% CI, 0.15-0.50; P < .001). The imbalance between groups also favored TAVI for additional myocardial revascularization (RR, 0.40; 95% CI, 0.24-0.68; P < .001). This study suggests that, in RCTs comparing TAVI vs SAVR, there are substantial proportions of DAT, loss to follow-up, and additional procedures together with systematic selective imbalance in the same direction characterized by significantly lower proportions of patients undergoing TAVI that might affect internal validity.

The Corruption Perceptions Index is constructed by the Transparency International. The Corruption Perceptions Index measures the perceived levels of public sector corruption in countries worldwide. Based on expert opinion, countries are scored from 0 (highly corrupt) to 100 (very clean). Some countries score well, but no country scores a perfect 100. Two-thirds of the 176 countries ranked in the 2012 index score below 50, showing that public institutions need to be more transparent, and powerful officials more accountable.