Real-World Performance Benchmarks in the Reading Ability of Prescription Drug Labels by Community-Dwelling Older Adults

BACKGROUND

Despite known recommendations regarding standards for print size and the intuitive importance of vision in reading prescription labels, the predictive nature of vision and prescription label readability remains largely undefined. Furthermore, while the importance of vision is recognized, various demographic factors associated with the ability to read prescription labels have not been fully elucidated.

OBJECTIVE

Describe relationships between visual acuity, point size, and readability of prescription labels and provide insight into demographic factors associated with prescription label readability.

METHODS

Cross-sectional examination of prescription label readability by older, community-dwelling adults. Subjects were evaluated as to demographics, visual acuity, and ability to read test instruments consisting of unaltered prescription label features of five medications dispensed by community pharmacies and two drug samples. Descriptive statistics in conjunction with a logit predictive model were employed for data analysis.

RESULTS

Instructions for medication use were most recognizable, identified and correctly read by 95.60% of the study cohort while directions for the use of drug samples were lowest (34.91%). Among prescription label features, auxiliary labels consistently demonstrated poor readability. Level of visual acuity was statistically related to the ability to read prescription labels while identifying prescription label components increased proportionally with point size. Race, gender, and history of a recent eye examination were statistically significant predictors of prescription label reading ability. Visual acuity alone was found to explain approximately 26% of the variablity in ability to read Rx labels.

CONCLUSION

Visual acuity is predictive of the ability to access Rx label information and should be considered a modifiable variable for improving prescription label reading ability amenable by appropriate eye care and spectacle correction.

What are the challenges for implementing an "organic label" to camel milk?

Increasing demand for camel's milk worldwide occurred in the context of the development of the organic sector in agriculture. The implementation of an organic label for camel milk has never been established. However, the creation of such a label faces to important challenges that are investigated in the present paper. Indeed, although camel milk conveys the image of a "natural product" issued from remote places, the risk of being produced in contaminated areas (mining activities, oil extraction) cannot be neglected for grazing animals. Moreover, the management of veterinary drugs for prevention or curative treatment can lead to the presence of residues in milk, especially in camel species with different pharmacokinetics, although similar instructions than for cow milk are used. Moreover, the lack of international standards regarding both composition and hygienic rules, the risks of adulteration, and the necessity to use specific indicators or analytical procedures adapted to the behavior of camel milk, have to be taken in account in the establishment of the specifications for the camel milk producers through the world.

Consumers' Segmentation Influences Acceptance and Preferences of Cheeses with Sanitary Inspection and Artisanal Seals

Food labeling serves as a crucial medium for industries to communicate product qualities to consumers. Sanitary inspection and artisanal seals are significant markers for traditional cheeses, yet current information on this topic is limited. Therefore, this study aims to evaluate the impact of sanitary inspection and the ARTE seal on the acceptance of artisanal cheese. To achieve this objective, four hypothetical cheese labels featuring all combinations of sanitary inspection and ARTE seals were presented to 404 consumers. These consumers rated their acceptance of each label, a conjoint analysis was conducted, and the relative importance of each seal was calculated. Subsequently, consumers were segmented using hierarchical cluster analysis. Their socio-demographic profiles were statistically correlated to the clusters through a chi-squared method. The results revealed the existence of three distinct consumer groups: those who strongly prefer cheeses with a sanitary seal (assigning a relative importance of 80.2% to the seal), those who favor cheeses with an artisanal seal (assigning a relative importance of 52.5% to the seal), and those for whom the presence of either seal did not significantly affect acceptance. Consumers residing in metropolitan areas generally placed less value on both seals, whereas frequent purchasers of artisanal foods and residents of rural areas showed a preference for the artisanal seal. Other socio-demographic variables did not statistically correlate with cluster membership. In conclusion, consumer segmentation based on preferences for sanitary inspection and artisanal seals in food labeling is vital for developing effective marketing strategies and food safety education policies.

A Review of Labeling Approaches Used in Small Extracellular Vesicles Tracing and Imaging

Small extracellular vesicles (sEVs), a subset of extracellular vesicles (EVs) originating from the endosomal compartment, are a kind of lipid bilayer vesicles released by almost all types of cells, serving as natural carriers of nucleic acids, proteins, and lipids for intercellular communication and transfer of bioactive molecules. The current findings suggest their vital role in physiological and pathological processes. Various sEVs labeling techniques have been developed for the more advanced study of the function, mode of action, bio-distribution, and related information of sEVs. In this review, we summarize the existing and emerging sEVs labeling techniques, including fluorescent labeling, radioisotope labeling, nanoparticle labeling, chemical contrast agents labeling, and label-free technique. These approaches will pave the way for an in-depth study of sEVs. We present a systematic and comprehensive review of the principles, advantages, disadvantages, and applications of these techniques, to help promote applications of these labeling approaches in future research on sEVs.

Every Museum Label for All? Reflection on Inclusive and Communicative Writing

Since our PhD, we aim to rethink the transposition of universal design (UD) in museums for narratives, specifically on labels. We have conceptualised a model of universal label, adding inclusive and communicative writing: inclusive, by using universal design merging on the same device several forms of communication (sign language, Braille, easy to read); communicative, because it explains and learns how citizens perceived as disabled communicate. UD writing could initiate and encourage communication. In this paper, we applied our reflections on UD writing to the label of The Mona Lisa at the Louvre Museum.

Labels and the Self: Identity Labels as Scaffold

This paper considers how labels may be used: "Neurodiverse," "genderfluid," "sex-positive," "ADHD," and "highly-sensitive" are just some of the labels that may be offered by patients in introducing themselves. Such labels can be thought of as shortcuts, a way to define identity and sum up a feeling state, attitude, or behaviour. While they may sometimes be "given" in the sense of a diagnosis, they are also "found" and self-adopted. Using scaffolding as a metaphor for allowing growth or development to take place (or compensate for its absence), the phenomenon of self-labelling is presented as fulfilling different functions, namely: Label as mirrored reflection; Label as creative defence; Label as something with which to play; Label as container for that which cannot yet be known; Label as calling something into being; and Label as collective dream image. The article starts with three brief composite clinical sketches, and goes on to explore some of the ways that labels may be used with reference to the presented clinical material.

Study on the detection of anthrax by ICP-MS based on gold nanoparticle labeling

BACKGROUND

In recent years, inductively coupled plasma mass spectrometry (ICP-MS) has been widely used in the field of molecular biology because of its unique advantages. Anthrax is a widespread and long-standing infectious disease, which affects and restricts people's work and life seriously.

OBJECTIVE

The study goal is to develop a new method for the detection of anthrax.

METHODS

A rapid, sensitive and accurate method for the detection of anthrax characteristic DNA was proposed by combing gold nanoparticles (AuNPs) and inductively coupled plasma mass spectrometry.

RESULTS

The linear range of this method is 100-2500 pmol/L and the limit of detection of 16.61 pmol/L.

CONCLUSION

The proposed method has numerous advantages, including simplicity of operation, high sensitivity, and specificity, which provides a new idea for the detection of anthrax. Importantly, this methodology has good potential for the detection of other biological substances such as bacteria and viruses by changing the modification sequence on the nanoparticle probe.

Unintentional poisoning from decanted toxic household chemicals

BACKGROUND

Although poisonings due to a toxic substance being decanted into a secondary container are often reported to poison centers, we were unable to locate prior European data about their circumstances, incidence and consequences. We sought to describe the circumstances and outcomes of this behavior.

MATERIALS AND METHOD

We conducted a prospective study of all poison exposures involving transfer to a secondary container reported to our poison center during a six month interval (January 1, 2021 through June 30, 2021). We called patients and clinicians for follow up the next day. We used a prepared questionnaire and added the responses to the national database for French poison centers.

RESULTS

We identified and included 238 patients (104 male, 134 female) with a median age of 39 years [range 0-94 y]. Exposure was mainly oral (n = 221), the secondary container was mainly a water bottle (n = 173), toxic substances were essentially cleaning products (n = 63) or bleach (n = 48). Symptoms were gastrointestinal (vomiting, diarrhea, abdominal pain) (n = 143) or respiratory (cough, dyspnea, aspiration pneumonia) (n = 15). The World Health Organisation/International Programme on Chemical Safety/European Commission/European Association of Poison Centres and Clinical Toxicologists Poisoning Severity Score was none in 76 cases (31.9%), minor in 147 (61.8%), moderate in 12 (5%), and severe in three cases (1.3%). Products that led to severe poisoning contained either ammonium hydroxide or sodium hydroxide. Two of the patients required intensive care treatment. At the end of the follow-up, 235 patients fully recovered, and three patients had sequelae.

CONCLUSIONS

The study illustrates the risk of toxic substance transfer. Water bottles were the secondary containers in most exposures to decanted substances. Most had minor or no effects, but nearly one-quarter were admitted to the hospital. The few severe exposures involved either ammonium hydroxide or sodium hydroxide.

Development of meat analogs: Focus on the current status and challenges of regulatory legislation

Population growth and the rising enthusiasm for meat consumption in developing countries have increased the global demand for animal protein. The limited increase in traditional meat production, which results in high resource consumption, greenhouse gas emissions, and zoonotic diseases, has affected the sustainable supply of meat protein. The technological development and commercialization of meat analogs derived from plant and microbial proteins provide a strategy for solving the abovementioned problems. However, before these innovative foods are marketed, they should comply with regulations and standards to ensure food safety and consumer rights. This review briefly summarizes the global development status and challenges of plant- and fungi-based meat analog products. It focuses on the current status, characteristics, and disputes in the regulations and standards worldwide for plant- and fungi-based meat analogs and proposes suggestions for perfecting the regulatory system from the perspective of ensuring safety and supporting innovation. Although plant- and fungi-based meat analogs have had a history of safe usage as foods for a certain period around the world, the nomenclature and product standards are uncertain, which affects product innovation and global sales. Regulatory authorities should promptly formulate and revise regulations or standards to clarify the naming of meat analogs and product standards, especially the use of animal-derived ingredients and limits of nutrients (e.g., protein, fat, vitamins, and minerals) to continuously introduce start-up products to the market.

Variations on a theme: Labeling patients as persons, the nursed, or client in nursing

The debate regarding the variation of names used for labeling the patient in a nursing care situation has always existed in nursing. Names such as patient, client, person, and nursed have been used widely among healthcare disciplines, including nursing. However, does the use of any of these identifying terms establish the appropriate identification of the nurse and the persons being nursed in a nursing care situation participating in a mutual relationship? This editorial aims to address the varieties and rationales of identifying persons participating in or receiving nursing care. Among these terms, "person" describing human beings underscores personhood, allowing nurse-nursed relations to foster, support, celebrate, and affirm living the meaning of what matters most to one's life. Therefore, it will be advantageous to nursing practice if the term "person being nursed" is the relevant descriptor to be considered as the primary label.

A Bright, Nontoxic, and Non-aggregating red Fluorescent Protein for Long-Term Labeling of Fine Structures in Neurons

Red fluorescent proteins are useful as morphological markers in neurons, often complementing green fluorescent protein-based probes of neuronal activity. However, commonly used red fluorescent proteins show aggregation and toxicity in neurons or are dim. We report the engineering of a bright red fluorescent protein, Crimson, that enables long-term morphological labeling of neurons without aggregation or toxicity. Crimson is similar to mCherry and mKate2 in fluorescence spectra but is 100 and 28% greater in molecular brightness, respectively. We used a membrane-localized Crimson-CAAX to label thin neurites, dendritic spines and filopodia, enhancing detection of these small structures compared to cytosolic markers.

Measurement of the physicochemical, performance, and consumer-information characteristics of commercial nonmedicated shampoo for dogs

The aim was to analyze the quality of commercial shampoo without prophylactic effect for dogs. The analysis was based on the evaluations and requirements established for human-line products since there is no guide for veterinary products in Mexico; such evaluations have not been carried out or published in Mexico. Physicochemical, sensory, performance, and consumer information tests of the shampoo were carried out. The sample consisted of twenty products marketed in Mexico City. During the evaluation of the label, a serious non-compliance with applicable regulations was found. The pH of the products ranged between 5.6 and 8.4; Significant differences (p⟨0.05) were found between the three groups with low (6.1), medium (7.2), and high (8.1) pH. Viscosity values were from 1131 to 3102. For the foam index, no statistically significant differences were found. 100% of the products analyzed complied with the rest of the quality tests carried out. The results of the quality analysis in this study will allow veterinarians specializing in small species to better select and recommend the products for their use and inform dog owners, about the safety, and value of the products.

Subgroups of Extracellular Vesicles: Can They Be Defined by "Labels?"

Extracellular vesicles (EVs) are a class of lipid bilayer membranes, containing lipids, nucleic acids (DNA and RNA), proteins, and other substances. They are produced by almost all types of cells and act as signaling intermediaries between cells and/or tissues through different mechanisms involving complex signals. EVs produced by each type of cells are composed of highly heterogeneous and inhomogeneous subgroups with different biological functions. Therefore, in the past few decades, researchers have tried to use different "labels" to define the subgroups of EVs, and explore the differences in them. However, a unified standard for defining the populations of EVs has not yet been established so far. In this study, we review and summarize the use of different "labels" to define subgroups of EVs.

The Explanatory Effect of a Label: Its Influence on a Category Persists Even If We Forget the Label

In this study we replicated the explanatory effect of a label which had been found by Giffin et al. (2017). In their experiments, they used vignettes describing an odd behavior of a person based on culturally specific disorders that were unfamiliar to respondents. It turned out that explanations which explain an odd behavior through a person's tendency to behave that way (circulus vitiosus) seemed more persuasive if the disorder was given a label that was used in the explanation. We replicated these results in Experiment 1, and in a follow-up Experiment 2 we examined the familiarity with category information and the evaluation of that category over time (the delay lasted one week). We realized that the label effect persists even when people make judgments based on their recollections about a category. Furthermore, according to a content analysis of the recollections, participants in the label condition remembered more information from the vignettes but tended to forget an artificial label; however, they used other words from the disorder domain instead (like "disease" or "kleptomania"). This allowed us to suggest a new interpretation of this effect: we suppose that in the Giffin et al. (2017) experiments the label did not bring any new features to a category itself, but pointed to a relevant domain instead, so the effect appeared from the activation of areas of knowledge in semantic memory and the application of relevant schema for learning a new phenomenon.

Effect of information about mandarin internal maturity on consumer hedonic and sensory expectations: a cross-cultural study in Spain and Mexico

BACKGROUND

Under certain climate conditions, citrus fruit may reach optimum internal maturity while the rind is still green. It is therefore customary to enhance skin colour changes by submitting early citrus varieties to ethylene degreening treatment, which implies a cost and may result in external disorders. In this study, the effect on consumer expectations (sensory and hedonic) of providing them with information about the internal maturity of non-degreened mandarins (greenish-coloured rind) was evaluated.

RESULTS

Mandarins with three different external colour indices (CI), CI = -6, CI = +1 and CI = +5, and three ways of conveying information, were investigated: (i) No information (NoInfo), (ii) The text 'Mandarins ready to eat' (Text) and (iii) Text + Visualisation of mandarin flesh (orange-coloured in all cases) (Text+Flesh). Consumer expected liking, purchase intention and sensory expectations were markedly affected after receiving the different information types. The greatest effect was detected when Text+Flesh information was provided. Rind mandarin colour was also a determinant factor of how consumer expectations were modified by the received information. Moreover, our results revealed some differences among Spanish and Mexican consumers, since maturity information had a stronger effect on hedonic expectations of Mexican consumers.

CONCLUSIONS

When mandarins reach CI = +5 (pale orange-coloured rind with small areas still green), letting consumers know that mandarins are ready to eat by means of Text+Flesh information may be a non-cost strategy to avoid degreening treatment or to shorten its length. © 2021 Society of Chemical Industry.

Adverse reactions related to proton pump inhibitors in pediatric population: an analysis of spontaneous reporting data

BACKGROUND

The use of proton pump inhibitors (PPIs) has increased in the last 10 years in children. Data regarding their safety profile are limited. The aim of this study was to analyze data from the Italian spontaneous reporting system (SRS) database to evaluate the incidence and characteristics of PPI-related adverse drug reactions (ADRs) in children.

RESEARCH DESIGN AND METHODS

This was an observational, retrospective study analyzing PPI-related ADR reports in children in the Italian SRS database between January 1^st, 2001, and December 31^st, 2020. ADRs were coded according to the system organ class term level. Factors associated with ADR seriousness were investigated.

RESULTS

Seventy spontaneous reports of ADRs related to PPIs were analyzed. Esomeprazole and lansoprazole caused the highest number of ADRs equally (27% respectively), and the most frequently reported ADRs presented with gastrointestinal (24%) and/or skin manifestations (21.3%). More than a half of PPI prescriptions were off label for pediatric population. Serious ADRs were 19 (27.1%). Serious ADRs were more frequent in reports presenting PPIs combined with other drugs in comparison to reports with PPI single therapies (p = 0.03).

CONCLUSIONS

PPI-related ADRs in children are mostly not serious, and combination therapy seems to be associated with ADR seriousness.

Comparison of 12 Different Animal Welfare Labeling Schemes in the Pig Sector

Simple Summary

Welfare requirements from an animal point of view are the same regardless of the country. However, differing requirements of animal welfare schemes make it hard for consumers to make informed choices. Therefore, an open and coherent labeling scheme that provides information on farm animal welfare will be beneficial from the consumer perspective. We reviewed 12 pig welfare schemes. We aimed to identify consistencies and differences in welfare requirements between these schemes. The studied welfare requirements were heterogeneous in the potential each scheme had to advance pig welfare. Certain requirements barely exceeded the minimum standards for the protection of pigs in European Union (EU) legislation, but the more demanding tiers of multitier schemes had the potential to enhance animal welfare. The most ambitious tiers could improve animal welfare substantially and, in terms of resources available to the animal, they often were convergent with organic animal farming standards. Because of variation of welfare requirements between the labels, it was challenging to compare existing labeling schemes. Adopting a harmonized labeling terminology and standard, increased use of animal-based measures, and open communication will make labeling more reliable and transparent, which will contribute to the availability of standardized animal-friendly products and will be equitable from an animal welfare perspective.

Abstract

Animal welfare labeling schemes have been developed to respond to consumers’ expectations regarding farm animal welfare. They are designed to certify that labeled products comply with certain animal welfare standards. In this study, 12 pig welfare labeling schemes were reviewed, and their criteria related to pig welfare were compared. Information regarding farrowing criteria, space allowance, outdoor access, mutilations, and provision of enrichments and bedding material were gathered from the labels’ internet pages and documentation. The results indicated a substantial variation between the labels in terms of the level of animal welfare they ensure. While certain schemes barely exceeded the minimum standards for the protection of pigs in the European Union, more demanding tiers of the multitier schemes had the potential to improve animal welfare substantially. The most ambitious tiers of multistage schemes were often comparable to organic standards providing outdoor facilities and additional space. The heterogeneity of the labels’ standards complicates the comparison of labels.

Supranational Assessment of the Quality of Probiotics: Collaborative Initiative between Independent Accredited Testing Laboratories

Recent acquisitions about the role of the microbiota in the functioning of the human body make it possible to envisage an increasing use of beneficial microbes, and more particularly of probiotics as well as their metabolites, as nutritional supplements. National and EU authorities are engaged in assuring the safety and quality of food supplements and in defining rules to assess and communicate their efficacy on human health. The quality of probiotics, intended as strains' identification, viability, and stability over time, is a crucial factor of credibility with consumers and health professionals. Analytical technologies for the quality control of probiotics must also be adapted to new preparations, such as those including new multistrains complex combinations. Accredited laboratories face this relevant challenge on a daily basis. Through its close collaboration with the laboratory commissioned to produce the specifications for its ESLP quality label (identification and quantitative analyses) together with its scientific committee, the ESLP has been focusing on this issue for 10 years. Recently, as part of the internationalization of the ESLP quality label, a new and unique initiative in Europe for the evaluation of the quality of probiotic preparations has been carried out. The collaboration between two accredited laboratories in Belgium and in Italy represented a concrete example of supranational collaboration in the assessment of the quality of probiotic preparations. Results show that both laboratories are in line as expected in terms of performance. Common approaches to the qualitative assessment of probiotic preparations, especially for complex and composite recipes, in terms of number of strains and included substances, should be encouraged and promoted all over the EU.

Assessing Use of a Standardized Allergy History Questionnaire for Patients with Reported Allergy to Penicillin

BACKGROUND

Inappropriate allergy labelling is associated with significant clinical and pharmacoeconomic implications. Detailed antimicrobial allergy assessments represent a key component of antimicrobial stewardship and aid in identifying true type I (immediate hypersensitivity) reactions. The allergy history form currently used at the University Hospital of Northern British Columbia (UHNBC), in Prince George, relies on the assessor's ability to ask appropriate prompting questions to obtain a thorough history, but it may not be sufficient to accurately identify true allergies.

OBJECTIVE

To compare a standardized allergy history questionnaire and the current allergy history form in terms of the quality and quantity of documentation gathered.

METHODS

This prospective observational study involved patients who were admitted to medical and surgical services at UHNBC from November 2018 to January 2019 with a penicillin-class allergy reported on their electronic medical record (EMR). A list of patients with EMR-reported allergies was generated by the hospital's health information software system, and these patients were interviewed using the standardized allergy history questionnaire.

RESULTS

A total of 48 patients were assessed during the study period. Nineteen (40%) of the patients had an inappropriate allergy label on their EMR. Only 36 (75%) had an allergic reaction described on their EMR. Furthermore, only 36 (75%) of the 48 patients had the same allergy recorded on the EMR and on the allergy history form contained in their paper chart, of whom 22 had a documented reaction. The mean time to complete the standardized allergy history questionnaire was 2 minutes.

CONCLUSIONS

At the study institution, documentation of allergy histories was often incomplete. Detailed allergy assessments are the first step in identifying true immunoglobulin E-mediated hypersensitivity reactions. Utilization of a standardized allergy history questionnaire is feasible and may serve to improve documentation and overall antimicrobial stewardship.

Chronic Pain: What Does It Mean? A Review on the Use of the Term Chronic Pain in Clinical Practice

Chronic pain is nowadays used as an umbrella term referring to a wide range of clinical conditions, such as fibromyalgia, migraine, or long-standing pain states without actual known causes. However, labeling a patient’s clinical condition with the term “chronic pain”, when dealing with pain lasting longer than 3 months, might be misleading. This paper aims at analyzing the possible pitfalls related to the use of the term “chronic pain” in the clinical field. It appears, indeed, that the term “chronic pain” shows a semantic inaccuracy on the basis of emerging scientific evidences on the pathogenesis of different long-standing pain states. The major pitfalls in using this label emerge in clinical settings, especially with patients having a biomedical perspective on pain or from different cultures, or with healthcare providers of other medical specialties or different disciplines. A label solely emphasizing temporal features does not help to discern the multifaceted complexity of long-standing pain states, whose onset, maintenance and exacerbation are influenced by a complex and interdependent set of bio-psycho-social factors. Thus, finding a more meaningful name might be important. We call upon the necessity of bringing awareness and implementing educational activities for healthcare providers, as well as for the public, on the biopsychosocial approach to assess, prevent and care of chronic pain. Further research on the etiopathogenetic processes of chronic pain states is also required, together with examinative diagnostic methods, to individuate the most appropriate label(s) representing the complex long-standing pain states and to avoid adopting the term “chronic pain” inappropriately.

Recent progress of surface-enhanced Raman spectroscopy for subcellular compartment analysis

Organelles are involved in many cell life activities, and their metabolic or functional disorders are closely related to apoptosis, neurodegenerative diseases, cardiovascular diseases, and the development and metastasis of cancers. The explorations of subcellular structures, microenvironments, and their abnormal conditions are conducive to a deeper understanding of many pathological mechanisms, which are expected to achieve the early diagnosis and the effective therapy of diseases. Organelles are also the targeted locations of drugs, and they play significant roles in many targeting therapeutic strategies. Surface-enhanced Raman spectroscopy (SERS) is a powerful analytical tool that can provide the molecular fingerprint information of subcellular compartments and the real-time cellular dynamics in a non-invasive and non-destructive way. This review aims to summarize the recent advances of SERS studies on subcellular compartments, including five parts. The introductions of SERS and subcellular compartments are given. SERS is promising in subcellular compartment studies due to its molecular specificity and high sensitivity, and both of which highly match the high demands of cellular/subcellular investigations. Intracellular SERS is mainly cataloged as the labeling and label-free methods. For subcellular targeted detections and therapies, how to internalize plasmonic nanoparticles or nanostructure in the target locations is a key point. The subcellular compartment SERS detections, SERS measurements of isolated organelles, investigations of therapeutic mechanisms from subcellular compartments and microenvironments, and integration of SERS diagnosis and treatment are sequentially presented. A perspective view of the subcellular SERS studies is discussed from six aspects. This review provides a comprehensive overview of SERS applications in subcellular compartment researches, which will be a useful reference for designing the SERS-involved therapeutic systems.

The Impact of the Covid-19 Pandemic on Consumers' Intention to Use Shared-Mobility Services in German Cities

One sector that severely suffers from the outbreak of the coronavirus is carsharing (i.e., short-term car access). The downswing of the carsharing industry may not only experience negative economic consequences but also ecological ones. Carsharing has the potential to reduce emissions, occupied space, and congestion and hence can actively contribute to mitigating climate change. As Bill Gates strikingly states: "Covid-19 is awful. Climate change could be worse." For this reason, it is important to understand which underlying mechanisms drive carsharing usage during the Covid-19 pandemic. The current research has the overall objective to provide deeper insights into the mediating mechanisms that explain carsharing usage intention during the Covid-19 pandemic. In particular, we draw on signaling theory to explore how different claims (environmental claims, safety claims) that prompt two different opposing underlying processes (perceived ecological benefits, perceived physical risk) influence carsharing usage intention. An online experiment employing a 3 (environmental claim vs. safety claim vs. no claim) × 2 (high information diagnosticity vs. low information diagnosticity) between-subjects design with participants acquired by the online panel platform Clickworker was conducted in April 2020. Fictitious labels and fictitious advertisements served as stimulus material and constituted the five experimental conditions. The data were analyzed by a multicategorial moderated mediation analysis and a multivariate analysis of covariance. Results reveal that environmental claims can stimulate perceived ecological benefits, which, in turn, positively affect carsharing usage intention. Interestingly, our research demonstrates that safety claims cannot decrease perceived physical risk in the context of Covid-19 and carsharing. Nevertheless, perceived physical risk has a (marginal) negative influence on carsharing usage intention and hence should not be discarded altogether. The findings of this article offer new insights into the mental processes that guide consumer decision-making during the coronavirus crisis and also offer important policy implications by highlighting the relevance of environmental claims during the Covid-19 pandemic. Furthermore, the negative influence of perceived physical risk on carsharing usage intention points to the need for alternative measures to reduce users' risk perceptions.

[Evaluation on monitoring effect of the electronic vaccine vial monitor label]

The cold chain safety of vaccines is a global issue. The electronic vaccine vial monitor (eVVM) label can monitor the temperature of vaccines in real time and provide "early warning" prompts. In order to comprehensively evaluate the monitoring efficiency of eVVM, this study selected 75 eVVM labels and distributed them with a total of 600 vaccine vial monitor (VVM) labels of four different types in different experimental environment (2-8℃, -20℃ and 40℃), and used a temperature recorder as "gold standard". The results showed that the accuracy of the eVVM labels and VVM labels in high temperature environment was as same as that of the temperature recorder ( P = 0.195). The accuracy of low temperature anomalies report and high temperature anomalies report of eVVM labels was 100%, which was better than those reported by VVM labels. Therefore, eVVM labels have high monitoring accuracy, which is suitable not only for ordinary environments, but also for severe temperature environments. It should be helpful for the improvement of the efficiency and accuracy of cold chain monitoring.

Tracking Progress from Policy Development to Implementation: A Case Study on Adoption of Mandatory Regulation for Nutrition Labelling in Malaysia

Mandatory nutrition labelling, introduced in Malaysia in 2003, received a "medium implementation" rating from public health experts when previously benchmarked against international best practices by our group. The rating prompted this qualitative case study to explore barriers and facilitators during the policy process. Methods incorporated semi-structured interviews supplemented with cited documents and historical mapping of local and international directions up to 2017. Case participants held senior positions in the Federal government (n = 6), food industry (n = 3) and civil society representations (n = 3). Historical mapping revealed that international directions stimulated policy processes in Malaysia but policy inertia caused implementation gaps. Barriers hindering policy processes included lack of resources, governance complexity, lack of monitoring, technical challenges, policy characteristics linked to costing, lack of sustained efforts in policy advocacy, implementer characteristics and/or industry resistance, including corporate political activities (e.g., lobbying, policy substitution). Facilitators to the policy processes were resource maximization, leadership, stakeholder partnerships or support, policy windows and industry engagement or support. Progressing policy implementation required stronger leadership, resources, inter-ministerial coordination, advocacy partnerships and an accountability monitoring system. This study provides insights for national and global policy entrepreneurs when formulating strategies towards fostering healthy food environments.

Factors Affecting Salt Reduction Measure Adoption among Chinese Residents

China has the highest mortality rate caused by diseases and conditions associated with its high-salt diet. Since 2016, China has initiated a national salt reduction campaign that aims at promoting the usage of salt information on food labels and salt-restriction spoons and reducing condiment and pickled food intake. However, factors affecting individuals’ decisions to adopt these salt reduction measures remain largely unknown. By comparing the performances of logistic regression, stepwise logistic regression, lasso logistic regression and adaptive lasso logistic regression, this study aims to fill this gap by analyzing the adoption behaviour of 1610 individuals from a nationally representative online survey. It was found that the practices were far from adopted and only 26.40%, 22.98%, 33.54% and 37.20% reported the adoption of labelled salt information, salt-restriction spoons, reduced condiment use in home cooking and reduced pickled food intake, respectively. Knowledge on salt, the perceived benefits of salt reduction, participation in nutrition education and training programs on sodium reduction were positively associated with using salt information labels. Adoption of the other measures was largely explained by people’s awareness of hypertension risks and taste preferences. It is therefore recommended that policy interventions should enhance Chinese individuals’ knowledge of salt, raise the awareness of the benefits associated with a low-salt diet and the risks associated with consuming excessive salt and reshape their taste choices.

Effect of Geographical Indication Information on Consumer Acceptability of Cooked Aromatic Rice

Geographical indication (GI) labeling is used to represent information about specific geographical origins of target products. This study aimed at determining the impact of GI information on sensory perception and acceptance of cooked aromatic rice samples. Ninety-nine participants evaluated cooked rice samples prepared using each of three aromatic rice varieties both with and without being provided with GI information. Participants rated the acceptance and intensity of the cooked rice samples in terms of appearance, aroma, flavor, texture, and overall liking, and also reported how important the GI information was to them. The results showed that consumers rated the cooked rice samples higher in appearance and overall liking when provided with GI information. Interestingly, participants who valued “state-of-origin” information more highly exhibited increased hedonic ratings of cooked rice samples when provided with GI information, but not when no GI information was given. Participants provided with GI information rated flavor or sweetness intensities of cooked aromatic rice samples closer to just-about-right than those without such information. This study provides empirical evidence about how GI information modulates sensory perception and acceptance of cooked aromatic rice samples. The findings will help rice industry, farmers, and traders better employ GI labeling to increase consumer acceptability of their rice products.

The Effect of Animate-Inanimate Soundscapes and Framing on Environments' Evaluation and Predicted Recreation Time

In this research, we investigated whether soundscapes’ animateness and the framing of environments affect participants’ assessment of the surroundings and their predicted recreation time. In an online study, we showed the participants six stimuli, each consisting of an animate or inanimate soundscape recording and of a verbal label of a natural or urban environment. We asked them to (a) imagine visiting the presented locations while mentally fatigued, in company or alone; (b) to visualize spending time there while engaged in recreational activities; and (c) to assess the environment and the predicted recreation time. We found that environments with animate soundscapes were rated as having a higher degree of naturalness and were favored in the urban condition. Environments with inanimate soundscapes, meanwhile, were preferred in the natural condition. Furthermore, natural-framed soundscapes were evaluated as having a higher degree of naturalness and were preferred over urban-framed soundscapes. Social context did not affect the results; however, we discovered the indirect effect of natural labels on the recreation time through the naturalness of the environments, both for the environments with animate and inanimate soundscapes. Overall, our findings demonstrate the influence of soundscapes’ animateness and framing on the settings’ evaluations and on recreation time.

Prevalence and Credibility of Nutrition and Health Claims: Policy Implications from a Case Study of Mongolian Food Labels

Nutrition and health claims should be truthful and not misleading. We aimed to determine the use of nutrition and health claims in packaged foods sold in Mongolia and examine their credibility. A cross-sectional study examined the label information of 1723 products sold in marketplaces in Ulaanbaatar, Mongolia. The claim data were analysed descriptively. In the absence of national regulations, the credibility of the nutrition claims was examined by using the Codex Alimentarius guidelines, while the credibility of the health claims was assessed by using the European Union (EU) Regulations (EC) No 1924/2006. Nutritional quality of products bearing claims was determined by nutrient profiling. Approximately 10% (n = 175) of products carried at least one health claim and 9% (n = 149) carried nutrition claims. The credibility of nutrition and health claims was very low. One-third of nutrition claims (33.7%, n = 97) were deemed credible, by having complete and accurate information on the content of the claimed nutrient/s. Only a few claims would be permitted in the EU countries by complying with the EU regulations. Approximately half of the products with nutrition claims and 40% of products with health claims were classified as less healthy products. The majority of nutrition and health claims on food products sold in Mongolia were judged as non-credible, and many of these claims were on unhealthy products. Rigorous and clear regulations are needed to prevent negative impacts of claims on food choices and consumption, and nutrition transition in Mongolia.

Microbiome characterization of poultry products based on the poultry part and production label

Poultry is one of the most consumed meats worldwide and there are many different types of poultry products available on the market for consumers. Many poultry producers provide a variety of labeled meats based on rearing system such as organic, free-range and antibiotic-free. However, these labels often can be misleading by implying organic products are better in safety and quality compared to poultry products without additional labels. In this study, the microbiological profiles of commercial poultry products were characterized via a next generation sequencing. A variety of poultry products including whole carcass, leg, breast and thigh were purchased from local markets and subdivided by labels indicating organic, non-antibiotic, free range and no-label. According to the microbiome analysis based on the 16S rRNA gene, similar level of species richness were observed in comparison by labels, however, different parts and producers exhibited significant differences. Also, microbial similarities among groups were measured and most samples showed relatively close clustering based on the poultry part and the producer. The results emphasize potential contamination routes and the importance of the control strategy during the pre-harvest step of poultry products. The results also envision potential opportunities to improve current production procedure being utilized by industries.

Polymer Labelling with a Conjugated Polymer-Based Luminescence Probe for Recycling in the Circular Economy

In this paper, we present the use of a disubstituted polyacetylene with high thermal stability and quantum yield as a fluorescence label for the identification, tracing, recycling, and eventually anti-counterfeiting applications of thermoplastics. A new method was developed for the dispersion of poly[1-phenyl-2-[p-(trimethylsilyl)phenyl]acetylene] (PTMSDPA) into polymer blends. For such purposes, four representative commodity plastics were selected, i.e., polypropylene, low-density polyethylene, poly(methyl methacrylate), and polylactide. Polymer recycling was mimicked by two reprocessing cycles of the material, which imparted intensive luminescence to the labelled polymer blends when excited by proper illumination. The concentration of the labelling polymer in the matrices was approximately a few tens ppm by weight. Luminescence was visible to the naked eye and survived the simulated recycling successfully. In addition, luminescence emission maxima were correlated with polymer polarity and glass transition temperature, showing a marked blueshift in luminescence emission maxima with the increase in processing temperature and time. This blueshift results from the dispersion of the labelling polymer into the labelled polymer matrix. During processing, the polyacetylene chains disentangled, thereby suppressing their intermolecular interactions. Moreover, shear forces imposed during viscous polymer melt mixing enforced conformational changes, which shortened the average conjugation length of PTMSDPA chain segments. Combined, these two mechanisms shift the luminescence of the probe from a solid- to a more solution-like state. Thus, PTMSDPA can be used as a luminescent probe for dispersion quality, polymer blend homogeneity, and processing history, in addition to the identification, tracing, and recycling of thermoplastics.

An Experimental Comparison of the Impact of 'Warning' and 'Health Star Rating' FoP Labels on Adolescents' Choice of Breakfast Cereals in New Zealand

This research investigated the performance of the red, octagonal Vienna Convention traffic ‘STOP’ sign as a front of pack (FoP) warning nutritional label. While the Vienna Convention traffic light system is an established FoP label, the potential of the ‘STOP’ sign in the role has not been investigated. The performance of the ‘STOP’ label was compared with that of a single star (low nutritional value) Australasian Health Star Rating (HSR) label using a fractionally replicated Latin square design. The labels were presented on choice diads of cold breakfast cereal packets. The sample of 240 adolescents aged 16–18 was drawn from a secondary school in the South Island of New Zealand. A large and significant main effect was observed at the p < 0.01 level for the difference between the ’STOP’ sign and the control condition (no nutritional FoP label), and at p < 0.05 for the difference between the HSR and the ‘STOP’ label. There was no significant difference between the HSR FoP and the control condition. A significant non-additivity (interaction) (p < 0.01) was also observed via the fractional replication. The results indicate that the Vienna Convention ‘STOP’ sign is worthy of further research with regard to its potential as an FoP nutritional label.

Optimization and characterization of position-selective labelling of RNA (PLOR) for diverse RNA and DNA sequences

Modifications of short RNAs at specific sites can be achieved commercially by solid-phase chemical synthesis method. However, labelling long RNAs is still challenging for the routine methods. Position-selective Labelling of RNA (PLOR) is a hybrid phase transcription method that allows to label RNAs at desired sites with great flexibility and decent efficiency. In principle, PLOR is a promising method for synthesis of long modified RNAs that are unable to be generated by solid-phase chemical synthesis and other methods. However, as a recently developed method, PLOR has been only applied to label a 71nt and a 104nt RNA, and the limited sequence applications of PLOR may hinder its potential usages. To extend PLOR to more RNAs, we tested the PLOR performances for various RNA sequences. Considering that the controlled transcriptional pauses at the initiation stage in PLOR may lead to different preferences on RNA sequences from in vitro transcription method, we here focused on identifying the effects of the 5'-end and initiated lengths of RNA on PLOR. In addition, our work demonstrated that PLOR efficiencies also varied with linker sizes of DNA templates. This work can facilitate PLOR to be the choice of synthesizing long modified RNAs for more users in the near future.

Retail refrigerated probiotic foods and their association with evidence of health benefits

Probiotic usage in food is widespread and growing. The objective of this study was to determine the percentage of probiotic food products sold in the refrigerated section of retail grocery stores in the Washington DC area that we could link to evidence of any health benefit. We surveyed refrigerated sections of eight large grocery stores representing five national chains for probiotic products. Based on declared probiotic composition (strain and count) for each product, we searched PubMed for controlled trials that provided evidence of any health benefit. Our assessment showed that 49% (22 out of 45 distinct probiotic foods) could be linked to evidence supporting a health benefit. All products indicating strain composition could be linked to evidence. Our study suggests that consumers have a reasonable likelihood of purchasing a refrigerated probiotic food with evidence, but room for improvement exists.

The challenge of de-labeling penicillin allergy

BACKGROUND

Even though 8%-25% of most populations studied globally are labeled as penicillin allergic, most diagnoses of penicillin allergy are made in childhood and relate to events that are either not allergic in nature, are low risk for immediate hypersensitivity, or are a potential true allergy that has waned over time. Penicillin allergy labels directly impact antimicrobial stewardship by leading to use of less effective and broader spectrum antimicrobials and are associated with antimicrobial resistance. They may also delay appropriate antimicrobial therapy and lead to increased risk of specific adverse healthcare outcomes. Operationalizing penicillin allergy de-labeling into a new arm of antimicrobial stewardship programs (ASPs) has become an increasing global focus.

METHODS

We performed an evidence-based narrative review of the literature of penicillin allergy label carriage, the adverse effects of penicillin allergy labels, and current approaches and barriers to penicillin allergy de-labeling. Over the period 1928-2018 in Pubmed and Medline, search terms used included "penicillin allergy" or "penicillin hypersensitivity" alone or in combination with "adverse events," "testing," "evaluation," "effects," "label," "de-labeling," "prick or epicutaneous," and "intradermal" skin testing, "oral challenge or provocation," "cross-reactivity," and "antimicrobial stewardship".

RESULTS

Penicillin allergy labels are highly prevalent, largely inaccurate and their carriage may lead to unnecessary treatment and inferior outcomes with alternative agents as well as adverse public health outcomes such as antibiotic resistance.

CONCLUSIONS

Operationalizing penicillin allergy de-labeling as an aspect of ASP has become an increasing global focus. There is a need for validated approaches that optimally combine the use of history and ingestion challenge with or without proceeding formal skin testing to tackle penicillin allergy efficiently within complex healthcare systems. At the same time, there is great promise for penicillin allergy evaluation and de-labeling as an individual and public health strategy to reduce adverse healthcare outcomes, improve antimicrobial stewardship, and decrease healthcare costs.

To what degree are review outcomes aligned for new active substances (NASs) between the European Medicines Agency and the US Food and Drug Administration? A comparison based on publicly available information for NASs initially approved in the time period 2014 to 2016

OBJECTIVE

To compare review outcome alignment between European Medicines Agency (EMA) and US Food and Drug Administration (FDA) for medicines approved by both agencies in the time period 2014-2016.

DESIGN

Using publicly available information from FDA and EMA websites, new active substances (NASs) approved by each agency from 2014 to 2016 were identified and their characteristics assessed. Divergences in regulatory outcomes for simultaneous (within 91 days) submissions to both agencies were identified and then examined for use of facilitated regulatory pathways and orphan designations; submitted versus approved indications; and approval times.

RESULTS

In 2014-2016, 115 NASs were approved by EMA or FDA or both; 74/115 were new chemical entities and 41 new biological/biotechnology entities; 82/115 were approved by both agencies, 24 only by FDA and nine only by EMA. Simultaneous submission occurred for 52/115; 13/52 received expedited review by both agencies and 18 only by FDA; 8/52 received conditional approval from both agencies, 2/52 only from FDA and 1/52 only from EMA; 17/52 were designated as orphans by both agencies and 10/52 by FDA only; 31/52 indications were approved as submitted and 21 changed by EMA and 29/46 were approved as submitted (six not assessed) and 17/46 changed by FDA. Median FDA review timelines were 319 days compared with 409 days for EMA.

CONCLUSIONS

There was general agreement in EMA / FDA conditional approvals. FDA used expedited pathways and orphan designation more often than EMA, suggesting stricter EMA criteria or definitions for these designations or less flexible processes. Despite consistency in submitted indications, there was lack of concordance in approved indications, which should be further investigated. FDA review times are faster because of a wider range of expedited pathways and the two-step EMA process; this may change with recent revisions to EMA accelerated assessment guidelines and the launch of Priority Medicines.

Preliminary Studies of 177Lu-Diethylenetriamine Penta-Acetic Acid-Deoxyglucose in Hepatic Tumor-Bearing Mice

Objective: The purpose of this study was to explore the potential use of ¹⁷⁷Lu-diethylenetriamine penta-acetic acid-deoxyglucose (¹⁷⁷Lu-DTPA-DG) as a radiopharmaceutical for hepatic tumor treatment. Methods: Lutetium-177 (¹⁷⁷Lu) was labeled with DTPA-DG by adding 2 mCi ¹⁷⁷LuCl₃ to 0.05 mg DTPA-DG (pH 5-6) at room temperature for 1 h. The quality of the¹⁷⁷Lu-DTPA-DG solutions was determined by thin-layer chromatography and high-performance liquid chromatography. Cellular uptake studies with ¹⁸F-fluorodeoxyglucose (FDG), ¹⁷⁷Lu-DTPA-DG and ¹⁷⁷Lu-DTPA and a blocking study with 1.0 mg d-glucose were performed. Biodistribution, imaging, and radiotherapy studies of ¹⁷⁷Lu-DTPA-DG were performed with the SMMC-7721 model. Results: ¹⁷⁷Lu-DTPA-DG had a high radiochemical purity (>97%). The cellular uptake of ¹⁷⁷Lu-DTPA-DG was much higher than that of the ¹⁷⁷Lu-DTPA. The biodistribution of ¹⁷⁷Lu-DTPA-DG demonstrated that the complex accumulated in the tumor with high tumor/blood and tumor/muscle ratios. The tumors in mice in the ¹⁷⁷Lu-DTPA-DG group clearly displayed the high uptake of ¹⁷⁷Lu-DTPA-DG. After radiotherapy with ¹⁷⁷Lu-DTPA-DG, tumor growth decreased, and the overall survival was longer than that in the ¹⁷⁷LuCl₃ group (268.58 ± 17.96 mm³ vs. 507.43 ± 55.72 mm³, p = 0.002) and the normal saline group (268.58 ± 17.96 mm³ vs. 483.68 ± 27.51 mm³, p < 0.05). Conclusions: This preliminary study suggests that ¹⁷⁷Lu-DTPA-DG has the potential to become a liver radiopharmaceutical agent and should be further investigated.

Factors Influencing Consumers' Perceptions of Food: A Study of Apple Juice Using Sensory and Visual Attention Methods

The aim of this study was to evaluate the influence of intrinsic product characteristics and extrinsic packaging-related factors on the food quality perception. Sensory and visual attention methods were used to study how consumers perceive the quality of commercial apple juices from four product categories: clear juices from concentrate, cloudy juices from concentrate, pasteurized cloudy juices not from concentrate, and fresh juices. Laboratory tests included the assessment of sensory liking in blind and informed conditions and expected liking based on packages only. The results showed that brand and package information have a large impact on consumers' sensory perceptions and generate high sensory expectations. An innovative visual attention tracking technique was used in online experiments to identify packages and label areas on individual packages, which attracted consumer attention. During an online shelf test, consumers mostly focused on not from concentrate juices from local producers, which were perceived as more natural, healthy, and expensive than juices reconstituted from concentrate. When individual labels were analyzed, consumers predominantly focused on nutritional data, brand name, and information about the type of product. The present results confirm a large impact of information and visual stimuli related to packaging on product perception.

To Raise or Not to Raise the Level of Ingredients in Yoghurts: Polish Consumer Preferences Regarding Dairy Products

Modern consumers are becoming increasingly aware of the perceived health benefits of food. As a result, they are in search of various types of information, for example, information on the packaging of food products that could confirm to what extent the purchased product will meet their expectations regarding the proper composition, that is, nutritional value, or perceived health values earlier mentioned. Furthermore, consumers increasingly seek new dairy products with additional health benefits and, therefore, it is essential to explore which attributes are important drivers of food choices and how producers can better respond to shifting consumer values and needs in each dairy product category. Therefore, the aims of our research was twofold: (1) To determine different segments of consumers based on their preferences towards food and nutrition, including opinion on new food products with a particular emphasis on a dairy market as well as (2) to study the importance of some statements related to nutrition presented on the yoghurt label with a precise focus on aspects of the increased and decreased content of some ingredients. The data were collected using a CAPI (Computer Assisted Personal Interview) survey on a sample of 489 adult Polish consumers. Respondents provided answers to questions and took part in a discrete choice-based experiment. The obtained data were analysed using the clustering method. The segmentation was performed using a hierarchical Ward's method. As a result, four segments were identified: Quality-oriented, Involved, Quality Enthusiasts, and Neutral. The results indicated that in relation to the features that are important in the case of yoghurts, the following were indicated above all: Beneficial effects on health, its sensory values, as well as its availability on the market and production by traditional methods. Consumers belonging to Quality Enthusiasts seemed to be the most promising segment due to their openness to new products, as well as positive feedback on yoghurt. From the perspective of taking action on the food market, Involved may also be interesting, as it showed their openness to new products available on the food market. However, due to the relatively lower, compared to other segments, assessment on the beneficial effect of yoghurt on health, their taste, aroma, availability, as well as the importance of information on care for the proper method of breeding animals, this segment can pose a special challenge to entrepreneurs. Moreover, Involved seemed to be more demanding and critical towards some projects undertaken on the market by policy makers and marketing practitioners.

Labeling of Disease-Modifying Therapies for Neurodegenerative Disorders

Neurodegenerative disorders are characterized by progressive degeneration of nerve cells resulting in functional decline of cognition and/or movement. As the prevalence of many of these disorders increases with the aging global population, there is an urgent need for disease-modifying drugs that will halt or slow the progression of these devastating diseases. A summary of the scientific information needed to guide the safe and effective use of a drug is provided in the product label in which the indication section should clearly state the treatment concept, e.g., distinguish between symptomatic, preventive, and curative treatments. However, a review of the United States (US) and European Union (EU) product labels for disease-modifying multiple sclerosis (MS) drugs reveals that the indications are not aligned with the regulatory guidance on labeling. Indication claims such as “delay of accumulation of disability” and “slowing of disease progression” were previously accepted by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA); however, all recently approved MS drugs include no such specification of the treatment concept in the label indication sections despite similar clinical data packages supporting the approvals. Coincidently, the FDA and EMA therapeutic guidelines pertaining to development of drugs for treatment of neurodegenerative disorders have changed from providing recommendations for specific disease modification label claims to a more general focus on the clinical development approach. Our analysis of MS drug labels could imply that the FDA and EMA may be unlikely to accept disease modification-related indication claims for drugs to treat neurodegenerative disorders in general. We envision that a potential disease-modifying effect is more likely to be inferred from the label descriptions of the mechanism of action, clinical efficacy data and trial design, and target patient population. This poses a challenge for communication of the clinical benefit in a language that can be easily understood by patients and prescribers.

Increasing Vegetable Intake by Emphasizing Tasty and Enjoyable Attributes: A Randomized Controlled Multisite Intervention for Taste-Focused Labeling

Healthy food labels tout health benefits, yet most people prioritize tastiness in the moment of food choice. In a preregistered intervention, we tested whether taste-focused labels compared with health-focused labels increased vegetable intake at five university dining halls throughout the United States. Across 137,842 diner decisions, 185 days, and 24 vegetable types, taste-focused labels increased vegetable selection by 29% compared with health-focused labels and by 14% compared with basic labels. Vegetable consumption also increased. Supplementary studies further probed the mediators, moderators, and boundaries of these effects. Increased expectations of a positive taste experience mediated the effect of taste-focused labels on vegetable selection. Moderation tests revealed greater effects in settings that served tastier vegetable recipes. Taste-focused labels outperformed labels that merely contained positive words, fancy words, or lists of ingredients. Together, these studies show that emphasizing tasty and enjoyable attributes increases vegetable intake in real-world settings in which vegetables compete with less healthy options.

Electrochemical DNA Biosensors Based on Labeling with Nanoparticles

This work reviews the field of DNA biosensors based on electrochemical determination of nanoparticle labels. These labeling platforms contain the attachment of metal nanoparticles (NPs) or quantum dots (QDs) on the target DNA or on a biorecognition reporting probe. Following the development of DNA bioassay, the nanotags are oxidized to ions, which are determined by voltammetric methods, such as pulse voltammetry (PV) and stripping voltammetry (SV). The synergistic effects of NPs amplification (as each nanoprobe releases a large number of detectable ions) and the inherent sensitivity of voltammetric techniques (e.g., thanks to the preconcentration step of SV) leads to the construction of ultrasensitive, low cost, miniaturized, and integrated biodevices. This review focuses on accomplishments in DNA sensing using voltammetric determination of nanotags (such as gold and silver NPs, and Cd- and Pb-based QDs), includes published works on integrated three electrode biodevices and paper-based biosystems, and discusses strategies for multiplex DNA assays and signal enhancement procedures. Besides, this review mentions the electroactive NP synthesis procedures and their conjugation protocols with biomolecules that enable their function as labels in DNA electrochemical biosensors.

Validity of an updated nutrition literacy assessment instrument with the new nutrition facts panel

The Nutrition Literacy Assessment Instrument (NLit) measures nutrition literacy, including a subscale for ability to interpret nutrition fact panels (NFP). Recent redesign of the NFP in the US was issued to improve usability. This study aimed to determine reliability of the NLit subscale using two NFP versions. A 35-item survey was administered to 48 attendees with very low incomes. Surveys included previously validated NLit numeracy questions referencing the Current NFP (C-NFP), demographic and financial literacy questions, and the same NLit numeracy questions referencing the New NFP (N-NFP). NLit numeracy between the C-NFP and N-NFP were related (r = 0.842, p < .001), and N-NFP showed excellent reliability (Cronbach-α = 0.815). Mean NLit numeracy scores for the C-NFP and N-NFP were 53.5% and 55.5%, respectively (p = .437). Exchanging the N-NFP for the C-NFP in the NLit maintains strong reliability. Similar numeracy scores between C-NFP and N-NFP suggest the redesign may not be easier to read.

Minimum Sulfuryl Fluoride Dosage for Bed Bug (Hemiptera: Cimicidae) Fumigation

Bed bugs (Cimex lectularius L.) are blood-feeding human ectoparasites. Their cryptic nature and pesticide resistance have led to an upsurge in infestation abundance and increased difficulty to achieve control. A dosage-response study was conducted for fumigation with sulfuryl fluoride against bed bug eggs at 25 and 15°C. The least accumulated dosage that resulted in 100% mortality was then used in a confirmation study in which adults, third-instar nymphs, and additional eggs were fumigated. It was determined that all life stages tested were killed after fumigations at 88.40 and 170.00 g-h/m3, at 25 and 15°C, respectively. These dosages correspond to an application rate of 1.7× (multiplier of the drywood termite rate of 1×). However, sulfuryl fluoride fumigations at 80.08 and 154.00 g-h/m3 (25 and 15°C, respectively) each yielded >99.6% mortality of bed bug eggs, the most fumigant-resistant life stage. These dosages, rounded to the closest tenth, correspond to an application rate of 1.5×. Thus, this study supports that the MasterFume label rate against bed bugs should be decreased from 3× to 1.7×, at the minimum, because fumigation at 1.5× would suffice due to overly conservative estimation of field factors when calculating fumigant dosage.

Patient, client, consumer, survivor or other alternatives? A scoping review of preferred terms for labelling individuals who access healthcare across settings

OBJECTIVES

Use of the term 'patient' has been recently debated, compared with alternatives including 'consumer' and 'client'. This scoping study aimed to provide an integrated view of preferred labels across healthcare contexts and countries to clarify labelling preferences of individuals accessing healthcare.

DESIGN

Scoping study.

DATA SOURCES

A preliminary literature search using GoogleScholar, Medline, Embase and PsycINFO found 43 key papers discussing terminology for labelling individuals accessing healthcare services. We then used citation chaining with PubMed and GoogleScholar to identify studies discussing term preferences among healthcare recipients.

ELIGIBILITY CRITERIA

No date limits were applied, and all healthcare settings were considered. Primary research studies examining terminology preferences of individuals accessing healthcare, published in peer-reviewed journals were eligible.

DATA EXTRACTION AND SYNTHESIS

All authors extracted data regarding preferred term and study characteristics, and assessed reporting quality of the studies using criteria relevant to our design.

RESULTS

We identified 1565 articles, of which 47 met inclusion criteria. Six articles that examined preference for personal address (eg, first name) were excluded. Of the remaining 41 studies, 33 examined generic terms ('patient', 'client', 'consumer') and 8 focused on cancer survivorship. Of the 33 examining generic terms, 27 reported a preference for 'patient' and four for 'client'. Samples preferring 'client' were typically based in mental health settings and conducted in the USA. Of the eight cancer survivorship studies, five found a preference for 'survivor', and three 'someone who had had cancer'.

CONCLUSIONS

Overall, healthcare recipients appear to prefer the term 'patient', with few preferring 'consumer'. Within general clinical and research contexts, it therefore seems appropriate to continue using the label 'patient' in the absence of knowledge about an individual's preferences. Reasons for preferences (eg, familiarity, social identity) and the implications of labelling for healthcare have not been investigated adequately, necessitating future empirical (including qualitative) research.

Post-marketing dosing changes in the label of biologicals

AIM

The aim of this study was to evaluate post-marketing label changes in dosing information of biologicals.

METHODS

Biologicals authorized between 2007 and 2014 by the European Medicines Agency (EMA) were included and followed up from marketing authorization until 31 December 2016 or date of withdrawal of the marketing authorization. The primary outcome of the study was defined as label change in dosing information for the initially approved indication. Incidence of changes, type of change and mean time to change were assessed. As a secondary outcome, label changes in dosing information for extended indications were assessed.

RESULTS

A total of 71 biologicals were included. Dosing information in the label changed for the initial indication during follow-up for eight products (11%). In one of the eight products the change concerned an increase in dose. Also, a change in dosing frequency was identified in three products, for one product a recommendation was added that therapy could be initiated with or without a loading dose, and for one product the minimum dose was removed and a maximum dose was added. For the remaining product the dose was decreased due to safety issues. For 30 products (42%) the indication was extended at least once. No changes in dosing information were observed for the extended indications (n = 59) during follow-up.

CONCLUSIONS

This study showed that in 11% of the biologicals, the dosing for the initial indication in the label was changed. In contrast to small molecules, the dose was rarely reduced for safety reasons.

Use of Population Pharmacokinetic Analyses Among FDA-Approved Biologics

Biologics, especially monoclonal antibodies, are increasingly important in the pharmaceutical marketplace. Population pharmacokinetic (PK) analyses could be useful to guide the need for dose adjustments among special populations, yet it is unknown how commonly such analyses are performed during biologics development. We summarized the characteristics of population PK models of biologics and examined their role in informing the drug labels. To do so, we extracted relevant characteristics of 86 biologics approved by the U.S. Food and Drug Administration's Center for Drug Evaluation and Research between 2003 and 2017. Ninety-four percent of monoclonal antibodies (51 of 54 biologics), 75% of fusion proteins with Fc receptor (6 of 8 biologics), and 33% of other proteins (8 of 24 biologics) included population PK analyses. Of these analyses, approximately half (45%) used a 2-compartment model with linear clearance as the base model structure. Body size was the most frequently included covariate in the final models (included in 94% of the 64 biologics in which covariate analysis was performed), although age (11%), sex (35%), race (26%), and renal function (27%) were also included in some models. In 70% to 90% of cases in which the effect of these covariates was examined, information regarding the effect of these on PK was included in the label. These results suggest that population PK analyses provide important information about the impact of intrinsic factors on the PK in the label of biologics by the U.S. Food and Drug Administration.

How do people with intellectual disabilities construct their social identity? A review

BACKGROUND

A 2005 review by Beart, Hardy and Buchan, asking how people with intellectual disabilities view their social identities, has been widely cited, indicating this important topic needs an updated review. This review covers research on how people with intellectual disabilities view their ascribed label; to what extent they ascribe it to themselves; and whether they recognize it as devalued in society.

METHOD

Rapid review methodology using PsycINFO, citation- and hand-searching identified relevant studies.

RESULTS

The 16 studies identified indicate that the majority are aware of their ascribed label, or acknowledge they are "different". Others reject it, focusing on alternative attributes or roles. Most recognize others view the label negatively and express feelings of shame, anger and powerlessness.

CONCLUSIONS

The review advances our understanding of social identity formation in people with intellectual disabilities, with implications for future research and practice to support construction of positive social identities and stigma resistance.

Hong Kong consumer preferences for Japanese beef: Label knowledge and reference point effects

The excellent flavor of Wagyu is becoming increasingly popular all over the world. However, the popularity of Wagyu has encouraged competition for authentic Japanese Wagyu, resulting in the appearance of inauthentic Wagyu beef. To ward off this export competition, Japanese Wagyu producers need to improve and differentiate their value-added beef. As hardly any past studies focus on the consumption of Japanese Wagyu in Hong Kong, this paper uses a choice experiment to examine the valuation of beef by Hong Kong consumers in terms of country of origin. Data from 250 Hong Kong consumers obtained through a web questionnaire were used to analyze the beef preferences. In addition to the beef's country of origin, its marbling level, the Japanese Wagyu label and reference point effects were considered. The results indicate that Hong Kong consumers place a significant premium on Japanese Wagyu over Australian or American Wagyu. That premium is greater among consumers who have seen the Japanese Wagyu label. Reference price effects were also statistically confirmed. To promote Japanese Wagyu beef consumption, therefore, it is important to make the consumer aware of the advantages of Japanese Wagyu.