Healthcare Products Research Articles

Statistical Signal Detection Algorithm in Safety Data: A Proprietary Method Compared to Industry Standard Methods.

Several quantitative methods have been established, in pharmacovigilance, to detect signals of disproportionate reporting (SDRs) from databases containing reports of adverse drug reactions (ADRs). The signal detection algorithms (SDAs) and the source of the reporting per product vary, but it is unclear whether any algorithm can provide satisfactory performance using data with such large variance factors. Determine the appropriate SDA for Biogen's internal Global Safety Database (GSD) given the characteristics of the database including frequencies of events, data skewness, outliers, and missing information. Compare performance of standard approaches (EBGM, EB05, PRR, and ROR), well accepted by industry, to a Biogen-developed Machine Learning (ML) Regression Decision Tree (RDT) model, across several Biogen products, to determine a champion SDA. All data associated with seven marketed Biogen products were chosen and a historical subset of reported ADRs were considered. Six SDAs (five common industry disproportionality methods) and RDT were evaluated. The SDRs were calculated on training and test data composed of quarterly reporting intervals from 2004-2019. The performance measures used were sensitivity, precision, time to detect new events, and frequency of detected cases for each algorithm for each product. Outcomes in the test data are known a priori and easily compared to predicted outcomes. Validation was performed via rates of misclassification. This work solely represents Biogen's internal information, intentionally chosen to serve the performance review of its signal detection systems, and results will not necessarily be generalizable to other external sources. Several algorithms performed differently among products, but no one method dominated any other. Performance was dependent on the thresholds used to define a signal according to different criteria. However, those different statistics subtly influenced the achievable performance. The relative performance of RDT and Medicines and Healthcare products Regulatory Agency (MHRA) algorithms were superior and paired across products. A reduction in precision for all methods spanning the products was present. Hence, companies evaluating signal detection approaches, search for innovative methods to minimize this effect. In designing signal detection systems, careful consideration should be given to the criteria that are used to define SDRs. The choice of disproportionality statistics does not affect the achievable range of signal detection performance. These choices should consider mainly ease of implementation and interpretation. The implementation of a method is specific to its accuracy. The RDT attempted to take advantage of known methods and compare results on a per-product basis. Many factors influencing ADRs may improve RDT in future efforts. In this experiment, RDT demonstrated superiority in terms of quickest time to detect and capturing of the highest number of ADRs. Next steps include expansion of data for products representing other indications and testing models in external databases to investigate generalizability of estimates when comparing SDAs.

Extraction and characterization of biofunctional lignocellulosic fibers from Pulicaria undulata plant and the effect of alkali treatment on their bio-physicochemical properties

This study aimed to extract and characterize natural fibers from the P. undulata plant and to evaluate their antioxidant and antimicrobial activities, including the influence of alkali treatment on the bio-physicochemical properties. The average yield of raw fibers obtained was 28.1 %. The raw fibers of P. undulata were rich in cellulose (36.2 %), followed by hemicellulose (30.3 %), lignin (16.2 %), moisture (11.1 %), and pectin (3.9 %). However, the alkali treatment removed 75.7 % of hemicellulose and 50.6 % of lignin from the raw fiber sample and also increased its crystallinity and hydrophobicity. Similarly, the degradation temperature of P. undulata fibers also increased from 324.4 °C to 332.6 °C after alkali treatment. The raw fiber showed promising radical scavenging and reducing power properties, and demonstrated antifungal activity against Candida albicans. In contrast, alkali-treated fibers showed a significant decrease in radical scavenging activity (almost 7–8 fold) and reducing power potential (6-fold) and exhibited no antifungal activity, potentially due to the loss of bioactive components such as lignin and essential oils. Overall, the findings of this study highlight the potential applications of raw P. undulata fibers in the healthcare and cosmetics products.

Enhancing user experience in the digital service environment: A comprehensive study on the design and evaluation of internet-based healthcare products.

In the era of burgeoning digital technology, healthcare is a challenging transformative change towards virtual and digital platforms. Internet-based healthcare services are emerging as a popular trend within the medical area. User experience (UX) is paramount for the healthcare service, as it significantly influences experience satisfaction and fosters user viscosity. Gaining a profound understanding of users' demands and crafting services that align with their expectations is essential. Consequently, exploring an effective design approach for the digital healthcare service that prioritizes UX along with utilizing a comprehensive evaluation methodology to handle UX data, is of profound importance. This study introduces a design methodology for Internet-based healthcare products grounded in the UX and mental (UX-M) model. Aiming to refine the Internet-based healthcare product design by integrating insights from the experience data, it employs the Delphi-ANP and the fuzzy comprehensive evaluation to determine evaluation indexes and conduct experiential assessments. The UX evaluation results of existing schemes are compared with the proposed design scheme of the intelligent guidance and internet hospital. The findings indicate that the UX evaluation of Internet-based medical services with the proposed method outperforms the existing schemes. On the one hand, UX research of Internet-based healthcare products can significantly enhance service satisfaction for patients utilizing online medical treatments. On the other hand, the analysis of experience-based evaluation empowers designers to refine and improve UX design of Internet-based medical services. Such research endeavors are critical for enhancing the overall quality of service offerings and elevating user satisfaction in the digital healthcare landscape.

Strengthening Healthcare Supply Chains: A Comprehensive Strategy for Resilience in the Face of Natural Disasters

Effective and uninterrupted management of the healthcare supply chain and healthcare system preparedness for natural disasters (e.g., pandemics, earthquakes, forest fires, etc.) is essential to ensure that victims receive critical healthcare services and products with minimal disruption, even in the event of damage to transport and logistics infrastructure as a result of significant disasters. The article examines this issue using the example of Vital Health Systems, a prominent hospital system with multiple facilities across a wide region. The qualitative data for the study was collected through interviews and focus groups with key stakeholders in Vital Health Systems, including supply chain managers, procurement specialists, frontline staff, etc. The quantitative data for the study were based on reports, internal documentation and archival documents, industry reports, market research, government databases. Analysis of the supply chain resilience of Vital Health Systems to natural disasters was carried out using the PESTLE framework, based on which a comprehensive risk reduction strategy was proposed. This strategy, while rooted in theory, is highly practical and feasible, with measures to optimise stocks, creation of alternative transport routes and logistics networks, and use of technological solutions. Organisational and managerial proposals for minimising supply chain disruptions for Vital Health Systems in the event of natural disasters are based on the theory of transformational leadership, Denison’s organisational culture, Levitt’s diamond model, and McKinsey’s theory of strategic horizons. The role of healthcare professionals, supply chain managers, procurement specialists, and researchers in healthcare management and disaster preparedness is crucial in implementing these strategies.

The formation of lamellar body-like structures may be a trigger of cetylpyridinium chloride-induced cell death and inflammatory response

Cetylpyridinium chloride (CPC) is a quaternary ammonium compound used widely in health and personal care products. Meanwhile, due to its increasing use, its potential adverse health effects are emerging as a topic of public concern. In this study, we first administered CPC by pharyngeal aspiration to determine the survival level (the maximum concentration at which no death is observed) and then administered CPC to mice repeatedly for 28 days using the survival level as the highest concentration. CPC increased the total number of pulmonary cells secreting pro- and anti-inflammatory cytokines and chemokines. Infiltration of inflammatory cells, production of foamy alveolar macrophages, and chronic inflammatory lesions were found in the lung tissue of male and female mice exposed to the highest dose of CPC. We also investigated the toxicity mechanism using BEAS-2B cells isolated from normal human bronchial epithelium. At 6 h after exposure to CPC, the cells underwent non-apoptotic cell death, especially at concentrations greater than 2 μg/mL. The expression of the transferrin receptor was remarkably enhanced, and the expression of proteins that contribute to intracellular iron storage was inhibited. The expression of both mitochondrial SOD and catalase increased with CPC concentration, and PARP protein was cleaved, suggesting possible DNA damage. In addition, the internal structure of mitochondria was disrupted, and fusion between damaged organelles was observed in the cytoplasm. Most importantly, lamellar body-like structures and autophagosome-like vacuoles were found in CPC-treated cells, with enhanced expression of ABCA3 protein, a marker for lamellar body, and a docking score between ABCA3 protein and CPC was considered to be approximately −6.8969 kcal/mol. From these results, we propose that mitochondrial damage and iron depletion may contribute to CPC-induced non-apoptotic cell death and that pulmonary accumulation of cell debris may be closely associated with the inflammatory response. Furthermore, we hypothesize that the formation of lamellar body-like structures may be a trigger for CPC-induced cell death.

Advancing Vaccinology Capacity: Education and Efforts in Vaccine Development and Manufacturing across Africa.

Africa, home to the world's second-largest population of approximately 1.3 billion, grapples with significant challenges in meeting its medical needs, particularly in accessing quality healthcare services and products. The continent faces a continuous onslaught of emerging infectious diseases, exacerbating the strain on its already fragile public health infrastructure. The COVID-19 crisis highlighted the urgency to build local vaccine production capacity and strengthen the health infrastructure in general. The risks associated with a heavy reliance on imported vaccines were exposed during the COVID-19 pandemic, necessitating the need to nurture and strengthen the local manufacturing of vaccines and therapeutic biologics. Various initiatives addressing training, manufacturing, and regulatory affairs are underway, and these require increasing dedicated and purposeful financial investment. Building vaccine manufacturing capacity requires substantial investment in training and infrastructure. This manuscript examines the current state of education in vaccinology and related sciences in Africa. It also provides an overview of the continent's efforts to address educational needs in vaccine development and manufacturing. Additionally, it evaluates the initiatives aimed at strengthening vaccine education and literacy, highlighting successful approaches and ongoing challenges. By assessing the progress made and identifying the remaining obstacles, this review offers insights into how Africa can enhance its vaccine manufacturing capacity to respond to vaccine-preventable disease challenges.

Associations between Suspected Adverse Drug Reactions of HMG-CoA Reductase Inhibitors and Polypharmacology Using a National Registry Approach

Aims: The aim of this study was to explore the suspected adverse drug reaction (ADR) data of five licensed statins in the UK: atorvastatin, fluvastatin, pravastatin, rosuvastatin, and simvastatin. A secondary aim was to determine if there are any associations between the polypharmacological properties of the statins and their associated muscle-related side effects. Methods: The chemical database of bioactive molecules with drug-like properties, European Molecular Biology Laboratory (ChEMBL), was used to obtain data on the pharmacological interactions of statins with human proteins. The Medicines and Healthcare Products Regulatory Agency’s (MHRA) Yellow Card scheme was used to obtain reports of suspected ADRs from 2018 to 2022. The OpenPrescribing database was used to obtain the prescribing rates for statistical interpretation. Results: The study found no significant difference between the statins association with suspected ADRs across all organ classes (X2, p > 0.05). Fluvastatin was found to have a higher incidence of ADRs/100,000 Rx across multiple system organ classes. Conclusions: No significant difference was found between the suspected ADR incidence of the statins across all system organ classes.

Occupation and SARS-CoV-2 in Europe: a review.

Workplace features such as ventilation, temperature and the extent of contact are all likely to relate to personal risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Occupations relating to healthcare, social care, education, transport and food production and retail are thought to have increased risks, but the extent to which these risks are elevated and how they have varied over time is unclear. We searched for population cohort studies conducted in Europe that compared coronavirus disease 2019 (COVID-19) outcomes between two or more different occupational groups. Data were extracted on relative differences between occupational groups, split into four time-periods corresponding to pandemic waves. We included data from 17 studies. 11 studies used SARS-CoV-2 as their outcome measure and six used COVID-19 hospitalisation and mortality. During waves one and two, the majority of studies saw elevated risks in the five groups that we looked at. Only seven studies used data from wave three onwards. Elevated risks were observed in waves three and four for social care and education workers in some studies. Evidence relating to occupational differences in COVID-19 outcomes in Europe largely focuses on the early part of the pandemic. There is consistent evidence that the direction and magnitude of differences varied with time. Workers in the healthcare, transport and food production sectors saw highly elevated risks in the early part of the pandemic in the majority of studies but this did not appear to continue. There was evidence that elevated risks of infection in the education and social care sectors may have persisted.

Three anti-inflammatory polysaccharides from Lonicera japonica Thunb.: Insights into the structure-function relationships

This study demonstrates the feasibility of producing three polysaccharides (neutral LJP-1, acidic LJP-2 and acidic LJP-3) with significant in vitro and in vivo anti-inflammatory activities from the flowers of Lonicera japonica. The three polysaccharides differed in chemical composition, molecular weight distribution, glycosidic linkage pattern, functional groups and morphology. They exhibited excellent protective effects (in a dose-dependent manner) in lipopolysaccharide-injured RAW264.7 macrophages and CuSO4-damaged zebrafish via reducing NO production and inhibiting the overexpressions of inflammation-related transcription factors, inflammatory proteins and cytokines in the NF-κB/MAPK signaling pathways. Their anti-inflammatory effects varied owing to their different molecular characteristics and chemical compositions. Overall, LJP-2 at 400μg/mL was the most effective. LJP-2 consisted mainly of → 5)-α-L-Araf (1→, →4)-α-L-GalpA (1→ and →2)-α-L-Rhap (1→ residues with terminal T-β-D-Glcp. Thus, honeysuckle flowers are good sources of anti-inflammatory polysaccharides, and precise fractionation enables the production of potent anti-inflammatory agents for the development of functional foods and healthcare products.

Enhancing Continuity of Physiotherapy Care: Investigating the Impact of Missed Follow-up Appointments in Outpatient Settings

Background: Physiotherapy is essential in managing chronic diseases in musculoskeletal, neurological and cardiovascular domains. These conditions have high morbidity rates and hence need therapeutic interventions that enhance the quality of life. However, poor adherence to review appointments diminishes treatment effectiveness and healthcare productivity. Evidence from developed countries reveals varying missed appointment (MA) rates, thereby calling for targeted treatments embedded in contextual factors. Methods: This was a retrospective study using clinic data to identify MA rates and associated variables that included age, gender, and residential origins. The effect of each variable on appointment adherence was investigated. An intervention plan was designed to reduce MA through appointment reminders and patient education. Incentives were also foreseen. Descriptive statistics, Pearson’s correlation and cost-benefit analysis was conducted using SPSS version 23. Results: The rate of MA was 22% initially, significantly reducing to 12% after the intervention (p<0.001). The demographic variables significantly relating to appointment adherence were age group and residential location (p<0.001, 0.012) respectively. Seasonality and referral sources played their role in attendance patterns, which align with earlier studies on healthcare use determinants. Conclusion: This study provides deep insights from physiotherapy appointment adherence in Pakistan and depicts successful measures for reducing MAs and improving treatment delivery. The findings represent the values of patient-centred treatments, which result in a better functional outcome for patients, with a smooth running of clinic operations. Keywords: Appointments, Follow-up, Physiotherapy, Records.

Preliminary Study To Assess Consumer Conception On Online Vs Offline Purchase Of Medicines

Background: The use of the Internet for buying and selling of medicines has increased over several years. Purchase of medicines from E-pharmacies has also grown exponentially with the increase in the usage of the internet for buying products. Online purchase of medicines comes with several advantages such as time-saving, variety of offers and quick home delivery but there are several disadvantages associated with it. Hence, to study the pros and cons of purchasing medicines online, this study was conducted. Methods: The main objective of this study is to assess the behaviour of consumers on online and offline purchase of medicines and what are the several factors that motivate them to purchase medicines online or vice-versa. For collecting responses, a questionnaire was prepared and distributed to the study participants through google forms. The questionnaire was divided into two sections including age and gender. Results: A total of 100 responses were obtained, out of which 50% of respondents opted for offline purchase of medicines from nearby pharmacies. In conclusion, it was observed that the majority of the population prefers the offline mode of purchase when it comes to the purchase of medicines and other healthcare products, though there are various major advancements in technology and variety of internet services and easy availability of e-medicines. Conclusion: It reflects a more health-conscious and traditional mindset and outlook of the people particularly while deciding about the mode of purchasing medicines- online or offline because people lack trust when it comes to online purchase of medicines.

Glycerol Metabolism Contributes to Competition by Oral Streptococci through Production of Hydrogen Peroxide.

Glycerol is an abundant carbohydrate found in oral cavity, both due to biological activities of humans and microbes, and as a common ingredient of foods and health care products. However, very little is understood regarding the metabolism of glycerol by some of the most abundant oral bacteria, commensal streptococci. This was in part because most streptococci cannot grow on glycerol as the sole carbon source. Here we show that Streptococcus sanguinis , an oral commensal associated with dental health, can degrade glycerol for persistence and competition through two independent pathways, one of which generates hydrogen peroxide at levels capable of inhibiting a dental pathobiont, Streptococcus mutans . Preliminary studies suggest that several other commensal streptococci are also able to catabolize glycerol, and glycerol-related genes are being actively expressed in human dental plaque samples. Our findings reveal the potential of glycerol to significantly impact microbial homeostasis which warrants further exploration.

Fluorescent sensing of rutin by carbon dots derived from the heart of cumin seeds

Carbon dots (CDs) prepared from biomass usually produce poor quantum yield and reproducibility. A fine separation of raw materials may enhance the fluorescence performance. In this work, embryos of cumin seeds were precisely chosen as the carbon source to prepare (CDs) through hydrothermal method. The obtained product (CDs-E) possessed a higher quantum yield of 10.60 % than those synthesized with testas or whole seeds, which may be due to the relatively smaller particle size and more C-N functional groups. Rutin, as a common natural active component, could quench the fluorescence of CDs-E notably through internal filtering effect. Herein, a highly selective fluorescent sensor based on CDs-E for detecting rutin was proposed with a linearity range of 0.05 ∼ 30 μM and a detection limit of 0.015 μM obtained. Additionally, the developed method was successfully applied for the detection of rutin in Flos Sophorae, rutin tablets and capsules. This work showed the significance of fine classification for natural carbon source in preparation of CDs and provided a feasible method for quality monitoring of rutin-related pharmaceuticals, health care products and traditional Chinese medicinal materials.

Advances in the synthesis of cytidine-5'-diphosphate choline

Cytidine-5'-diphosphate choline (CDP-choline) plays a crucial role in the formation of the phospholipid bilamolecular layer in cell membranes and the stabilization of the neurotransmitter system, acting as a precursor to phosphatidylcholine and acetylcholine. CDP-choline has been found effective in treating functional and consciousness disorders resulting from brain injury, Parkinson's disease, depression and glaucoma, and other conditions. As such, CDP-choline is widely utilized in clinical medicine and health care products. The conventional chemical synthesis process of CDP-choline is gradually being replaced by biosynthesis due to the expensive and toxic reagents involved, the production of various by-products, and the high cost of industrial production. Biosynthesis of CDP-choline offers two strategies: microbial fermentation and biocatalysis. Microbial fermentation utilizes inexpensive raw materials but results in a relatively low conversion rate and requires a complex separation and purification process. Biocatalysis, on the other hand, involves two stages: the growth of a living "catalyst" and the conversion of the substrate. Although the synthetic process in biocatalysis is more complex, it offers a higher conversion ratio, and the downstream processing technique for extraction is relatively less costly. Consequently, biocatalysis is currently the primary strategy for the industrial production of CDP-choline. This review aims to summarize the progress made in both chemical synthesis and biosynthesis of CDP-choline, with particular focus on the metabolic pathway and the synthetic processes involved in biocatalysis, in order to provide insights for the industrial production of CDP-choline.

Mitigating human fall injuries: A novel system utilizing 3D 4-stream convolutional neural networks and image fusion

Unintentional human falls, especially in seniors, lead to serious injuries, fatalities, and reduced standard of life. Vision-based fall detection methods have demonstrated their usefulness in timely fall response, helping to lessen such injuries. This paper presents an automated vision-based fall detection system that triggers immediate fall reporting. By incorporating human segmentation and image fusion in the pre-processing stage, the system enhances the accuracy of human action classification, thereby ensuring precise fall alerts. It further employs the innovative 4-stream 3D convolutional neural network (4S-3DCNN) model to learn different but consecutive spatial and temporal features. The system processes video input or live surveillance, segmenting human presence every 32 frames using a fine-tuned deep-learning model and applying a three-level image fusion to accentuate movement differences. This technique produces four pre-processed images, input to the 4S-3DCNN model for classification. Consecutive detection of “Falling” and “Fallen” actions triggers an alert for immediate intervention. The original 4S-3DCNN model is an end-to-end trained deep learning model with a fully connected layer serving as a classifier. The research also evaluates the performance of combining the 4S-3DCNN model with Autoencoders and Support Vector Machines (SVM) networks as classifiers. The SVM classifier demonstrated ideal fall detection performance with 100% accuracy using the MCFD, URFD, and Le2i FDD datasets. The proposed system is vital for detecting and preventing falls and reducing healthcare expenses and productivity losses.

Clinical Simulation in the Regulation of Software as a Medical Device: An eDelphi Study.

Accelerated digitalization in the health sector requires the development of appropriate evaluation methods to ensure that digital health technologies (DHTs) are safe and effective. Software as a medical device (SaMD) is a commonly used DHT by clinicians to provide care to patients. Traditional research methods for evaluating health care products, such as randomized clinical trials, may not be suitable for DHTs, such as SaMD. However, evidence to show their safety and efficacy is needed by regulators before they can be used in practice. Clinical simulation can be used by researchers to test SaMD in an agile and low-cost way; yet, there is limited research on criteria to assess the robustness of simulations and, subsequently, their relevance for a regulatory decision. The objective of this study was to gain consensus on the criteria that should be used to assess clinical simulation from a regulatory perspective when it is used to generate evidence for SaMD. An eDelphi study approach was chosen to develop a set of criteria to assess clinical simulation when used to evaluate SaMD. Participants were recruited through purposive and snowball sampling based on their experience and knowledge in relevant sectors. They were guided through an initial scoping questionnaire with key themes identified from the literature to obtain a comprehensive list of criteria. Participants voted upon these criteria in 2 Delphi rounds, with criteria being excluded if consensus was not met. Participants were invited to add qualitative comments during rounds and qualitative analysis was performed on the comments gathered during the first round. Consensus was predefined by 2 criteria: if <10% of the panelists deemed the criteria as "not important" or "not important at all" and >60% "important" or "very important." In total, 33 international experts in the digital health field, including academics, regulators, policy makers, and industry representatives, completed both Delphi rounds, and 43 criteria gained consensus from the participants. The research team grouped these criteria into 7 domains-background and context, overall study design, study population, delivery of the simulation, fidelity, software and artificial intelligence, and study analysis. These 7 domains were formulated into the simulation for regulation of SaMD framework. There were key areas of concern identified by participants regarding the framework criteria, such as the importance of how simulation fidelity is achieved and reported and the avoidance of bias throughout all stages. This study proposes the simulation for regulation of SaMD framework, developed through an eDelphi consensus process, to evaluate clinical simulation when used to assess SaMD. Future research should prioritize the development of safe and effective SaMD, while implementing and refining the framework criteria to adapt to new challenges.

Synthesis of silver nanoparticles as an antimicrobial mediator

AbstractSilver nanoparticles (AgNPs) become a topic of great research on account of their exemplary properties (optical, electrical, and antimicrobial properties). They have been executed as an exceptional antimicrobial agent having ability to combat microorganism’s in vivo and in vitro causing infections. The antibacterial activity of AgNPs covers Gram-positive and Gram-negative bacteria, as well as multidrug resistant (MDR) strains. AgNPs display manifold and immediate mechanisms of activity and in incorporation with antimicrobial agents as antibiotics or organic compounds, it exhibit synergistic impact against pathogens bacteria. The properties of AgNPs make them appropriate for their usage in healthcare and medical products where they might treat infections or inhibit them competently. A range of approaches to synthesize AgNPs are stated in literature; including physical, biological, and chemical techniques, with a growing need to establish eco-friendly processes. With the imperative need for novel and effective antimicrobial agents, this review intends to establish aspects affecting antimicrobial impacts of AgNPs, as well as to descript the benefits of employing AgNPs as new antimicrobial in different life science applications. This review summarizes synthesis of AgNPs and remarkable implementation of AgNPs dealing with their antimicrobic properties in the field of textile, food industry, agriculture, water treatment, and most importantly in health care sector. Additionally fundamental mechanism by which they implement their antimicrobic activity will also be addressed. Graphical abstract

Health care utilization, productivity losses, and burden of adverse childhood experiences in Singapore: Findings from a national survey.

There is poor understanding on health care utilization, productivity losses, and burden of adverse childhood experiences (ACEs) in multiethnic Asian populations. Part of this research gap stems from the limited epidemiological data on neglect, emotional abuse, bullying, and dysfunctional home environments. This study estimated health care utilization, productivity losses, and burden of ACEs (at least one exposure and multiple exposures) in Singapore. A total of 4,441 adult residents were recruited via door-to-door surveys in a nationally representative study in Singapore. All participants were assessed for ACEs, health care utilization, productivity losses, chronic physical disorders, and mental disorders on structured interviews. Approximation formulas were applied to calculate the estimated cost of ACEs in Singapore. ACEs were prevalent (63.9%) in the Singapore population. Individuals exposed to ≥ 3 ACEs (13.1%) utilized more direct medical care (e.g., primary care doctor and accident and emergency visits) and experienced greater productivity losses than those without ACEs (36.1%). The adjusted excess costs associated with ACEs per person were estimated to be S$767.40 (at least one ACE; 63.9%) and S$2167.84 (≥ 3 ACEs; 13.1%). The adjusted incremental costs of ACEs in the Singapore population were estimated to be S$1.18 billion (at least one ACE) and S$680 million (≥ 3 ACEs) per year. The health and economic burden of ACEs is substantial in Singapore. Our results highlight the importance of investing in novel, population-based ACEs interventions, and the potential return on investment through preventive care and alleviation of the health care burden. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An approach-based machine learning and automated thermal images to predict the dark-cutting incidence in cattle management of healthcare supply chain

The healthcare supply chain is a network made up of various systems, processes, and elements that function and interact seamlessly to offer healthcare services and products. Food safety is an essential component of the healthcare supply chain. In the cattle industry, the healthcare supply chain contributes positively to the global economy through providing high-quality products such as milk and meat. Stress in cattle is one of main factor that cause low quality meat called “dark meat”. Numerous studies have been conducted on the development of different non-invasive methods based on Infrared Thermography Technology (IRT) to enhance the meat quality by detecting stress in cattle pre-slaughtering. These studies have the following issues: lack of automating in detecting body temperature of cattle and ignoring detecting stress with prediction dark meat incidence. The present study endeavors a new fully automated system for detecting stress, and dark meat incidence, incorporating the following new approaches: Multiview face detecting, Automatic eye localisation for detecting body temperature automatically employing computer vision and image processing, respectively. Furthermore, machine learning algorithms like Support Vector Machine (SVM), Logistic Regression (LR), Naïve Bayes (NB), and Decision Tree (DT) have been developed specifically for stress detection and the prediction of dark meat. To develop automated system, two forms of data were collected: statistical temperature and infrared thermal images. Infrared thermal images are used to develop Multiview face detection and Automatic eye localisation. Temperature data used to develop the machine learning model. Results reveal that Multiview face detection better than the current methods in term of Precision 0.99, Recall 0.91, F-score 0.95 with high True positive rate 0.90 and zero False-positive rate. Automatic eye localisation has high accuracy, with the following values: sensitivity 0.9780, precision 0.7212, F measure of 0.8024, and misclassification 0.0455. Lastly, results elaborate that the decision tree model can attain a notable level of accuracy in terms of specificity, recall, F-measure, and Area Under the Curve (AUC), all at an optimal rate of 98%.

Dossier submission in the UK after Brexit

The withdrawal of the United Kingdom (UK) from the European Union (EU), commonly known as Brexit, occurred on January 31, 2020, triggering a transition period until December 31, 2020, during which the UK and EU negotiated their future relationship. Brexit has brought significant changes to regulatory frameworks, particularly in the pharmaceutical sector. This article examines the transition of dossier submission procedures in the UK following Brexit, focusing on the implications for marketing authorizations (MAs) and pharmacovigilance. The Medicines and Healthcare Products Regulatory Agency (MHRA) transitioned to an independent regulatory body, establishing new guidelines for pharmaceutical companies seeking MAs in the UK. Key changes in marketing authorization routes include the conversion of centrally authorized products (CAPs) to UK MAs, the introduction of the Decentralized and Mutual Recognition Reliance Procedure (MRDCRP), and the implementation of a 150-day assessment timeline for national procedures. This article compares dossier requirements before and after Brexit in the UK and highlights pharmacovigilance requirements post-Brexit, emphasizing adjustments to reporting obligations, Qualified Person for Pharmacovigilance (QPPV) responsibilities, and the establishment of UK-specific Pharmacovigilance System Master Files (PSMFs). Additionally, it addresses the dossier Module 1 administrative information requirements to provide a comprehensive overview of the changes in regulatory procedures in the UK pharmaceutical sector following Brexit. Overall, the article aims to serve as a valuable resource for industry professionals, regulatory experts, and other stakeholders seeking clarity on the regulatory changes and their implications for pharmaceutical products in the UK following Brexit.