Labeling System Research Articles

Ru(bpy)3 2+ -Enabled Cell-Surface Photocatalytic Proximity Labeling toward More Efficient Capture of Physically Interacting Cells.

Intercellular proximity labeling has emerged as a promising approach to enable the study of cell-cell interactions (CCIs), but the efficiency of current platforms is limited. Here, we use Ru(bpy)3 2+ to construct an efficient photocatalytic proximity labeling (PPL) system on the cell surface that allows the highly discriminative CCI detection with spatiotemporal resolution. Through the mechanism study and quantitative characterization on living cells, we demonstrate that the singlet-oxygen (1 O2 ) mechanism is more efficient and specific than the single electron transfer (SET) mechanism in Ru-mediated PPL. Ru(bpy)3 2+ catalysts with different cell-anchoring moieties are prepared to facilitate the catalyst loading on primary cells. Finally, based on this system, we develop a "live" T cell receptor (TCR) multimer with TCR-T cells that could sensitively identify and discriminate cells presenting antigens of different affinity, providing a powerful tool to better understand the heterogeneity of antigen presenting cells.

Ru(bpy)32+‐Enabled Cell‐Surface Photocatalytic Proximity Labeling toward More Efficient Capture of Physically Interacting Cells

AbstractIntercellular proximity labeling has emerged as a promising approach to enable the study of cell‐cell interactions (CCIs), but the efficiency of current platforms is limited. Here, we use Ru(bpy)32+ to construct an efficient photocatalytic proximity labeling (PPL) system on the cell surface that allows the highly discriminative CCI detection with spatiotemporal resolution. Through the mechanism study and quantitative characterization on living cells, we demonstrate that the singlet‐oxygen (1O2) mechanism is more efficient and specific than the single electron transfer (SET) mechanism in Ru‐mediated PPL. Ru(bpy)32+ catalysts with different cell‐anchoring moieties are prepared to facilitate the catalyst loading on primary cells. Finally, based on this system, we develop a “live” T cell receptor (TCR) multimer with TCR‐T cells that could sensitively identify and discriminate cells presenting antigens of different affinity, providing a powerful tool to better understand the heterogeneity of antigen presenting cells.

Driving Sustainable Food Choices: How to Craft an Effective Sustainability Labeling System

Previous articleNext article No AccessDriving Sustainable Food Choices: How to Craft an Effective Sustainability Labeling SystemPaul Stillman, Anna Gavrieli, Jane Upritchard, Chavanne Hanson, Treeny Ahmed, Jonathan Kaplan, Ravi Dhar, and Michiel BakkerPaul Stillman Search for more articles by this author , Anna Gavrieli Search for more articles by this author , Jane Upritchard Search for more articles by this author , Chavanne Hanson Search for more articles by this author , Treeny Ahmed Search for more articles by this author , Jonathan Kaplan Search for more articles by this author , Ravi Dhar Search for more articles by this author , and Michiel Bakker Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Journal of the Association for Consumer Research Just Accepted Sponsored by the Association for Consumer Research Article DOIhttps://doi.org/10.1086/725112 Views: 6Total views on this site HistoryAccepted March 15, 2023 © 2023 The Association for Consumer Research. All Rights reserved.PDF download Crossref reports no articles citing this article.

Toxicological evaluation of antiretroviral Tenofovir Disoproxil Fumarate on the mollusk Biomphalaria glabrata and its hemocytes

Tenofovir disoproxil fumarate (TDF) is a drug used in HIV treatment, and several studies have detected its presence in surface water. Furthermore, more information on its environmental impact is needed in the scientific literature. Thus, due to the lack of data on the impact of this drug, and its presence in different waters of the world, this work aimed to evaluate the potential toxicological effects of TDF on the mollusk Biomphalaria glabrata in vivo and in vitro. For in vitro analysis, hemocytes were exposed to different drug concentrations for 1 h and evaluated for feasibility, and phagocytic and metabolic activity. The in vivo analysis consisted of the exposure of groups of five mollusks, in triplicate, at the same drug concentrations for 72 h and 21 days, evaluating mortality, and mollusk and hemolymph behavior. Although the exposure of the mollusk to TDF did not reduce its survival, however it was toxic to its hemocytes. Even if toxicity was identified on the mollusk and its hemocytes initially, further studies should be conducted to understand the effects of this residue on the environment and different life stages of the mollusk because, per the Globally Harmonized System of Classification and Labeling of Chemicals, for aquatic ecosystems, the results obtained were classified as toxic (EC50% 2.65 [1.98; 5.29] mg/L) and could cause unfeasibility in hemocytes at concentrations below 10 mg/l.

Operating Characteristic Curves of Optical Packet-Switching Using Optical Code-Division Multiplexing for Label Switching

In this paper, the operating characteristic curves (OCCs) of optical code-division multiplexing (OCDM) technology for label switching of an optical packet-switching (OPS) network was evaluated. A node structure for processing the packets, with spectral-amplitude-coding (SAC) labels, considering a balanced detector and an optical switch, was developed and modeled. The effects of decoding noises on the performance of both M-sequence and stuffed quadratic congruence (SQC) labeling systems were addressed. Hypothesis testing was applied to the decoder to investigate the results of label recognition. The null and alternative hypotheses were, respectively, defined as a decoder receiving the matching and mismatching labels. Due to the noise effects, the decoder output may not reflect the label status correctly. Type I error occurs when the null hypothesis is true while accepting the alternative one. Type II error occurs when the alternative hypothesis is true while accepting the null one. Analytic equations of both errors were given, considering a desired packet that was missed and an undesired packet shown in a switched path. The trade-off between these two errors, regarding the decoder threshold, was demonstrated in operating characteristic curves (OCCs). A better OCC could be found when a packet had more labeled payload bits, or when the utilized label code had a lower auto-to-cross-correlation ratio.

FoodSmarTag: An innovative dynamic labeling system based on pyranoflavylium-based colorimetric films for real-time monitoring of food freshness

A colorimetric pyranoflavylium-based pH-indicator with an improved formulation was obtained and studied as an intelligent label for food freshness monitoring. Pyranoflavylium pigment at 0.2% (w/w) and glycerol at 30% (w/w) were immobilized in a cellulose acetate matrix, and a thin film was obtained by the solvent casting method. The pH-responsive properties of the film were evaluated in solutions at different pH values (pH 4 to 8) and compared with a previous formulation. Film photostability and pigment migration over time were assessed. The label's performance was evaluated using real samples (fish and meat) at controlled conditions (3 °C and modified atmosphere packaging). The results showed that increased pigment concentration visually favored its colorimetric efficacy. Regarding pigment migration and photostability, the label showed to be suitable for application in fresh meat and fish packaging. The best performance was observed for the freshness monitoring of fish samples. The indicator demonstrated high efficacy in detecting spoilage of Atlantic horse mackerel (Trachurus trachurus). After 5 days of storage, freshness parameters exceeded the limit defined by EU regulations, indicating that the fish was unfit for consumption. Simultaneously, the yellow label started to turn purple, effectively indicating the beginning of the spoilage process.

Front-of-package label in Brazil: Comparison of guideline daily amounts, traffic-light and warning systems

Chronic non-communicable diseases (NCDs) are considered a global public health problem related to dietary factors. In this sense, front-of-package (FOP) labeling is a valuable tool to help consumers assess food products’ composition and make healthier choices. The mandatory FOP labeling adoption process in Brazil was initiated in 2014 and ended in 2020. This work aims to evaluate consumer’s perception and preference towards three different FOP label systems (Guideline Daily Amounts (GDA), Traffic-Light (TL), and Triangular Warnings (TW)) and identify which one is more effective in improving consumer’s understanding. An online survey with 1671 participants was conducted with a nutrient quiz, a healthiest product quiz, and questions about perception and preference. Data were analyzed using chi-square tests, analysis of variance, and logistic regression. TL performed better on the nutrient quiz than GDA. On the healthiest product quiz, TL and TW had a higher rate of correct answers. GDA was considered helpful in deciding which product to buy. TL was considered easy and quick to understand. TW was considered incomplete but helpful in deciding which product to buy. TL was the preferred label, followed by GDA and TW. The evidence from the present study highlights TL and TW’s potential to help consumers understand the products’ nutritional profile. However, any FOP label implementation must be accompanied by educational campaigns to ensure the population can understand and use it effectively.

Improved mini-Tn7 Delivery Plasmids for Fluorescent Labeling of Stenotrophomonas maltophilia.

Fluorescently labeled bacterial cells have become indispensable for many aspects of microbiological research, including studies on biofilm formation as an important virulence factor of various opportunistic bacteria of environmental origin such as Stenotrophomonas maltophilia. Using a Tn7-based genomic integration system, we report the construction of improved mini-Tn7 delivery plasmids for labeling of S. maltophilia with sfGFP, mCherry, tdTomato and mKate2 by expressing their codon-optimized genes from a strong, constitutive promoter and an optimized ribosomal binding site. Transposition of the mini-Tn7 transposons into single neutral sites located on average 25 nucleotides downstream of the 3'-end of the conserved glmS gene of different S. maltophilia wild-type strains did not have any adverse effects on the fitness of their fluorescently labeled derivatives. This was demonstrated by comparative analyses of growth, resistance profiles against 18 antibiotics of different classes, the ability to form biofilms on abiotic and biotic surfaces, also independent of the fluorescent protein expressed, and virulence in Galleria mellonella. It is also shown that the mini-Tn7 elements remained stably integrated in the genome of S. maltophilia over a prolonged period of time in the absence of antibiotic selection pressure. Overall, we provide evidence that the new improved mini-Tn7 delivery plasmids are valuable tools for generating fluorescently labeled S. maltophilia strains that are indistinguishable in their properties from their parental wild-type strains. IMPORTANCE The bacterium S. maltophilia is an important opportunistic nosocomial pathogen that can cause bacteremia and pneumonia in immunocompromised patients with a high rate of mortality. It is now considered as a clinically relevant and notorious pathogen in cystic fibrosis patients but has also been isolated from lung specimen of healthy donors. The high intrinsic resistance to a wide range of antibiotics complicates treatment and most likely contributes to the increasing incidence of S. maltophilia infections worldwide. One important virulence-related trait of S. maltophilia is the ability to form biofilms on any surface, which may result in the development of increased transient phenotypic resistance to antimicrobials. The significance of our work is to provide a mini-Tn7-based labeling system for S. maltophilia to study the mechanisms of biofilm formation or host-pathogen interactions with live bacteria under non-destructive conditions.

The Functional Aspects of Resting EEG Microstates: A Systematic Review.

A growing body of clinical and cognitive neuroscience studies have adapted a broadband EEG microstate approach to evaluate the electrical activity of large-scale cortical networks. However, the functional aspects of these microstates have not yet been systematically reviewed. Here, we present an overview of the existing literature and systematize the results to provide hints on the functional role of electrical brain microstates. Studies that evaluated and manipulated the temporal properties of resting-state microstates and utilized questionnaires, task-initiated thoughts, specific tasks before or between EEG session(s), pharmacological interventions, neuromodulation approaches, or localized sources of the extracted microstates were selected. Fifty studies that met the inclusion criteria were included. A new microstate labeling system has been proposed for a comprehensible comparison between the studies, where four classical microstates are referred to as A-D, and the others are labeled by the frequency of their appearance. Microstate A was associated with both auditory and visual processing and links to subjects' arousal/arousability. Microstate B showed associations with visual processing related to self, self-visualization, and autobiographical memory. Microstate C was related to processing personally significant information, self-reflection, and self-referential internal mentation rather than autonomic information processing. In contrast, microstate E was related to processing interoceptive and emotional information and to the salience network. Microstate D was associated with executive functioning. Microstate F is suggested to be a part of the Default Mode Network and plays a role in personally significant information processing, mental simulations, and theory of mind. Microstate G is potentially linked to the somatosensory network.

Biologically Important Areas II for cetaceans within U.S. and adjacent waters – Gulf of Alaska Region

We delineated and scored Biologically Important Areas (BIAs) for cetacean species in the Gulf of Alaska region. BIAs represent areas and times in which cetaceans are known to concentrate for activities related to reproduction, feeding, and migration, and also the known ranges of small and resident populations. This National Oceanic and Atmospheric Association (NOAA)-led effort uses structured expert elicitation principles to build upon the first version of NOAA’s BIAs for cetaceans. Supporting evidence for these BIAs came from aerial-, land-, and vessel-based surveys; satellite-tagging data; passive acoustic monitoring; Indigenous knowledge; photo-identification data; and/or prey studies. A total of 20 BIAs were identified, delineated, and scored for six species: beluga whale (Delphinapterus leucas), fin whale (Balaenoptera physalus), gray whale (Eschrichtius robustus), humpback whale (Megaptera novaeangliae), North Pacific right whale (Eubalaena japonica), and sperm whale (Physeter macrocephalus). Of the 20 total BIAs, there were two small and resident populations, one migratory, and 17 feeding areas; no reproductive BIAs were identified. An additional five watch list areas were identified, a new feature to the second version of BIAs. In addition to more comprehensive narratives and maps, the BIA II products improve upon the first version by creating metadata tables and incorporating a scoring and labeling system which improves quantification and standardization of BIAs within and across regions. BIAs are compilations of the best available science and have no inherent regulatory authority. They have been used by NOAA, other federal agencies, and the public to support planning and marine mammal impact assessments, and to inform the development of conservation measures for cetaceans.

Awareness, use and understanding of nutrition labels among children and youth from six countries: findings from the 2019 – 2020 International Food Policy Study

BackgroundNutrition facts tables (NFTs) on pre-packaged foods are widely used but poorly understood by consumers. Several countries have implemented front-of-package labels (FOPLs) that provide simpler, easier to use nutrition information. In October 2020, Mexico revised its FOPL regulations to replace industry-based Guideline Daily Amount (GDA) FOPLs with ‘Warning’ FOPLs, which display stop signs on foods high in nutrients of concern, such as sugar and sodium. This study examined self-reported awareness, use, and understanding of NFTs and FOPLs among young people in six countries with different FOPLs, with an additional focus on changes before and after implementation of Mexico’s FOPL warning policy.MethodsA ‘natural experiment’ was conducted using ‘pre-post’ national surveys in Mexico and five separate comparison countries: countries with no FOPL policy (Canada and the US), countries with voluntary FOPL policies (Traffic Lights in the UK and Health Star Ratings in Australia), and one country (Chile) with mandatory FOPL ‘warnings' (like Mexico). Population-based surveys were conducted with 10 to 17-year-olds in 2019 (n = 10,823) and in 2020 (n = 11,713). Logistic regressions examined within- and between-countries changes in self-reported awareness, use, and understanding of NFTs and FOPLs.ResultsAcross countries, half to three quarters of respondents reported seeing NFTs ‘often’ or ‘all the time’, approximately one quarter reported using NFTs when deciding what to eat or buy, and one third reported NFTs were ‘easy to understand’, with few changes between 2019 and 2020. In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were higher than for NFTs in all countries, and compared with GDA FOPLs in Mexico (p < .001). Mandated Warning FOPLs in Mexico and Chile had substantially higher levels of awareness, use, and understanding than the voluntary Traffic Lights in the UK and Health Star Ratings in Australia (p < .001 for all).ConclusionsMandated easy-to-understand FOPLs are associated with substantially greater levels of self-reported awareness, use and understanding at the population-level compared to NFT and GDA-based labeling systems.

Portrait Technology in Campus Recruitment

One limitation of campus recruitment is the ability of recruiters to quickly and accurately evaluate the comprehensive quality of students , resulting in the low success rate of signing, talent misjudgment, unreasonable post arrangement after successful signing and other problems. The application of traditional scientific research with small sample data based on statistics has gradually become difficult. This paper attempts to use artificial intelligence, big data and other technical means to develop intelligent solutions for campus recruitment scene. Starting from the problem, the researchers used clustering and neural network algorithms to realize the labeling of student behavior data, create the subjective and objective labeling system of students, and create the talent portrait suitable for campus recruitment. Research results of this paper shows such concerns can be effectively handled using talent portrait technology.

Neurogenic timing of the inferior olive subdivisions is related to the olivocerebellar projection topography

The olivocerebellar projection is organized into an intricate topographical connection from the inferior olive (IO) subdivisions to the longitudinally-striped compartments of cerebellar Purkinje Cells (PCs), to play an essential role in cerebellar coordination and learning. However, the central mechanisms for forming topography need to be clarified. IO neurons and PCs are generated during overlapping periods of a few days in embryonic development. Therefore, we examined whether their neurogenic timing is specifically involved in the olivocerebellar topographic projection relationship. First, we mapped neurogenic timing in the entire IO by using the neurogenic-tagging system of neurog2-CreER (G2A) mice and specific labeling of IO neurons with FoxP2. IO subdivisions were classified into three groups depending on their neurogenic timing range. Then, we examined the relationships in the neurogenic-timing gradient between IO neurons and PCs by labeling topographic olivocerebellar projection patterns and PC neurogenic timing. Early, intermediate, and late groups of IO subdivisions projected to late, intermediate, and early groups of the cortical compartments, respectively, except for a few particular areas. The results indicated that the olivocerebellar topographic relationship is essentially arranged according to the reverse neurogenic-timing gradients of the origin and target.

Proteomic approach to explore the role of Rho-related BTB Domain Containing 1 (RhoBTB1)-Cullin-3 (CUL-3) pathway in identifying potential therapeutic candidates in cardioprotection

Protein-protein interaction studies have contributed enormously to understand the fundamentals of human impairments including cardiovascular diseases. We previously identified Phosphodiesterase 5 (PDE5) as an interacting partner of RhoBTB1. The latter can function as an adapter for CUL-3 E3 ring ubiquitin ligase complex delivering PDE5 for ubiquitination and proteasomal degradation. This in turn regulates the nitric oxide response of vascular smooth muscle (VSM) and consequently blood pressure. Ubiquitous expression of RhoBTB1, its link with CUL-3, and PDE5 suggests that RhoBTB1 may have other binding partners in VSM and other cells. The binding sites of these partners on RhoBTB1 might be similar to PDE5. With the notion that PDE5 binding region on RhoBTB1 could be responsible for binding of unknown partners in RhoBTB1-CUL-3 pathway, we truncated full-length RhoBTB1 into its component domains, individually (GTPase, BTB1, BTB2, and C-terminal (CT)) and in combination (e.g. B1B2C, B2C, and PB1B2). HEK293 cells were used to express epitope-tagged RhoBTB1 constructs and PDE5. The interaction between different constructs of RhoBTB1 and PDE5 was determined by co-immunoprecipitation (Co-IP). We showed that RhoBTB1 could bind to PDE5 utilizing the combination of its B1B2C domains. Our data also suggest that the CT domain itself was essential for the interaction between RhoBTB1 and PDE5 but was not sufficient on its own to bind PDE5. The Co-IP data was further corroborated with the findings of immunofluorescence and proximity labeling assay (PLA). Subsequent protein stability and ubiquitination studies revealed that B1B2C is catalytically sufficient for CUL3-dependent proteasomal degradation like full-length RhoBTB1. Furthermore, macromolecular protein-protein docking revealed the binding interface between RhoBTB1 and CUL-3 comprising of 24 amino acids. Additional Co-IP data suggested that Ser363 and Pro353 on RhoBTB1 domain are required for binding to CUL-3 as mutants of RhoBTB1 (Ser363Ala and Pro353Ala) could not deliver PDE5 for proteasomal degradation. To further identify unknown interacting partners in RhoBTB1-CUL-3 axis, we utilized the ascorbate peroxidase (APEX2) proximity labelling system involving B1B2C as “bait.” Proteomic profiling of the biotinylated proteome through mass spectrometry has identified several unknown interacting partners involved in RhoBTB1-CUL-3 pathway. Some of these have demonstrated upregulation on pharmacological inhibition of proteasome and CUL-3 which establishes their potential involvement in RhoBTB1-CUL-3 pathway. Exploring the involvement of such interacting partners in RhoBTB1-CUL-3 axis may open novel therapeutic avenues in cardioprotection. NIH R35 HL144807 (to Dr. Curt D. Sigmund) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

SUSTIE Core Engine: Efficient IoT Platform for Smart Facility Solutions with Gateway, Spatiotemporal Database, and Simulation Interface

The SUSTIE test facility was completed in 2020, and it facilitates to the development of energy-conservation technologies while contributing to the realization of more comfortable and energy-efficient indoor environments. The facility achieved the top rank of energy performance certification “Building-Housing Energy-efficiency Labeling System (BELS)” and wellness-office certification “Comprehensive Assessment System for Built Environment Efficiency-Wellness Office (CASBEE-WO)” in Japan. To accelerate research and evaluation, we propose an efficient Internet-of-things (IoT) platform called the SUSTIE Core Engine. The platform gathers data in real time, stores both design data and time-series data with coordinates, and act as simulation interface to satisfy three requirements of an IoT platform for smart facilities: an architecture that allows adding / removing functions without stopping operation, data management features for time-series / coordinates data, and common interface for simulations / controls. We implement the platform which covers the requirements to on-site system in the test facility, and evaluate the gateway, spatiotemporal database, and simulation interface. Our platform showed that it satisfies the three functional requirements of IoT platforms. Furthermore, it was shown that the database can obtain sufficient demonstrated for practical use.

Nutrition Information and Visual Attention: Insights from a Meta-Analytical Approach

ABSTRACT The present study investigated how different nutrition information influences consumer attention. This study aims to provide a meta-analytic model to understand nutrition information as a stimulus element for visual attention. This paper explores the literature about nutrition information while debating four divergent questions regarding levels of visual attention, such as: which labeling systems generate the most visual attention? Are there differences in visual attention between vice and virtue nutrition information? Monochromatic create more attention than polychromatic labels? Does the position of the label influence visual attention? The findings contribute additional information to the results on perceived nutrition information from previous studies indicating that consumer attention tends to be increased (reduced) by the non-directive system (directive system), vice nutrition information (virtue nutrition), and nutritional information at the top of the package (nutritional information at the bottom of the package).

Barriers to Safe and Effective Medication for Individuals with Sensory Impairment: A Systematic Literature Review

Visual impairment (VI) and hearing impairment (HI) are common disabilities whose prevalence increases with age, potentially presenting a major challenge in the future. Identifying the types of obstacles which they encounter during drug administration is essential to improve health outcomes. This systematic literature review aimed to identify types of medication barriers encountered by individuals with VI or HI to improve their health outcomes. Combination of keywords indicating VI or HI, barrier, challenge, or difficulty, and drug or medication were used to identify potential studies up to May 31, 2021, from Ovid Medline, Embase, and Cochrane. Overall, 20 and 17 articles met the predefined eligibility criteria for VI and HI, respectively. Individuals with VI were found to encounter difficulties in the entire process of pharmaceutical therapy, including drug identification, medication management, access to pharmacies, medication instructions, drug information (labeling), and communication. Individuals with HI were found to experience challenges in communication, health literacy, and negative experiences and emotions toward doctors/pharmacists. The drug management needs of individuals with VI and HI remain unmet. For safe and effective medication in individuals with VI and HI, it is essential to establish practical solutions, such as providing identification tools for tablets for those with VI, deploying sign language interpreters at designated healthcare institutions and pharmacies for individuals with HI, utilizing novel technologies, including audio prescription labeling systems or mobile applications, and providing education for both healthcare providers and individuals with disabilities to improve their partnership in drug therapy.

Pemahaman dan Penerimaan Label Gizi Front of Pack Produk Snack oleh Siswa SMA di Depok

Labels play a crucial role in providing essential information that helps consumers choose their food products. Despite this, the comprehension and acceptance of nutrition labels remain low. The objective of this study was to compare the understanding and acceptance of nutrition labels with and without Front of Pack (FoP) in adolescents aged between 15 and 18 years. The FoP nutrition label is a labeling system that simplifies nutritional information and displays it on the front of food packaging. It includes three types: daily intake guide (DIG), multi-traffic light (MTL), and health star rating (HSR). The study targeted high school students in Depok, selected through stratified sampling based on school accreditation. Only 11.1% of respondents reported reading nutrition labels. The results of the Chi-square test indicated a significant difference (p &lt;0.05) in the use of nutrition labels based on exposure to nutrition, nutritional knowledge, and label reading. ANOVA test results showed significant differences in comprehension and acceptance of the four labels. The HSR label was the most comprehensible (63.7%), followed by DIG (58.7%), nutrition fact panel/NFP (51.1%), and MTL (45.7%). Additionally, respondents rated the HSR label as the most preferred, attractive, and easiest to understand.

487 Understanding the Medicines Labelling System in a Tertiary Hospital in Kuwait Using Work Domain Analysis

Abstract Introduction A report by the World Health Organisation highlighted a lack of clarity in medicine labelling regulations in Kuwait and the subsequent risk of patient harm from labelling errors (1). In response, the Undersecretary of the Kuwait Ministry of Health (MOH) issued a ministerial decree governing the labelling of medicines (M.D 4451/2021, June 2021) (2), stipulating a requirement to affix an identification label containing specific patient, medicine, and supplier information on medication packaging. Aim To develop a map of the Medicines Labelling System (MLS) in a tertiary hospital in Kuwait (TH). Methods A Work Domain Analysis (WDA) was conducted using qualitative data from 1) semi-structured interviews with a purposive sample of 10 nurses, 10 patients/caregivers, and 10 pharmacists involved in the delivery or administration of medicines to TH patients, as well as 2) an analysis of medicine labelling documents published by the Kuwaiti MOH and TH. After gaining informed consent, one-to-one semi-structured interviews were conducted in TH, in accordance with the latest COVID-19 prevention procedures. All interviews were audio-recorded and transcribed verbatim. Both deductive – informed by Abstraction Hierarchy (AH), the modelling tool of WDA – and inductive thematic analysis was conducted. Results Thirty participants took part in semi-structured interviews averaging 34 minutes, from which five levels of abstraction in the AH were constructed. The first level, “functional purposes”, describes the reason why any given system exists: for the MLS in TH, they were “compliance with regulations, policies, and protocols of the Kuwaiti MOH and TH” and “providing an identification of medicine issued by ISH pharmacies”. Five aspects of the second level, “values and priority measures”, were identified, including “optimisation of service workflow” and “time-efficient clinical practices.” The third level, “purpose-related functions”, describes the key functions that need to be in place for the MLS to work; these were “the production of medicines labels”, “coordination”, and “management of medicines and resources”. The last two levels in the AH, “object-related functions” and “physical objects”, describe the resources that are required in the MLS, their functionality, and their limitations: there were 16 groups of physical objects, which afforded 19 different functions. Means-ends links showed the crucial relationships and significance between functions at different levels of the AH, the most prominent of which were coordination and communication. Conclusion TH’s MLS is a complex system that was visually represented using an AH, showing the constraints and structure of the work system. The AH constructed a knowledge base. Subsequent analyses of the current system issues may draw on this knowledge, such as a potential analysis of how specific tasks, like the use of labels by nurses within wards, are performed. The limitations of this study included only exploring ‘work as imagined’ (i.e., accounts from healthcare staff and documents), which does not fully capture how the MLS functions on a day-to-day basis. Future work will focus on deepening our understanding of the MLS through observations of work in practice.

Differentiated implementation and European integration: the development of EU food quality labelling

The article examines how differentiated national implementation of EU policies affects later European integration – whether it leads to renewed unified vertical integration, differentiated integration, the status quo or renationalisation. It examines the case of geographical indications (GIs), an EU labelling system for food and drink based on place of origin and processes of production. Despite features such as diverse national interests and gastronationalism, differentiated implementation has resulted in renewed unified vertical integration. The article identifies three processes: EU legislative requirements encouraging the establishment of producer groups; European Court of Justice decisions which gave priority to quality over cross-border trade; the use of free trade negotiations to alter EU rules. While the integration outcomes are those expected by neo-functionalist analyses, the processes are more institutionally-based. Differences in implementation may aid rather than hinder further integration due to institutional features of EU legislation and decision making.