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1.
Front Psychiatry ; 15: 1380410, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39156609

RESUMEN

Background: Attention Deficit Hyperactivity Disorder (ADHD) frequently persists into adulthood. There are practice guidelines that outline the requirements for the assessment and treatment of adults. Nevertheless, guidelines specifying what constitutes a good quality diagnostic assessment and report and the competencies required to be a specialist assessor are lacking. This can lead to variation in the quality and reliability of adult ADHD assessments. Poor quality assessments may not be accepted as valid indicators of the presence of ADHD by other clinicians or services, resulting in wasteful re-assessments and delays in providing treatment. To address this issue the UK Adult ADHD Network (UKAAN) proposes a quality framework for adult ADHD assessments - the Adult ADHD Assessment Quality Assurance Standard (AQAS). Methods: The co-authors agreed on five questions or themes that then guided the development of a set of consensus statements. An initial draft was reviewed and amended in an iterative process to reach a final consensus. Results: What constitutes a high-quality diagnostic assessment and report was agreed by consensus of the co-authors. The resulting guideline emphasises the need to evaluate impairment, describes core competencies required by the assessor and highlights the importance of linking the diagnosis to an appropriate post-diagnostic discussion. Assessments should be completed in the context of a full psychiatric and neurodevelopmental review, and need good interview skills, using a semi-structured interview with open questioning and probing to elicit real life examples of symptoms and impairments. It is recommended that 2 hours or more is required for an adequate assessment including both the diagnostic assessment and initial post-assessment discussions. Conclusion: The AQAS has been developed as a practical resource to support reliable and valid diagnostic assessments of adult ADHD. It is intended to complement formal training. A secondary objective is to empower patients by providing them with evidence-based information on what to expect from an assessment and assessment report.

2.
J Hazard Mater ; 476: 135091, 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-38959828

RESUMEN

The relative severity between chromium (Cr)-mediated ecotoxicity and its bioaccumulation has rarely been compared and evaluated. This study employed pot incubation experiments to simulate the soil environment with increased Cr pollution and study their effects on the growth of crops, including pepper, lettuce, wheat, and rice. Results showed that increasing total Cr presented ascendant ecotoxicity in upland soils when pH > 7.5, and significantly reduced the yield of pepper, lettuce and wheat grain by 0.3-100 %, whereas, this effect was weakened even reversed as the pH decreased. Surprisingly, a series of soils with Cr concentration of 22.7-623.5 mg kg-1 did not cause Cr accumulation in four crops over the Chinese permissible limit. The toxicity of Cr was highly associated with extractable Cr, where Cr (VI) made the greater contributions than Cr (III). Conclusively, the ecotoxicity of Cr poses a greater environmental issue as compared to the bioaccumulation of Cr in crops in upland soils, while extractable Cr (VI) makes the predominant contributions to the ecotoxicity of Cr as the total Cr increased. Our study proposes a synchronous consideration involving total Cr and Cr (VI) as the theoretical basis to establish a more reliable soil quality standard for safe production in China.


Asunto(s)
Cromo , Productos Agrícolas , Contaminantes del Suelo , Cromo/toxicidad , Contaminantes del Suelo/toxicidad , Productos Agrícolas/crecimiento & desarrollo , Productos Agrícolas/efectos de los fármacos , Productos Agrícolas/metabolismo , Agricultura , Suelo/química , China
3.
Environ Sci Pollut Res Int ; 31(31): 44244-44253, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38937357

RESUMEN

In many studies, linear methods were used to calculate health benefits of air quality improvement, but the relationship between air pollutants and diseases may be complex and nonlinear. In addition, previous studies using reference number as average number of diseases may overestimate the health benefits. Therefore, the nonlinear model estimation and resetting of the reference number were very important. Hospital admission data for coronary heart disease (CHD), meteorological data, and air pollutant data of Zibo City from 2015 to 2019 were collected. The generalized additive model (GAM) was used to explore the association between air pollutants and hospital admission for CHD, and to evaluate the effects on health benefits under different reference number settings. A total of 21,105 hospitalized cases for CHD were reported in Zibo during the study period. The results of the GAM showed there was a log-linear exposure-response relationship between O3 and hospital admissions for CHD, with RR (relative risk) of 1.0143 (95% CI: 1.0047 ~ 1.0239). There were log-nonlinear exposure-response relationships between PM10, PM2.5, SO2, and hospital admissions for CHD. With the increase of pollutants concentrations, the risk for hospital admission showed a trend of increasing first and then decreasing. Compared with the average hospital admissions as the reference number, health benefits calculated by hospital admissions predicted by the GAM model yielded lower. Using the World Health Organization air quality guidelines as reference, attributable fractions of O3, PM10, and PM2.5 were 1.97% (95% CI: 0.63 ~ 3.40%), 11.82% (95% CI: 8.60 ~ 15.24%), and 11.82% (95% CI: 8.79 ~ 15.04%), respectively. When quantifying health benefits brought by improving air quality, corresponding calculation methods should first be determined according to the exposure-response relationships between air pollutants and outcomes. Then, applying the average hospital admissions as reference number may overestimate health benefits resulting from improved air quality.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Atmosféricos/análisis , Humanos , Material Particulado/análisis , Mejoramiento de la Calidad , Hospitalización/estadística & datos numéricos , Exposición a Riesgos Ambientales , Enfermedad Coronaria
4.
J Med Imaging Radiat Sci ; 55(4): 101420, 2024 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-38789291

RESUMEN

BACKGROUND: The Mammography Quality Standards Act (MQSA) has significant impact on providing high-quality mammography services for the early detection of breast cancer. MQSA emphasizes quality assurance, regulatory compliance, and patient safety. It guides technological integration, ensuring uniform quality across the United States of America (USA). This review synthesizes key MQSA information, analysing compliance, and facilitating policy discussions for improvements, aiming to inspire further policy research in cancer screening by adopting MQSA's success factors. METHODS: The review spanned 1997 to 2023, adhering to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Databases like PubMed, ScienceDirect, and Google Scholar were searched for relevant literature. Selection criteria covered English-language journals, US Food and Drug Administration (FDA) guidelines, and professional organizational standards, revealing key aspects of MQSA and breast cancer diagnostics in the USA. RESULTS AND DISCUSSION: MQSA's legislative aspects guarantee the effectiveness of regulations for high-quality mammography. It addresses technology, emphasizes inspections, and balances compliance with healthcare burdens. Procedural guidelines prioritize patient outcomes, minimize errors, and address access disparities. Regular updates are crucial to align screening services with technological changes, maintaining safety and accuracy nationwide. CONCLUSION: The FDA's collaboration with stakeholders, including medical specialists and patient advocacy groups, has contributed to crucial legislative aspects of MQSA. The accuracy of mammography screenings has significantly improved by MQSA's installation of stringent quality and regulatory standards. Compliance with MQSA guidelines led to higher accuracy, safety, and better detection rates. Ongoing efforts must aim to refine guidelines, address emerging challenges, and optimize breast cancer detection.

5.
J Med Internet Res ; 26: e54705, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38776538

RESUMEN

BACKGROUND: In recent years, there has been an upwelling of artificial intelligence (AI) studies in the health care literature. During this period, there has been an increasing number of proposed standards to evaluate the quality of health care AI studies. OBJECTIVE: This rapid umbrella review examines the use of AI quality standards in a sample of health care AI systematic review articles published over a 36-month period. METHODS: We used a modified version of the Joanna Briggs Institute umbrella review method. Our rapid approach was informed by the practical guide by Tricco and colleagues for conducting rapid reviews. Our search was focused on the MEDLINE database supplemented with Google Scholar. The inclusion criteria were English-language systematic reviews regardless of review type, with mention of AI and health in the abstract, published during a 36-month period. For the synthesis, we summarized the AI quality standards used and issues noted in these reviews drawing on a set of published health care AI standards, harmonized the terms used, and offered guidance to improve the quality of future health care AI studies. RESULTS: We selected 33 review articles published between 2020 and 2022 in our synthesis. The reviews covered a wide range of objectives, topics, settings, designs, and results. Over 60 AI approaches across different domains were identified with varying levels of detail spanning different AI life cycle stages, making comparisons difficult. Health care AI quality standards were applied in only 39% (13/33) of the reviews and in 14% (25/178) of the original studies from the reviews examined, mostly to appraise their methodological or reporting quality. Only a handful mentioned the transparency, explainability, trustworthiness, ethics, and privacy aspects. A total of 23 AI quality standard-related issues were identified in the reviews. There was a recognized need to standardize the planning, conduct, and reporting of health care AI studies and address their broader societal, ethical, and regulatory implications. CONCLUSIONS: Despite the growing number of AI standards to assess the quality of health care AI studies, they are seldom applied in practice. With increasing desire to adopt AI in different health topics, domains, and settings, practitioners and researchers must stay abreast of and adapt to the evolving landscape of health care AI quality standards and apply these standards to improve the quality of their AI studies.


Asunto(s)
Inteligencia Artificial , Inteligencia Artificial/normas , Humanos , Atención a la Salud/normas , Calidad de la Atención de Salud/normas
6.
Environ Int ; 186: 108614, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38583295

RESUMEN

Recognition of per- and polyfluoroalkyl substances (PFAS) as widespread environmental pollutants and a consequent risk to human health, has recently made the European Union (EU) adopt several regulatory measures for their management. The coherence of these measures is challenged by the diversity and the ubiquitous occurrence of PFAS, which also complicates the EU's endeavor to advance justified, harmonized, and transparent approaches in the regulatory assessment of chemical risks. Our study critically reviews the European approach for the risk assessment of PFAS, by applying a comparative analysis of the current and pending regulatory thresholds issued for these chemicals in water bodies, drinking water, and certain foodstuffs. Our study shows that the level of health protection embedded in the studied thresholds may differ by three orders of magnitude, even in similar exposure settings. This is likely to confuse the common understanding of the toxicity and health risks of PFAS and undermine reasonable decision-making and the equal treatment of different stakeholders. We also indicate that currently, no consensus exists on the appropriate level of required health protection regarding PFAS and that the recently adopted tolerable intake value in the EU is too cautious. Based on our analysis, we propose some simple solutions on how the studied regulations and their implicit PFAS thresholds or their application could be improved. We further conclude that instead of setting EU-wide PFAS thresholds for all the environmental compartments, providing the member states with the flexibility to consider case-specific factors, such as regional background concentrations or food consumption rates, in their national regulatory procedures would likely result in more sustainable management of environmental PFAS without compromising the scientific foundation of risk assessment, the legitimacy of the EU policy framework and public health.


Asunto(s)
Unión Europea , Fluorocarburos , Medición de Riesgo , Fluorocarburos/análisis , Humanos , Contaminantes Ambientales/análisis , Exposición a Riesgos Ambientales , Agua Potable/química
7.
Trials ; 25(1): 217, 2024 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-38532432

RESUMEN

BACKGROUND: Depression ranks as the foremost mental health concern among childbearing women. Within low- and middle-income countries (LMICs), between 20 and 25% of women encounter depression during pregnancy or soon after delivery. This condition impacts not only the mothers but also their offspring. Offspring of women suffering from postnatal depression (PND) exhibit suboptimal cognitive development and increased emotional and behavioural issues throughout their growth. This scenario becomes more pronounced in LMICs, where numerous adversities further jeopardise children's developmental progress. Despite antenatal services providing a pivotal platform to address women's mental health needs, PND treatment remains inaccessible in many LMICs. The World Health Organization advocates interpersonal psychotherapy (IPT) for treating depression. While research from high-income countries has established the efficacy of IPT and group-IPT (g-IPT) for PND, its effectiveness within the LMIC context and its potential benefits for child development remain uncharted. This study seeks to gauge the potency of g-IPT for women with PND in two LMICs. METHODS: This multi-site randomised controlled trial is a continuation of two preceding phases-conceptual mapping and a feasibility study executed in Lebanon and Kenya. Insights gleaned from these phases underpin this comprehensive RCT, which contrasts the efficacy and cost-effectiveness of high-quality standard care (HQ-SC) augmented with g-IPT against HQ-SC in isolation. The trial, characterised as an individually randomised superiority assessment, targets women with postnatal depression in Beirut, Lebanon, and Nairobi, Kenya. It aims to determine if culturally tailored g-IPT, administered within community settings in both countries, outperforms HQ-SC in influencing child developmental outcomes, maternal depression, and the quality of the mother-child bond. DISCUSSION: The SUMMIT trial, designed with pragmatism, possesses the magnitude to evaluate g-IPT within two LMIC frameworks. It seeks to enlighten policymakers, service commissioners, professionals, and users about g-IPT's potential to alleviate maternal PND and bolster child developmental outcomes in LMICs. Additionally, the trial will generate valuable data on the clinical and economic merits of high-quality standard care. TRIAL REGISTRATION: ISRCTN, ISRCTN15154316. Registered on 27 September 2023, https://doi.org/10.1186/ISRCTN15154316.


Asunto(s)
Depresión Posparto , Psicoterapia de Grupo , Femenino , Humanos , Depresión Posparto/terapia , Kenia , Líbano , Salud de la Mujer
8.
Eco Environ Health ; 3(1): 11-20, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38169841

RESUMEN

The ambient air quality standard (AAQS) is a vital policy instrument for protecting the environment and human health. Hainan Province is at the forefront of China's efforts to protect its ecological environment, with an official goal to achieve world-leading air quality by 2035. However, neither the national AAQS nor the World Health Organization guideline offers sufficient guidance for improving air quality in Hainan because Hainan has well met the former while the latter is excessively stringent. Consequently, the establishment of Hainan's local AAQS becomes imperative. Nonetheless, research regarding the development of local AAQS is scarce, especially in comparatively more polluted countries such as China. The relatively high background values and significant interannual fluctuations in air pollutant concentrations in Hainan present challenges in the development of local AAQS. Our research proposes a world-class local AAQS of Hainan Province by reviewing the AAQS in major countries or regions worldwide, analyzing the influence of different statistical forms, and carefully evaluating the attainability of the standard. In the proposed AAQS, the annual mean concentration limit for PM2.5, the annual 95th percentile of daily maximum 8-h mean (MDA8) concentration limit for O3, and the peak season concentration limit for O3 are set at 10, 120, and 85 µg/m3, respectively. Our study indicates that, with effective control policies, Hainan is projected to achieve compliance with the new standard by 2035. The implementation of the local AAQS is estimated to avoid 1,526 (1,253-1,789) and 259 (132-501) premature deaths attributable to long-term exposure to PM2.5 and O3 in Hainan in 2035, respectively.

9.
J Sci Food Agric ; 104(3): 1756-1767, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37862235

RESUMEN

BACKGROUND: The nutritional composition of stingless bee honey (SBH) can be affected by different climates and soil composition across different geographical areas. However, the range of attributes set for a honey quality standard should be inclusive. This study analysed the sugar profile's physiochemical properties, including quantifying the rare sugar trehalulose, organic acid and mineral composition of SBH collected from inland, and west and east coasts of Peninsular Malaysia. Forty-three SBH (Heterotrigona itama) samples were collected and labelled as <20 and <40 West Coast (<20WC, <40WC), <20 and <40 East Coast (<20EC, <40EC) and Inland, according to their distance from the coasts. RESULTS: The moisture, pH and sugar composition of all SBH samples adhered to the Malaysian Kelulut Honey Standard (MS2683:2017) but not to the International Codex Standard (CODEX) for honey. Trehalulose presence in all samples, regardless of geographical area, was predominant alongside fructose and glucose. Only hydroxymethylfurfural (HMF) content and electrical conductivity (EC) results complied with both standards. The principal component analysis biplot showed that the discrimination of SBH according to the five different areas was not feasible, indicating sample homogeneity. CONCLUSION: The physicochemical evaluation of SBH from Peninsular Malaysia shows mainly homogeneous attributes of samples across geographical locations. These findings demonstrated that the current MS2683:2017 is relevant and accommodates all SBH of H. itama species produced in Peninsular Malaysia. Furthermore, the trehalulose range calculated in this study can be implemented as a new benchmark for the indicator of SBH honey quality standard by national and international food standard committees. © 2023 Society of Chemical Industry.


Asunto(s)
Miel , Abejas , Animales , Miel/análisis , Malasia , Azúcares
10.
J Pharm Biomed Anal ; 240: 115924, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38142499

RESUMEN

The quality standards for Andrographis paniculata, a widely used medicinal herb, exhibited significant variations across different pharmacopeias. In this study, we compared the HPLC content determination methods and total lactone content of A. paniculata samples from different regions, as specified in the Chinese (CP), United States (USP), European (EP), Thai (TP), and Indian pharmacopeias (IP), as well as the Hong Kong Chinese Materia Medica Standards (HK). We aimed to assess the differences and similarities among these pharmacopeias and harmonized international quality standards for A. paniculata. The analysis revealed variations in sample preparation, liquid chromatographic conditions, fingerprint profiles, and total lactone content among the different pharmacopeias. Specifically, the CP and HK methods exhibited superior sample preparation and chromatographic separation. Further comparing the content of 20 A. paniculata samples with the CP, USP, EP and HK methods showed consistent determinations for the same components, indicating similar detection capabilities. The discrepancies in total lactone content primarily stemmed from differences in the number and types of detected compounds. Moreover, the acceptance criteria exhibited a stringency in the order CP > HK > EP > USP. In conclusion, this comparison analysis of content determination in CP, USP, HK, EP, TP and IP provided a scientific foundation for the international standardization and trade regulations of A. paniculata. It also served as a valuable reference for the development of international quality standards for other medicinal herbs, facilitating the harmonization of global pharmaceutical standards.


Asunto(s)
Andrographis , Diterpenos , Plantas Medicinales , Andrographis paniculata , Andrographis/química , Diterpenos/análisis , Plantas Medicinales/química , Lactonas , Estándares de Referencia , Extractos Vegetales/química
11.
Front Pharmacol ; 14: 1275244, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37927599

RESUMEN

Hawthorn leaves also known as crataegi foilum, are a combination of botanical drugs used commonly in Traditional Chinese Medicine. Hawthorn, the plant from which hawthorn leaves are prepared, is distributed in Northeast China, North China, and other regions in China. Hawthorn leaves are known to activate blood circulation and eliminate stasis, invigorating Qi, eliminating turbidity, and reducing the levels of lipids. So far, over a hundred compounds have been isolated from hawthorn leaves, including flavonoids, terpenoids, lignans, organic acids, and nitrogenous compounds. Hawthorn leaves are used for the treatment of hypertension, protecting against ischemic injury, angina, hyperglycemia, hyperlipidemia, and certain other conditions. Several of the currently available clinical preparations also use hawthorn leaves as raw materials, such as Yixintong capsules, Xinan capsules, etc. The present report systematically reviews the chemical composition, biological activities, and quality standards of hawthorn leaves, to provide a scientific basis and reference for detailed research on hawthorn leaves.

12.
Environ Monit Assess ; 195(12): 1509, 2023 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-37989796

RESUMEN

Although existing studies mainly focused on the air quality status in Bangladesh, quantifying the natural and manmade effects, the frequency of high pollution levels, and the associated health risks remained beyond detailed investigation. Air quality and meteorological data from the Department of Environment for 2012-2019 were analyzed, attempting to answer those questions. Cluster analysis of PM2.5, PM10, and gaseous pollutants implied that Dhaka and neighboring cities, Narayangonj and Gazipur, are from similar sources compared to the other major cities in the country. Apart from the transboundary sources, land use types and climate parameters unevenly affected local pollution loadings across city domains. The particulate concentrations persistently remained above the national standard for almost half the year, with the peaks during the dry months. Even though nitrogen oxides remained high in all three cities, other gaseous pollutants, such as CO and O3, except SO2, showed elevated concentrations solely in Dhaka city. Concentrations of gaseous pollutants in Dhaka vary spatially, but no statistical differences could be discerned between the working days and holidays. Frequency analysis results and hazard quotients revealed the likelihood of adverse health outcomes in Narayangonj ensuing from particulate exposures surpasses the other cities for different age, gender, and occupation groups. Nonetheless, school-aged children and construction workers were most at risk from chronic exposure to gaseous pollutants mostly in Dhaka. One limitation of this study was that the routine air quality monitoring happens just from five sites, making the evidence-based study concerning health outcomes quite challenging.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Ambientales , Niño , Humanos , Contaminantes Atmosféricos/análisis , Ciudades , Efectos Antropogénicos , Monitoreo del Ambiente , Bangladesh , Contaminación del Aire/análisis , Contaminantes Ambientales/análisis , Polvo/análisis , Gases/análisis , Material Particulado/análisis
13.
Stud Health Technol Inform ; 306: 153-159, 2023 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-37638911

RESUMEN

A quality standard for the ICF-oriented provision of arm supports and robotic arms was designed. To facilitate this new working method, tools were developed in co-creation with all stakeholders. Professionals received training and were asked to apply the new working method among their clients who participated in the intervention group of the OMARM project. To find out whether the provision had changed following the introduction of the quality standard, and to gain insight into the usage of tools and the perceived added value, a process evaluation was conducted after 3, 6 and 9 months by an online survey. In sum, the new working method was applied to 43 of 137 clients, and tools were used 105 times. Opinions on perceived changes, benefit, and practicability varied widely. Although tools were developed in co-creation with all stakeholders, several professionals' satisfaction with the developed way of working is lower than expected and its adoption lags.


Asunto(s)
Robótica , Dispositivos de Autoayuda , Extremidad Superior , Humanos
14.
Zhongguo Zhong Yao Za Zhi ; 48(10): 2699-2712, 2023 May.
Artículo en Chino | MEDLINE | ID: mdl-37282930

RESUMEN

Fermented Chinese medicine has long been used. Amid the advance for preservation of experience, the connotation of fermented Chinese medicine has been enriched and improved. However, fermented Chinese medicine prescriptions generally contain a lot of medicinals. The fermentation process is complicated and the conventional fermentation conditions fail to be strictly controlled. In addition, the judgment of the fermentation end point is highly subjective. As a result, quality of fermented Chinese medicine is of great difference among regions and unstable. At the moment, the quality standards of fermented Chinese medicine are generally outdated and different among regions, with simple quality control methods and lacking objective safe fermentation-specific evaluation indictors. It is difficult to comprehensively evaluate and control the quality of fermented medicine. These problems have aroused concern in the industry and also affected the clinical application of fermented Chinese medicine. This article summarized and analyzed the application, quality standards, and the modernization of fermentation technology and quality control methods of fermented Chinese medicine and proposed suggestions for improving the quality standards of the medicine, with a view to improving the overall quality of it.


Asunto(s)
Medicina Tradicional China , Estándares de Referencia , Control de Calidad , Fermentación
15.
J Food Prot ; 86(7): 100098, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37142125

RESUMEN

Food safety is a credence good that is hard for consumers to assess even after consumption. Government have used minimum quality standards (MQSs) to prevent producers from selling products below a predetermined quality threshold, thereby improving the overall quality in the market. This study is the first to empirically examine the impact of MQSs on food safety in China. We constructed the number of mutton criminal cases (per billion people) as a proxy for food safety in a province, based on the data obtained from China Judgments Online, we evaluated the effect for the period of 2013 through 2019. Using the generalized difference-in-difference econometric method, we found that a higher minimum quality standard led to an increase in mutton criminal cases related to the production and sale of counterfeit and shoddy products. Such results highlight a potential unintended consequence of a higher MQS and call for a higher penalty cost to mitigate the unintended consequence.


Asunto(s)
Criminales , Humanos , Alimentos , China , Inocuidad de los Alimentos
16.
Ther Innov Regul Sci ; 57(5): 963-974, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37202592

RESUMEN

INTRODUCTION: Standardization is an import factor in ensuring the safety, efficacy, and quality of herbal medicines, and facilitates their international commerce. Heavy metal poisoning due to herbal medicines has been reported in many countries. Here, to better understand the current state of harmonization, we compared regulations for arsenic and heavy metals in herbal medicines across seven countries and two regions with two international standards. METHODS: We studied the monographs of herbal medicines of seven countries and two regions, as well as the WHO guidelines and ISO standards. We then compared the limits and test methods adopted for elemental impurities in herbal medicines listed in the monographs and standards among countries. RESULTS: The number of herbal medicines assessed amounted to over 2000. Limits and test methods adopted for elemental impurities in herbal medicines varied by country/region and organization. Although WHO recommends a uniform upper limit for lead and cadmium for all herbal medicines, some countries set unique upper limits for individual herbal medicines. ISO 18664:2015 lists only instrumental analysis methods, whereas Japan and India list only chemical methods. CONCLUSIONS: Many countries do not adhere to the WHO or ISO recommendations on elemental impurities in herbal medicines. These findings suggest the presence of differences in regulations for herbal medicines among countries/regions, likely rooted in cultural differences and policies aimed at maintaining the diversity of herbal medicines. Regulatory convergence by "loose harmonization" to internationally agreed standards appears a feasible option to maintain diversity and safety, and promote international trade in herbal medicines.


Asunto(s)
Arsénico , Metales Pesados , Arsénico/análisis , Comercio , Internacionalidad , Metales Pesados/análisis , Extractos Vegetales
17.
Regul Toxicol Pharmacol ; 141: 105401, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37116737

RESUMEN

The concentration of chemicals in drinking water may transiently and accidently exceed the Drinking Water Quality Standard (DWQS). If the level of a contaminant is not expected to cause adverse effects for a limited period of exposure, immediate suspension of the water supply may not be necessary. Assessments should be conducted using subacute guidance values (SGVs). In this study, we assessed 26 chemicals for the DWQS to establish the SGVs. Principally, a key study was selected from subacute studies to derive a Subacute Reference Dose (saRfD). The SGV was calculated from the saRfD for adults (drinking water intakes: 40 mL/kg/day) and children (drinking water intakes: 150 mL/kg/day). No allocation factor was applied to derive the SGV. We established the SGV for 20 chemicals, which were 2-38 times higher than the corresponding DWQS. However, SGVs for six chemicals were the same as the corresponding DWQS. Therefore, immediate action will be required for these six accidental contaminants. Our established SGVs are useful for assessing accidental contamination.


Asunto(s)
Agua Potable , Contaminantes Químicos del Agua , Niño , Adulto , Humanos , Monitoreo del Ambiente , Japón , Contaminantes Químicos del Agua/análisis , Calidad del Agua , Abastecimiento de Agua
18.
Artículo en Inglés | MEDLINE | ID: mdl-36833571

RESUMEN

The chloride in water frequently exceeds the standard; directly quoting foreign water-quality criteria (WQC) or standards will inevitably reduce the scientific value of the water-quality standard (WQS) in China. Additionally, this may lead to the under- or overprotection of water bodies. This study summarized the sources, distribution, pollution status, and hazards of chloride in China's water bodies. Additionally, we compared and analyzed the basis for setting WQS limits for chloride in China; we systematically analyzed the basis for setting the WQC for chloride in foreign countries, especially the United States. Finally, we collected and screened data on the toxicity of chloride to aquatic organisms; we also used the species sensitivity distribution (SSD) method to derive the WQC value for chloride, which is 187.5 mg·L-1. We put forward a recommended value for freshwater WQS for chloride in China: less than 200 mg·L-1. The study of a freshwater WQC for chloride is not only a key point of environmental research, but also an urgent demand to ensure water ecological protection in China. The results of this study are of great significance for the environmental management of chloride, protection of aquatic organisms, and risk assessment, especially for the revision of WQSs.


Asunto(s)
Cloruros , Contaminantes Químicos del Agua , Estados Unidos , Contaminantes Químicos del Agua/análisis , Calidad del Agua , Agua Dulce , Organismos Acuáticos , China , Agua
19.
Animals (Basel) ; 13(3)2023 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-36766395

RESUMEN

The current Quality Standard regulating the Iberian pig provides for various differentiated farming systems subject to the type of management implemented and the breed of the pigs. This study attempts to analyse the differences between two of these production systems, i.e., the outdoor and the indoor rearing systems by comparing the main technical and economic factors of six farms, three operating under each system, in order to ascertain the most profitable production system. This analysis is based on the information provided by the farm owners. It also evaluates the impact that the COVID-19 pandemic outbreak had on profitability. The results show that both systems spend the same resources on animal feed, which represents nearly 60% of the expense, with the price of purchase of piglets representing 30-32% of the total; however, there are differences in the cost of labour, which is higher in the outdoor variant. In economic terms, outdoor farms obtained a higher gross margin than indoor farms did. Although their production costs are higher, these are offset with larger incomes due to the higher market price of the pigs at the time of slaughter. Lastly, all the farms under study reveal large financial losses on account of COVID-19, given that there was a general decrease in the revenues due to the decrease in the selling price of the pigs, which seems to be the most determinant factor for the economic profits made by these kinds of farms.

20.
Environ Sci Pollut Res Int ; 30(13): 38212-38225, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36580243

RESUMEN

In the present study, a field experiment was conducted to investigate arsenic (As) concentrations in soils and in grains of 15 rice varieties in a contaminated site in Taiwan. The studied site was divided into two experimental units, namely plot A and plot B. The results showed that mean total As concentrations were 70.94 and 61.80 mg kg-1 in plot A and plot B, respectively, and thus greater than or approximate to the soil quality standard for total As in Taiwan (60 mg kg-1). The As levels in rhizosphere soil in plot A (19.71-32.33 mg kg-1) were much higher than in plot B (6.41-8.60 mg kg-1); however, As accumulation in brown rice did not significantly differ between the plots. These results implied that a significant variation in the bioconcentration factor (BCF) value of As existed among different rice genotypes, and a negative correlation was observed between BCF value and rhizosphere As level in the soil. In phytotoxicity, the median values of the ecological risk indicator were 104.85 and 103.89 in plot A and plot B, respectively, indicating considerable risk. In human health risk assessment, the median and 97.5%-tile values for cancer risk for both male and female residents were markedly higher than the acceptable risk (1 × 10-4). Furthermore, non-cancer and cancer risks were higher for males than females, mainly due to the greater rice ingestion rate of males. Sensitivity analysis showed that total As concentration in soil was the main factor affecting health risks, suggesting that priority should be given to the reduction of soil As levels. To better manage the phytotoxicity of As on rice, as well as the health risk to residents resulting from exposure to As-contaminated soils, the soil quality standard for As in farmland soils should be set between 5 and 10 mg kg-1. The methodology developed in this study could also be applied to provide the basis for refining and revising the soil quality standard for heavy metals in farmland in other regions and countries.


Asunto(s)
Arsénico , Metales Pesados , Oryza , Contaminantes del Suelo , Humanos , Masculino , Femenino , Arsénico/análisis , Suelo , Granjas , Contaminantes del Suelo/toxicidad , Contaminantes del Suelo/análisis , Metales Pesados/análisis , Medición de Riesgo , Oryza/genética , China
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