COVID-19 and the Medical Devices in India: Trade for a Resilient Health System.

BACKGROUND: The medical devices industry plays a critical role in public health and requires attention in research and policy. The COVID-19 pandemic exposed a lack of resilience in areas of drugs and vaccines but also in medical products. OBJECTIVES: The study analyzes India's strengths and weaknesses in the trade of medical devices and identifies specific devices where India can attain self-sufficiency and areas where trade is still beneficial. MATERIALS AND METHODS: A set of critical products traded during the COVID-19 pandemic were identified from the World Integrated Trade Solution website at the 6-digit Harmonized System code level. A detailed analysis of exports and imports of medical products at disaggregated 8-digit codes was carried out. RESULTS: During the pandemic, India had a trade surplus in some low-technology-based products such as suture needles, catheters, and cannulae along with X-ray apparatus and electrocardiographs among the medium-tech products. The imports of high-tech devices like in vitro diagnostics almost doubled to meet the surge in demand. The requirement of pulse oximeters, ventilators, and other monitoring devices jumped, and their imports reported an 800% increase from $134 million in 2019-2020 to $1162 million in 2021-2022. Most of India's imports of medical devices come from the top five exporting countries, with the share of the USA and China at 39%-40%. CONCLUSION: There is a need to expand the manufacturing capacity of surgical instruments, consumables and disposables, apart from some high-tech products. The public health care facilities should procure domestically manufactured medical devices and trade with neighbouring countries to reduce import concentration must be prioritised.

Estimating The Effects Of COVID-19 On Globalized Markets For Active Pharmaceutical Ingredients.

Global supply chains for active pharmaceutical ingredients (APIs) are highly centralized in certain countries and are susceptible to supply-chain shocks. However, there is no systematic monitoring or global coordination to manage risk and ensure equitable supply continuity during public health emergencies. In this study, we applied quasi-experimental methods on shipment-level customs data to determine how prices and export volume for APIs exported from India were affected by the COVID-19 pandemic. We found that API prices for key essential medicines not used for COVID-19 did not change significantly in the year after the World Health Organization pandemic declaration, but volume decreased by 80 percent. Prices for medicines speculatively repurposed for COVID-19, such as hydroxychloroquine and ivermectin, increased by as much as 250 percent compared with prices for nonrepurposed medicines, but only ivermectin saw a decrease in volume. Systematic monitoring of API markets, investments to promote supply diversification, and legal and political reforms to disincentivize price speculation could support supply-chain resilience and safeguard access to medicines.

Evaluating the drivers of B2B performance: An empirical analysis based on Alibaba.

The rapid development of B2B has brought about fierce competition among suppliers, and how to gain customer attention and improve performance has become a common concern in academia and industry. This study examined the drivers and mechanisms of B2B performance from an enterprise capability perspective. We collected transaction and enterprise data from 325 suppliers on Alibaba 1688 platform and constructed a structural equation model (SEM). Results showed that supplier service capability, logistics capability, and production capacity all positively impacted B2B performance through the mediating role of customer attention. In addition, we found that service and logistics capabilities are more critical for attracting customer attention for Original Equipment Manufacturer (OEM) suppliers than for non-OEM suppliers. The findings contribute to understanding B2B commerce and provide constructive directions for B2B suppliers to improve their performance.

The influence of ESG practices on domestic value-added to exports during the period of technological change.

Sustainable development and raising the domestic value-added rate of exports (DVARE) have become essential priorities in the pursuit of high-quality economic growth. An econometric spatial model is developed in this research using data on Chinese enterprises spanning 2008 to 2019. According to a study, exports' domestic value-added rate (DVAR) can be successfully increased using environmental, social, and governance (ESG) practices. Spatial spillover analysis demonstrates that adopting ESG practices boosts export DVAR both within and between regions. According to heterogeneity analysis, the sample's overall increase in DVARE as a result of ESG practices is mostly attributable to the mix and processing trade organizations, the eastern area, and large firms. An examination of the underlying mechanisms shows that businesses that implement advanced technologies are able to reinforce the favorable impact of ESG practices on DVARE. This article gives evidence from real-world studies that show how ESG practices help boost Chinese exports and advance sustainable development. The findings hold significant implications for other developing nations as they make the transition towards a pattern of economic growth.

Trade in torture tools threatens detainees and protestors everywhere - it must be banned.

With social upheaval, economic strain, and political unrest growing, peaceful demonstrations worldwide are increasingly met with brutal tactics by law enforcement and security forces. The UN Special Rapporteur on Torture outlines her call for States to negotiate a new international treaty to ban the manufacture, use and trade in "torture tools" and regulate the trade in law enforcement equipment. Her proposal outlines two critical components: a prohibited list of items that she has deemed to be inherently cruel, inhuman or degrading, and a second controlled list of ordinary law enforcement equipment that has a high risk of misuse. Effective international regulation is imper-ative to curb the indiscriminate use of force by law enforcement and to uphold human dignity. Improved national regulation is also required. Research has revealed a pervasive market for these items, with more than 335 companies in 54 countries manufacturing or promoting the most egre-gious torture instruments. Major producers include China, the EU, and the USA, with emerging economies also contributing significantly. The outsourcing of public functions to private security companies further exacerbates the issue, underscoring the pressing need for robust national and international regulations.

The effect of an annual temporary abstinence campaign on population-level alcohol consumption in Thailand: a time-series analysis of 23 years.

RATIONALE: A small number of earlier studies have suggested an effect of temporary abstinence campaigns on alcohol consumption. However, all were based on self-reported consumption estimates. OBJECTIVES: Using a time series of 23-year monthly alcohol sales data, this study examined the effect of an annual temporary abstinence campaign, which has been organised annually since 2003 during the Buddhist Lent period (spanning 3 months), on population-level alcohol consumption. METHODS: Data used in the analysis included a time series of monthly alcohol sales data from January 1995 to September 2017 and the midyear population counts for those years. Generalised additive models (GAM) were applied to estimate trends as smooth functions of time, while identifying a relationship between the Buddhist Lent abstinence campaigns on alcohol consumption. The sensitivity analysis was performed using a seasonal autoregressive integrated moving average with exogenous variables (SARIMAX) model. INTERVENTION: The Buddhist Lent abstinence campaign is a national mass media campaign combined with community-based activities that encourages alcohol abstinence during the Buddhist Lent period, spanning 3 months and varying between July and October depending on the lunar calendar. The campaign has been organised annually since 2003. MAIN OUTCOME: Per capita alcohol consumption using monthly alcohol sales data divided by the midyear total population number used as a proxy. RESULTS: Median monthly per capita consumption was 0.43 (IQR: 0.37 to 0.51) litres of pure alcohol. Over the study period, two peaks of alcohol consumption were in March and December of each year. The significant difference between before-campaign and after-campaign coefficients in the GAM, -0.102 (95% CI: -0.163 to -0.042), indicated an effect of the campaign on alcohol consumption after adjusting for the time trend and monthly seasonality, corresponding to an average reduction of 9.97% (95% CI: 3.65% to 24.18%). The sensitivity analyses produced similar results, where the campaign was associated with a decrease in consumption of 8.1% (95% CI: 0.4% to 15.7%). CONCLUSIONS: This study demonstrated that the temporary abstinence campaign was associated with a decrease in population-level alcohol consumption during campaign periods. The finding contributed to a growing body of evidence on the effectiveness of emerging temporary abstinence campaigns.

Examining direct and indirect flood damages in residential and business sectors through an empirical lens.

Investment to reduce flood risk for social and economic wellbeing requires quantitative evidence to guide decisions. Direct and indirect flood damages at individual household and business building levels were assessed in this study using multivariate analysis with three groups of flood damage attributes, i.e., flood characteristics, socioeconomic conditions, and building types. A total of 172 and 45 respondents from residential and commercial buildings were gathered through door-to-door interviews at areas in Peninsular Malaysia that were pre-identified to have frequently flooded. Two main findings can be drawn from this study. First, flood damage is greatly contributed by high-income households and businesses, despite them being less exposed to floods than low-income earners. This supports the current use of mean economic damage in engineering-based flood intervention analysis. Second, indirect damages increase with the increase in family size, indicating the importance of strengthening preparedness and social support to those with great social responsibility. Overall, the study highlights the importance of holistic flood management accounting for both direct and indirect losses.

Uncertainty in banking and debt financing of firms in Vietnam.

This study explores the effects of banking uncertainty on firms' debt financing. Employing data from 2007 to 2022 of Vietnam-a bank-based economy, we document that banking uncertainty negatively impacts corporate debt. The impact firmly holds across various debt maturities and sources, with the most predominant driver witnessed in bank debt. We also investigate the potential underlying mechanism linking banking uncertainty to debt financing, thereby validating the working of three crucial channels, including increased costs of debt, substitution of trade credit, and contractions in firm investment. Furthermore, conducting extended analysis, we find that debt financing exhibits more pronounced reactions to banking uncertainty for firms with closer ties to banks or during macroeconomic shocks, as captured by the financial crisis and the COVID-19 pandemic. Our findings survive after robustness checks by alternative measurement, static and dynamic econometric models, and endogeneity controls.

[THE ON-LINE TURNOVER OF BIOLOGICALLY ACTIVE ADDITIVES. PART 2. CUSTOMS CONTROL FOR THE TURNOVER OF IMPORTED DIETARY SUPPLEMENTS ON MARKETPLACES AS A MEASURE TO PROTECT THE LIFE AND HEALTH OF CITIZENS].

Various dietary supplements are used as prevention, and in some cases treatment, of a large number of pathological processes in the human body. The purchase of such dietary supplements on various online platforms, including marketplaces, as evidenced by the results of monitoring the Russian online market for 2021-2022, turned out to be the riskiest for human life and health: the components actually contained do not correspond to the declared ones, the presence of Dietary supplement of prohibited substances, lack of a state registration certificate, the presence of which confirms the safety of such dietary supplement for use. The listed violations in the conditions of complete lack of control during the sale of dietary supplements on marketplaces confirm the danger to health, and in some cases, to human life. Uncontrolled use of such products can lead to serious side effects and complications: allergic reactions, kidney failure, liver failure, complications from the gastrointestinal tract, nervous system and genitourinary tract. In this regard, issues related to ensuring the safety of human health and life in the event of their purchasing dietary supplements on marketplaces are relevant. The analysis carried out in the study confirmed the existence of a problem of unreliable declaration of imported dietary supplements on marketplaces by participants in foreign economic activity. In this regard, this article examines the requirements of technical regulations that must be observed when importing dietary supplements into the territory of the EAEU, studies in detail the issue of the possibility of selling imported dietary supplements on marketplaces, and formulates appropriate conclusions and recommendations for eliminating identified problems, which will eliminate possible sales of low-quality products on the marketplace. and prohibited products and identify sellers selling dietary supplements with violations.

[On the issue of logistic support of export of medicinal preparations of national production].

The current geopolitical situation raised pointed question of developing new supply chains and looking for rolling stock to develop newly formed cargo flows, including medicinal preparations transportation. Considering necessity in timely and safe supply of medicines, it is necessary to develop set of measures permitting to implement export of this production of national industry to ensure ultimate independence from unfriendly states. The article considers main indicators of import and export operations of medicinal preparations and measures taken by the state to support industry in current conditions, requirements for international transportation of this category of goods. The measures increasing exports within the framework of the Pharmaceutical Industry Development Strategy until 2030, such as expansion of fleet of autonomous refrigerated containers, use of consolidation warehouses in Turkey and Kazakhstan to ensure decreasing of cost of multi-modal transportation of medicinal preparations, as well as validation of rolling stock in accordance with GDP requirements.

[The problems and prospects of import substitution in medical industry].

The achievement of economic sustainability and assurance of national security through activation of production sectors, medical industry in particular, is the integral component of successful strategy of state development. The importance of achieving autonomy in production of medical technique is targeted to reducing dependence of external factors, ensuring continuity of supply of critically important equipment and increasing level of technical characteristics of production. Besides it, expansion of medical production positively impact on innovative development, organization of new work places and level of scientific research in this industry. The development of national medical industry contributes to improvement of quality of medical care that directly affect population health. The necessity to maintain stability of health care through import substitution of medical products is indisputable fact in modern conditions, determined by strategically important direction from national security point of view. The article considers measures within the framework of import substitution plan in medical industry of the Russian Federation for period up to 2024. The analysis of volume of national production of medical equipment in dynamics over 5 years was carried out. The main problems of production of medical devices at the present stage were considered. The measures of state support targeted to development of national production of medical equipment and innovative medical technologies were discussed.

Short-term forecasting of vegetable prices based on LSTM model-Evidence from Beijing's vegetable data.

The vegetable sector is a vital pillar of society and an indispensable part of the national economic structure. As a significant segment of the agricultural market, accurately forecasting vegetable prices holds significant importance. Vegetable market pricing is subject to a myriad of complex influences, resulting in nonlinear patterns that conventional time series methodologies often struggle to decode. In this paper, we exploit the average daily price data of six distinct types of vegetables sourced from seven key wholesale markets in Beijing, spanning from 2009 to 2023. Upon training an LSTM model, we discovered that it exhibited exceptional performance on the test dataset. Demonstrating robust predictive performance across various vegetable categories, the LSTM model shows commendable generalization abilities. Moreover, LSTM model has a higher accuracy compared to several machine learning methods, including CNN-based time series forecasting approaches. With R2 score of 0.958 and MAE of 0.143, our LSTM model registers an enhancement of over 5% in forecast accuracy relative to conventional machine learning counterparts. Therefore, by predicting vegetable prices for the upcoming week, we envision this LSTM model application in real-world settings to aid growers, consumers, and policymakers in facilitating informed decision-making. The insights derived from this forecasting research could augment market transparency and optimize supply chain management. Furthermore, it contributes to the market stability and the balance of supply and demand, offering a valuable reference for the sustainable development of the vegetable industry.

Quantifying economic vulnerabilities induced by interdependent networks.

Under economic globalization, countries are linked through trade and investments. This economic interdependence creates vulnerabilities. The indirect vulnerability induced by interdependent networks of trade and investments can put a country's economy at risk, but this risk has yet to be systematically quantified and investigated. In this paper, we developed the novel Potential Indirect Vulnerability Index (PIVI) to capture how interdependencies between networks of trade and foreign direct investment (FDI) may induce economic vulnerabilities. The model consisted of three main components: a target country (the importer of goods), an investing country (the exporter of FDI), and the intermediary countries that export commodities to the target country and receive FDI from the investing country, serving as conduits of the vulnerabilities caused indirectly by the investing country. The PIVI quantifies the indirect vulnerabilities based on the product of two fractions: 1) the dependency of the target country on commodities from each intermediary country; and 2) the dependency of each intermediary country on FDI from the investing country. We demonstrated the utility of PIVI by examining the US economy's vulnerability to China using 2019 trade and FDI data. Several Asian countries and a mix of agricultural products and raw materials were identified as conduits through which China could potentially influence the US economy. Vietnam was a sizeable risk because, while it has been a primary source of many US imports, it also received about 30% of its FDI from China. The US policy makers might opt to increase diversity in trade partners or to promote investment in countries such as Vietnam. We also applied the PIVI analysis to critical minerals, identifying cobalt, tungsten, and copper as the most vulnerability-inducing among them. PIVI is a flexible metric than can be aggregated and modified to provide a more nuanced and focused assessment of an economy's vulnerability.

Senior executive characteristics: Impact on ESG practices and corporate valuation relationship.

In recent years, sustainable development and green growth and performance of companies in environmental, social, and corporate governance (ESG) has received widespread attention from all sectors of society. Based on panel data of A-share listed companies in China from 2009 to 2022, this study employs a two-way fixed effects model to explore the mechanism of the relationship between ESG practices and corporate value, as well as the moderating effect of executive characteristics within this relationship. The results indicate a robust positive relationship between ESG practices and corporate value. However, this relationship is moderated by the academic backgrounds of senior executives, who negatively influence it, and by male executives, who exert a positive moderating effect. Furthermore, this study reveals the variable impacts of ESG practices in different corporate settings, industries, and institutional frameworks. Moreover, it demonstrates how ESG practices boost corporate value through an enhanced reputation and increased government innovation subsidies. It offers new insights on the strategic value of ESG for corporations and policymakers. It also extends the theoretical framework by integrating attention-based and upper echelons perspectives into the ESG discourse. .

The antecedents of customer satisfaction in the live-streaming commerce of green agricultural products.

Live-streaming technology has been widely adopted to promote the sale of green agricultural products. Based on the literature regarding electronic commerce and customer satisfaction, this article integrates expectation-disconfirmation theory and the SERVQUAL model to investigate the antecedents of customer satisfaction and the routes along which the former drives the latter in the live-streaming commerce of green agricultural products. Our results demonstrate that most consumers are satisfied with the live-streaming commerce of green agricultural products, with an overall satisfaction degree of medium to high. In addition, a total of four antecedents are identified, namely commodity, live-streaming platforms, live-streaming contents and supporting services. Among the variables relevant to commodity, "commodity brand building" has the highest weight. Meanwhile, the corresponding variables for live-streaming platforms, live-streaming contents and supporting services are "interface design", "live-streaming atmosphere" and "privacy protection", respectively. Furthermore, live-streaming platforms are found to have the strongest direct influence on customer satisfaction, while commodity is found to have the strongest indirect and total influence on customer satisfaction. The theoretical and managerial implications are discussed at the conclusion of this article.

Benchmarking for healthy food stores: protocol for a randomised controlled trial with remote Aboriginal and Torres Strait Islander communities in Australia to enhance adoption of health-enabling store policy and practice.

BACKGROUND: Aboriginal and Torres Strait Islander communities in remote Australia have initiated bold policies for health-enabling stores. Benchmarking, a data-driven and facilitated 'audit and feedback' with action planning process, provides a potential strategy to strengthen and scale health-enabling best-practice adoption by remote community store directors/owners. We aim to co-design a benchmarking model with five partner organisations and test its effectiveness with Aboriginal and Torres Strait Islander community stores in remote Australia. METHODS: Study design is a pragmatic randomised controlled trial with consenting eligible stores (located in very remote Northern Territory (NT) of Australia, primary grocery store for an Aboriginal community, and serviced by a Nutrition Practitioner with a study partner organisation). The Benchmarking model is informed by research evidence, purpose-built best-practice audit and feedback tools, and co-designed with partner organisation and community representatives. The intervention comprises two full benchmarking cycles (one per year, 2022/23 and 2023/24) of assessment, feedback, action planning and action implementation. Assessment of stores includes i adoption status of 21 evidence-and industry-informed health-enabling policies for remote stores, ii implementation of health-enabling best-practice using a purpose-built Store Scout App, iii price of a standardised healthy diet using the Aboriginal and Torres Strait Islander Healthy Diets ASAP protocol; and, iv healthiness of food purchasing using sales data indicators. Partner organisations feedback reports and co-design action plans with stores. Control stores receive assessments and continue with usual retail practice. All stores provide weekly electronic sales data to assess the primary outcome, change in free sugars (g) to energy (MJ) from all food and drinks purchased, baseline (July-December 2021) vs July-December 2023. DISCUSSION: We hypothesise that the benchmarking intervention can improve the adoption of health-enabling store policy and practice and reduce sales of unhealthy foods and drinks in remote community stores of Australia. This innovative research with remote Aboriginal and Torres Strait Islander communities can inform effective implementation strategies for healthy food retail more broadly. TRIAL REGISTRATION: ACTRN12622000596707, Protocol version 1.

Early warning signals for predicting cryptomarket vendor success using dark net forum networks.

In this work we focus on identifying key players in dark net cryptomarkets that facilitate online trade of illegal goods. Law enforcement aims to disrupt criminal activity conducted through these markets by targeting key players vital to the market's existence and success. We particularly focus on detecting successful vendors responsible for the majority of illegal trade. Our methodology aims to uncover whether the task of key player identification should center around plainly measuring user and forum activity, or that it requires leveraging specific patterns of user communication. We focus on a large-scale dataset from the Evolution cryptomarket, which we model as an evolving communication network. Results indicate that user and forum activity, measured through topic engagement, is best able to identify successful vendors. Interestingly, considering users with higher betweenness centrality in the communication network further improves performance, also identifying successful vendors with moderate activity on the forum. But more importantly, analyzing the forum data over time, we find evidence that attaining a high betweenness score comes before vendor success. This suggests that the proposed network-driven approach of modelling user communication might prove useful as an early warning signal for key player identification.

Predicting pharmaceutical prices. Advances based on purchase-level data and machine learning.

BACKGROUND: Increased costs in the health sector have put considerable strain on the public budgets allocated to pharmaceutical purchases. Faced with such pressures amplified by financial crises and pandemics, national purchasing authorities are presented with a puzzle: how to procure pharmaceuticals of the highest quality for the lowest price. The literature explored a range of impactful factors using data on producer and reference prices, but largely foregone the use of data on individual purchases by diverse public buyers. METHODS: Leveraging the availability of open data in public procurement from official government portals, the article examines the relationship between unit prices and a host of predictors that account for policies that can be amended nationally or locally. The study uses traditional linear regression (OLS) and a machine learning model, random forest, to identify the best models for predicting pharmaceutical unit prices. To explore the association between a wide variety of predictors and unit prices, the study relies on more than 200,000 purchases in more than 800 standardized pharmaceutical product categories from 10 countries and territories. RESULTS: The results show significant price variation of standardized products between and within countries. Although both models present substantial potential for predicting unit prices, the random forest model, which can incorporate non-linear relationships, leads to higher explained variance (R2 = 0.85) and lower prediction error (RMSE = 0.81). CONCLUSIONS: The results demonstrate the potential of i) tapping into large quantities of purchase-level data in the health care sector and ii) using machine learning models for explaining and predicting pharmaceutical prices. The explanatory models identify data-driven policy interventions for decision-makers seeking to improve value for money.