AI Quality Standards in Health Care: Rapid Umbrella Review.

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.

Physicochemical homogeneity of stingless bee honey (Heterotrigona itama) produced in the west coast, east coast and inland area of Peninsular Malaysia.

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.

[Availability of physicians with geriatric qualifications to implement the requirements for the care of geriatric patients with proximal femoral fractures]. / Verfügbarkeit von Ärzten mit geriatrischer Qualifikation für die Umsetzung der Anforderungen zur Versorgung geriatrischer Patienten mit hüftgelenknaher Femurfraktur.

BACKGROUND/OBJECTIVE: Since 2024, according to the guidelines on the treatment of proximal femoral fractures of the German Joint Federal Committee (QSFFx-RL), the geriatric qualification of physicians is the new quality standard for the daily guarantee of geriatric competence in the care of fractures near the hip joint in hospitals. The article examines whether there are enough physicians qualified in geriatrics available to implement this quality standard in practice. MATERIAL AND METHODS: The data were based on physician statistics, quality assurance procedures and hospital billing records. The available geriatric competence was determined on the basis of physicians with the required geriatric qualifications and potential orthogeriatric cooperation partners, hospital locations with guideline cases using the main diagnoses and procedures. RESULTS: The total increase in the number of physicians qualified in geriatrics for 2023 can be estimated at around 4800 (of whom 2700 are active in inpatient and 1700 in outpatient fields). In 2022 there were 1005 hospital locations with > 20 guideline cases, 55% of which also offered geriatric services. A total of 908 geriatric locations (hospital/rehabilitation) and 1476 contract doctors were identified as potential cooperation partners. Only 4.6% of hospital locations with > 20 guideline cases did not have a potential geriatric location within a distance radius of ≤ 20 km. DISCUSSION: The number of physicians qualified in geriatrics and potential geriatric cooperation partners, the long transition period, already established local geriatric care services and the possibility of using telemedicine support the feasibility of implementing the new quality standard; however, the planned exclusion of geriatric consultations on request starting in 2027 will require even more physicians qualified in geriatrics.

[Research strategy for homogenization feeding of Chinese patent medicines].

Chinese patent medicine constitutes a vital segment of the traditional Chinese medicine(TCM) industry and stands as a significant emblem of TCM modernization. At present, the quality stability between batches of Chinese patent medicine preparations has become a pivotal factor directly restricting the high-quality development of the TCM industry. Consequently, addressing the homogeneity of Chinese patent medicines, this paper proposes a research scheme of homogenization feeding. It systematically elaborates on the object and pretreatment of homogenization, operational procedures of homogenization feeding, selection of homogenization evaluation indices, homogenization feeding algorithm, and homogenization feeding process. With the key quality control indicators as the homogenization target, the homogenization feeding process and its quality analysis were discussed. Finally, a demonstration strategy for homogenization feeding of Chinese patent medicine was formed, providing the scientific basis for advancing the research of quality consistency across batches of Chinese patent medicine preparations.

Derivation of subacute guidance values for chemical contaminants of drinking water quality standard in Japan.

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.

A quantitative assessment of natural and anthropogenic effects on the occurrence of high air pollution loading in Dhaka and neighboring cities and health consequences.

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.

Prospect of China's ambient air quality standards.

Ambient air quality standards are the core strategic goal of ambient air quality management. Countries worldwide have given importance to research on the development of ambient air quality standards. To understand the history of the development of China's ambient air quality standards, this study analyzed the background associated with all previous formulations and revisions of the standards, classification of functional areas, standard grading, pollutants, and evolution of the standard limits over the past 40 years. The results show that since the initial release of the "Ambient Air Quality Standard" by China in 1982, it has been supplemented once, revised twice, and modified twice. The first ambient air quality standard specified the standard limits of six pollutants commonly found in ambient air. With the development of ambient air quality management, the number of pollutants has increased to ten. Since the release of the "Ambient Air Quality Standards" in 2012, the ambient air quality in China has significantly improved. However, the proportion of cities meeting these standards is still low. At present, China is suitably positioned to make the standards associated with 24 hr SO2 concentrations more stringent such that it meets the values defined in the World Health Organization (WHO) interim target-2 and the WHO air quality guideline (AQG). We further suggested that the SO2 standard should be revised promptly. Simultaneously, regions with a relatively high proportion of cities meeting the standard are encouraged to introduce more stringent interim target limits in due course to manage the local ambient air quality.

[Varieties systematization and standards status analysis of fermented Chinese medicine].

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.

Derivation of human health risk-based thresholds for lead in soils promote the production of safer wheat and rice.

A reliable and accurate soil threshold helps prevent excessive dietary Pb intake risks to consumers of locally grown wheat and rice crops. Based on a three-year investigation of 206 wheat fields and 358 rice fields throughout China, this study aimed to improve the soil protection guidelines by investigating Pb accumulation in soil-wheat and soil-rice systems and by assessing Pb exposure risks through the soil-grain-human pathway. A site-specific bioconcentration factor (BCF, ratio of Pb concentration in plant to that in soil) was calculated and used to assess grain Pb intake risks instead of a generic BCF value to reduce data uncertainty. In addition to soil pH, cation-exchange capacity exerted a major influence on the Pb BCF variations in wheat, whereas the organic carbon dynamics affected the BCF variations in rice. Once normalized BCF against those soil variables, the distributions of BCF were log-normal in nature. Optimizing the pH and cation-exchange capacity of wheat soils would help protect 49.8% of local adults from excessive Pb dietary intake. The scenario soil thresholds linked to soil variables and grain Pb intake risks were then derived and validated by independent data from field surveys and published articles. Poor production practices in the wheat fields under study included using soils with low fertility.

Toward harmonizing global pesticide regulations for surface freshwaters in support of protecting human health.

To promote international collaboration on environmental pollution management and human health protection, we conducted a global-level study on the management of pesticides for surface freshwater quality. Prior to actions being taken in terms of water treatment or remediation, it is essential that clear and definite regulations be disseminated. In our study, 3094 surface freshwater quality standards for 184 different pesticides were recorded from 53 countries and categorized according to pesticide types and standard types, as well as diverse use of freshwater by humans, and compared water quality standards related to human health. Our results indicate large variations in pesticide regulations, standard types (i.e., long- or short-term water quality standards), and related numerical values. With regard to the protection of human health, the 10 most frequently regulated pesticides account for approximately 47% of the total number of standards across 184 considered pesticides. The average occurrence-weighted variations of standard values (i.e., numerical values provided in a standard in terms of residue limits of a given pesticide in water) for the 20 most regulated persistent organic pollutants (POPs) and other phase-out pesticides (i.e., pesticides not currently-approved for use in agriculture across various countries) are 4.1 and 2.6 orders of magnitude, respectively, with human-exposure related standard values for some pesticides varying with over 3 orders of magnitude (e.g., lindane). In addition, variations in water quality standard values occurred across standard types (e.g., maximum and average), water use types (e.g., unspecified waters and human consumption), and standard values (e.g., pesticide individuals and groups). We conclude that regulatory inconsistencies emphasize the need for international collaboration on domestic water treatment, environmental management as well as specific water quality standards for the wider range of current-use pesticides, thereby improving global harmonization in support of protecting human health.

[High quality standard of Scutellariae Radix based on plant metabolomics and index components].

Scutellariae Radix(SR), derived from the dried root of Scutellaria baicalensis in the family Lamiaceae, commonly serves as Chinese medicinal material. Affected by producing areas, growing years, and harvesting periods, the quality of SR fluctuates in the market. However, baicalin≥9% in SR required in the Chinese Pharmacopoeia(2020 edition) can only determine the qualified SR but cannot identify high-quality SR. To improve the quality control methods of SR, the present study analyzed the accumulation of metabolites in SR of different growth years by plant metabolomics, and identified 28 metabolites increasing with growth years(1-3 years). Subsequently, 14 main metabolites were quantitatively analyzed by ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry(UPLC-QQQ-MS). Among them, baicalin, wogonoside, baicalein, and wogonin with high content and good activity were selected as the index components of SR for quality evaluation. A high-performance liquid chromatography(HPLC) method was established to determine the content of four index components in 32 batches of SR from different producing areas, harvesting perio-ds, and growth years. The results showed that the growth years could greatly affect the content of index components. The total content of four index components in 2-year SR was the highest, followed by the 3-/4-year SR and 1-year SR. Based on HPLC data and verification results by enterprises, baicalin ≥12.0%, wogonoside ≥2.3%, baicalein ≥0.1%, and wogonin ≥0.03% were proposed as the evaluation criteria for the high-quality SR. The findings of this study are expected to provide a basis for improving the quality of SR.

[Quality standard of Lobeliae Chinensis Herba].

In light of related methods in Chinese Pharmacopoeia(2020 edition), this study established the quality standard for Lobeliae Chinensis Herba. The TLC identification method was established with silica gel GF_(254) thin layer plate, diosmin standard, linarin standard, and the reference material of Lobeliae Chinensis Herba. The loss on drying, total ash, acid-insoluble ash, and ethanol-soluble extracts of 18 batches of Lobeliae Chinensis Herba samples were determined according to the general principles in Chinese Pharmacopoeia. Then, HPLC was adopted in the establishment of characteristic chromatogram and content determination. The results showed that the established method can achieve good separation for diosmin, linarin, and lobetyolin. Based on the results of detection for 18 batches of Lobeliae Chinensis Herba samples, the draft quality standard was established, which was expected to provide reference for the revision of this medicinal herb in Chinese Pharmacopoeia.

[Research progress of Curcuma kwangsiensis root tubers and analysis of liver protection and anti-tumor mechanisms based on Q-markers].

Curcuma kwangsiensis root tuber is a widely used genuine medicinal material in Guangxi, with the main active components of terpenoids and curcumins. It has the effects of promoting blood circulation to relieve pain, moving Qi to relieve depression, clearing heart and cooling blood, promoting gallbladder function and anti-icterus. Modern research has proved its functions in liver protection, anti-tumor, anti-oxidation, blood lipid reduction and immunosuppression. Considering the research progress of C. kwangsiensis root tubers and the core concept of quality marker(Q-marker), we predicted the Q-markers of C. kwangsiensis root tubers from plant phylogeny, chemical component specificity, traditional pharmacodynamic properties, new pharmacodynamic uses, chemical component measurability, processing methods, compatibility, and components migrating to blood. Curcumin, curcumol, curcumadiol, curcumenol, curdione, germacrone, and ß-elemene may be the possible Q-markers. Based on the predicted Q-markers, the mechanisms of the liver-protecting and anti-tumor activities of C. kwangsiensis root tubers were analyzed. AKT1, IL6, EGFR, and STAT3 were identified as the key targets, and neuroactive ligand-receptor interaction signaling pathway, nitrogen metabolism pathway, cancer pathway, and hepatitis B pathway were the major involved pathways. This review provides a basis for the quality evaluation and product development of C. kwangsiensis root tubers and gives insights into the research on Chinese medicinal materials.

A machine learning model to estimate ambient PM2.5 concentrations in industrialized highveld region of South Africa.

Exposure to fine particulate matter (PM2.5) has been linked to a substantial disease burden globally, yet little has been done to estimate the population health risks of PM2.5 in South Africa due to the lack of high-resolution PM2.5 exposure estimates. We developed a random forest model to estimate daily PM2.5 concentrations at 1 km2 resolution in and around industrialized Gauteng Province, South Africa, by combining satellite aerosol optical depth (AOD), meteorology, land use, and socioeconomic data. We then compared PM2.5 concentrations in the study domain before and after the implementation of the new national air quality standards. We aimed to test whether machine learning models are suitable for regions with sparse ground observations such as South Africa and which predictors played important roles in PM2.5 modeling. The cross-validation R2 and Root Mean Square Error of our model was 0.80 and 9.40 µg/m3, respectively. Satellite AOD, seasonal indicator, total precipitation, and population were among the most important predictors. Model-estimated PM2.5 levels successfully captured the temporal pattern recorded by ground observations. Spatially, the highest annual PM2.5 concentration appeared in central and northern Gauteng, including northern Johannesburg and the city of Tshwane. Since the 2016 changes in national PM2.5 standards, PM2.5 concentrations have decreased in most of our study region, although levels in Johannesburg and its surrounding areas have remained relatively constant. This is anadvanced PM2.5 model for South Africa with high prediction accuracy at the daily level and at a relatively high spatial resolution. Our study provided a reference for predictor selection, and our results can be used for a variety of purposes, including epidemiological research, burden of disease assessments, and policy evaluation.

Data Quality Management in the Internet of Things.

Nowadays, IoT is being used in more and more application areas and the importance of IoT data quality is widely recognized by practitioners and researchers. The requirements for data and its quality vary from application to application or organization in different contexts. Many methodologies and frameworks include techniques for defining, assessing, and improving data quality. However, due to the diversity of requirements, it can be a challenge to choose the appropriate technique for the IoT system. This paper surveys data quality frameworks and methodologies for IoT data, and related international standards, comparing them in terms of data types, data quality definitions, dimensions and metrics, and the choice of assessment dimensions. The survey is intended to help narrow down the possible choices of IoT data quality management technique.

[Overview of quality standards of Eucommiae Cortex in China and overseas].

Eucommiae Cortex is an authentic medicinal material with broad growing areas( such as Hunan and Sichuan provinces in China. It is well-known for its efficacy in tonifying liver and kidney,strengthening muscles and bones,and stabilizing fetus. It has also been proven in pharmacology to possess the functions such as lowering blood pressure and lipids. Hence,Eucommiae Cortex has attracted increasing attention. The current quality standards of Eucommiae Cortex vary in different countries or regions. The quality of Eucommiae Cortex products on the market is affected by mix-ups of non-medicinal parts and insufficient growth years. In view of these problems,this paper summarizes the current quality standards and research progress of Eucommiae Cortex in China and overseas,aiming to provide a reference for the establishment of the quality standards of Eucommiae Cortex.

[Current quality standards of cattle bile and sheep bile quality standards and discussion on related problems].

To analyze quality standards of cattle bile and sheep bile, and to discuss the related problems in the standards. The results showed that physical forms of the related medicinal materials of cattle bile and sheep bile were chaotic, and the technical methods adopted in the quality standards were generally backward. In addition, there were still problems that some medicinal material standards lacked necessary test items, which were especially obvious in the relevant medicinal material standards of sheep bile and brought difficulties to quality evaluation and control. We suggest that physical forms of cattle bile and sheep bile in quality standards should be determined, and inspection items should be completed. Based on mainstream analytical technology, some technical methods of these standards should be improved.

[Quality standards of Gleditsiae Spina and its decoction pieces].

In view of the current inadequate standards for Gleditsiae Spina in the Chinese Pharmacopoeia, this study put forward some new items of the quality standards of Gleditsiae Spina. Thin-layer chromatography(TLC) was performed for identification with the reference substance of taxifolin and the reference material of Gleditsiae Spina as the control. According to the general principles of the Chinese Pharmacopoeia(2020 edition, Vol. 4), the moisture, total ash content, and alcohol-soluble extract of medicinal materials and decoction pieces of Gleditsiae Spina were determined. The content determination method for medicinal materials and decoction pieces of Gleditsiae Spina was established using high-performance liquid chromatography(HPLC), with taxifolin as the quality control index. Based on the determination results of 30 batches of samples of Gleditsiae Spina from different habitats, the draft quality standards of Gleditsiae Spina were developed, which provided suggestions for the revision of the quality standards of Gleditsiae Spina in the Chinese Pharmacopoeia.

Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain.

In Spain, the QUANTUM project has been promoted to reduce variability in clinical practice and improve the care and quality of life of people with psoriatic arthritis (PsA) by accrediting PsA units throughout the Spanish national health system. To present the results of this approach which sought to ensure an optimum level of quality for patients with PsA. Descriptive analysis of the self-assessments that the PsA units have carried out assessing their degree of compliance with the quality standards established in the QUANTUM project grouped into four blocks: shortening time to diagnosis; optimizing disease management; improving multidisciplinary collaboration; and improving patient monitoring. A total of 41 PsA units were self-evaluated. They met 64.1% of the defined quality standards. Optimize disease management obtained a higher level of standards compliance (72%) and improve multidisciplinary collaboration the lesser (63.9%). Accessibility to the treatments available for PsA in all hospitals was guaranteed (100%). Appropriate diagnostic equipment is available (97.6%). Compliance with specific quality standards leads to detect actions that should be implemented: quality of life assessment (9.8%), locomotor system assessment (12.2%), physical examination data record (14.6%), periodic cardiovascular risk assessment (17.1%). The QUANTUM project results make it possible to visualise how to care for patients with PsA is being developed in Spain. Problems identified in recent multinational reports are also identified in Spain.

Quality in Non-GxP Research Environment.

There has been increasing evidence in recent years that research in life sciences is lacking in reproducibility and data quality. This raises the need for effective systems to improve data integrity in the evolving non-GxP research environment. This chapter describes the critical elements that need to be considered to ensure a successful implementation of research quality standards in both industry and academia. The quality standard proposed is founded on data integrity principles and good research practices and contains basic quality system elements, which are common to most laboratories. Here, we propose a pragmatic and risk-based quality system and associated assessment process to ensure reproducibility and data quality of experimental results while making best use of the resources.