Exploring the Impact of Food Labels on Consumer Purchasing Decisions: A Study on Awareness and Preferences

Food labels are an excellent avenue of communication. The food package has assumed the responsibility of communicating relevant information that consumers need to know about the product. The objectives of this study was to understand the impact of food labels on consumer purchasing decisions and also to understand the impact of Demographic variables on awareness and Preference level about Food labels among women consumer in Mysore urban. A total of 200 Housewives between age group of 25-45 years from the residential areas of Mysore Urban and who gave consent to participate in the study were included. The research was based on survey using standardized questionnaire and personal interview. The results showed that 33 percent of the respondents were graduates and 63.5 percent were housewives. The awareness about food labels and the attitude of reading labels was studied and the results were encouraging to note that the entire respondent practiced to read the label information. 70-74 percent of the respondents believed that the label information ascertained the safety of the food for used. There was a positive correlation between the Respondents� score and preference score towards food labels and consumer purchasing decisions. It was evident that demographic profile of the consumers has an impact on the awareness of food label and consumer purchasing decision. It was found (Table 4) that subjects Awareness score positively correlated with attitude score towards food labels (r = 0.7825) and similarly Awareness score was also positively correlated with Preference of the same (r = 0.9704). The results also showed that Attitude and Preference for making purchasing decision had a significant correlation with each other (r= 0.8913). It can be concluded that many demographic factors such as age, occupation, family income and food habits had impact on decision making for purchasing the food products. This results of the present study highlight the needs to improve food labeling, provide education to consumers to raise their awareness on importance of reading and use of food labeling information to make an informed choice of the food.

Revolutionizing Food Quality and Safety: Recent Advances in Clean-Label Technology

The rising incidence of foodborne illnesses and scandals, coupled with heightened consumer awareness of the negative impacts of artificial ingredients, has driven a significant shift toward clean label products梖oods defined by simple, recognizable ingredients and minimal processing. This review provides a comprehensive analysis of clean label technology, exploring its historical evolution, key definitions, applications, and current market trends. It also examines consumer behavior toward clean label products and the marketing strategies employed by brands to foster transparency. Drawing on 61 peer-reviewed references published between 2020 and 2024, this narrative review integrates findings from academic research and industry reports to offer a holistic perspective on clean label practices. Key challenges hindering the implementation of clean label technologies, such as the effectiveness of natural preservatives, the impact of ingredient removal on sensory qualities, and the financial implications of transitioning to clean label practices, are discussed. The findings underscore the necessity for the food industry to address these challenges to ensure the sustained growth of the clean label movement, aligning with consumer preferences for healthier and more transparent food options.

Assessment of Knowledge and Attitude of Community Pharmacists towards of Label Medications in Khartoum State: A Descriptive Cross Sectional Study

Background: Healthcare providers, including pharmacists who prescribe medications, have a professional obligation to select treatments that are in the best interests of their patients. Consequently, the concept of off-label drug use, where drugs are used outside their approved indications, dosages, routes, or patient groups, often appears in medical literature, continuing education, and online resources. This term can be contentious, linked to both significant benefits and risks for patients. This study aimed to assess community pharmacists' knowledge and attitudes towards off-label medications. Methods: A descriptive cross-sectional study was conducted using a self-administered, 24-item questionnaire distributed to 330 randomly selected community pharmacies in Khartoum State from December 2020 to February 2021. Results: A 100% response rate was achieved. Most respondents were female (63.3%), aged 25-29 years (59.5%), and had 1-6 years of experience (36.6%). Over 75.1% were familiar with the concept of off-label prescribing, primarily through practical experience rather than formal education. Reasons mentioned for off-label prescriptions included indications (76.5%). More than half (62%) believed that prescribing off-label drugs is illegal, and only 16% felt they had adequate knowledge about off-label drug use. Despite concerns about safety (51%) and efficacy (54.7%), the majority of pharmacists relied on the British National Formulary (50%) or national guidelines (18.1%) rather than local formularies or package inserts for information. While 59.5% agreed they had a responsibility to inform prescribers about off-label use, 51.5% felt similarly towards informing patients. Regarding specific medications, 88% of respondents considered the use of metformin for obesity to be off-label, compared to 26.9% for pregabalin for neuropathic pain, and 66.7% and 31.3% for prazosin and clomiphene, respectively. Conclusion: Community pharmacists in Khartoum State appear to have limited awareness and concerns about the issues surrounding off-label prescribing. Most acquired relevant knowledge through work experience rather than formal training.

Tamsulosin Off-Label Use in Kidney Stones: Review and Survey

This study investigates the effectiveness and healthcare perceptions of Tamsulosin, an off-label medication for kidney stone management. Despite the documented benefits, the quest for alternative treatments like Tamsulosin persists, driven by its advantages and patient satisfaction levels. This research includes a literature review and a survey of pharmacy students’ opinions on Tamsulosin, aiming to bridge the knowledge gap. This study, which involved 38 first-year professional pharmacy students, achieved a 92% response rate. The research used questionnaire that collected demographic information and assessed participants' knowledge and opinions using a Likert scale, which was integrated into a drug informatics course. We analyzed the responses using SPSS software, utilizing descriptive and chi-square statistical methods. The survey, completed by 38 participants, revealed discrepancies between current treatment practices and the students' understandings. Despite Tamsulosin's documented efficacy in facilitating stone passage, significant skepticism exists about its use without FDA approval. The research showed varied levels of understanding and skepticism towards off-label use among the students. Moreover, 70.3% of respondents recognized Tamsulosin's potential for managing kidney stones, despite its lack of FDA approval, indicating a cautious yet acknowledging attitude towards non-approved drug use for organ rejection. There's a noted need for improved education and the dissemination of evidence-based guidelines in clinical practice. The study uncovers varied knowledge and perceptions among healthcare professionals and pharmacy students regarding Tamsulosin's use in kidney stone management. The gap between clinical evidence and survey participants' awareness underscores the importance of further research and education to align clinical practices with evidence-based guidelines.

Uso y comprensión del etiquetado nutricional en personas mayores mexicanas: un estudio secundario de la Encuesta Nacional de Salud y Nutrición (ENSANUT 2021) / Nutritional label use and understanding among Mexican older persons: a secondary study of National Health and Nutrition Survey (ENSANUT 2021)

Resumen Antecedentes: En México, en 2020 se implementó el etiquetado frontal de advertencia (EFA) como parte de una estrategia para incrementar el consumo consciente de alimentos. Sin embargo, la limitada cobertura mediática, la falta de conocimiento entre los profesionales de la salud y el uso de terminología técnica parecen ser impedimentos que afectan a algunos grupos de la población, particularmente a las personas mayores. Objetivo: Analizar el perfil del uso y comprensión del etiquetado nutricional entre las personas mayores, según diferentes factores que podrían influir en ello. Material y métodos: El uso y comprensión del EFA se evaluó en una muestra representativa de 1884 personas mayores de la Encuesta Nacional de Salud y Nutrición (ENSANUT) 2021. Se realizó regresión logística para determinar la asociación de conocer o usar el EFA, ajustando por edad, género, capacidad de lectura, nivel educativo, vivir con diabetes, hipertensión y estatus de seguridad social. Resultados: La probabilidad de leer y usar el EFA estuvo influida por una menor edad, ser mujer, un nivel educativo más alto y tener seguridad social. No existió un efecto significativo de vivir con diabetes o hipertensión. Conclusiones: Es oportuna una educación nutricional adaptada a las circunstancias de las personas mayores en México.

Abstract Background: Front package warning labeling (FWL) was implemented in Mexico in 2020 as part of a strategy to raise food-related knowledge. However, limited media coverage, a lack of awareness among health professionals, and the usage of technical terminology appear to be impediments affecting many groups of the population, particularly older persons. Objective: Analyze the profile of nutritional label use and understanding among older persons considering different factors that might have an effect on it. Material and methods: The use and knowledge of FWL were assessed using a representative sample of 1884 older individuals from the 2021 National Health and Nutrition Survey (ENSANUT). Logistic regression was used to determine the association of knowing or using FWL, adjusted by age, sex, able to read, educational level, living with diabetes, hypertension, and social security status. Results: The probability of reading and using the FWL was influenced by lower age, being female, higher education level and having social security. There was no discernible effect of living with diabetes or hypertension. Conclusions: Nutritional education tailored to the circumstances of older persons in Mexico is timely.

A Randomised Open Label Trial to Evaluate the Efficacy of TCA Peel with Oral Metformin vs TCA Peel with Oral Alpha Lipoic Acid in Acanthosis Nigricans

Background: Acanthosis Nigricans (AN) is a condition acquired by keratinization. It presents as velvety skin and hyperpigmentation and can affect any area of the body, including the face. Several topical, systemic, and physical therapies, including laser therapy have been studied. For the most part, randomised controlled trials are lacking for therapy choices other than weight loss and lifestyle adjustments. Therefore, the present study was designed to compare the efficacy of 15% trichloroacetic acid (TCA) peel with oral metformin against 15% TCA peel with alpha lipoic acid in cases of AN with metabolic syndrome. Methods: Fifty patients were included & divided into two groups. Each patient in Group A was given oral alpha lipoic acid 200 mg BID along with monthly 15% TCA for 03 months, while in Group B, patients were given monthly oral metformin 500 mg BID for three months along with monthly 15% TCA. The effectiveness of each peel was assessed by looking into the severity of neck lesions & texture. Results: The generalized estimating equations method was used to compare the total change over time in the two groups. Over time, there was a substantial difference between the two groups (p<0.001). When compared to a TCA peel with an oral lipoic acid group, the skin thickness and texture changed more in the metformin group. Conclusion: In both groups, oral metformin with TCA peel was more effective than oral alpha lipoic acid in our study. As a safe and efficient treatment for AN, we advise using metformin in conjunction with a 15% TCA peel. For supporting data, however, more thorough randomized control studies are needed.

Evaluation of dual-parameter 3D-ASL on blood-supply of patients with CMCAO and the relationship between that and cerebral infarction area / 中国医学装备

Objective:To explore the evaluation of dual-parameter three dimension arterial spin labelling(3D-ASL)perfusion imaging on blood-supply situation of patients with chronic middle cerebral artery occlusion(CMCAO)and the relationship between that and cerebral infarction area.Methods:A total of 112 patients with unilateral CMCAO admitted to Handan Central Hospital from April 2019 to December 2021 were selected,and all of them were divided into a compensatory group(50 cases)with anterior cerebral artery(ACA)leptomeningeal anastomoses(LMA)and an uncompensated group(62 cases)according to the results of digital subtraction angiography(DSA)examination.The results of diffusion weighted imaging(DWI),magnetic resonance angiography(MRA)and dual-parameter 3D-ASL detection were respectively analyzed,and the clinical data,3D-ASL parameters and the incidence of cerebral infarction between the two groups were compared.The influence factors of compensation were further analyzed.The receiver operating characteristics(ROC)curve of LMA diagnostic value of CMCAO patients was drawn according to cerebral blood flow values[post label delay(PLD)=1.5 s,2.5 s)].The 3D-ASL parameters of patients with different cerebral infarction areas were compared,and the relationship between 3D-ASL parameters and cerebral infarction area was compared.Results:The apparent diffusion coefficient(ADC)at the side of lesion of CMCAO patients was(0.31±0.10),and cerebral blood flow values at 1.5s and 2.5s were respectively(25.67±4.25)and(54.09±4.49),which were significantly lower than those at the side of healthy,and the differences were statistically significant(t=27.591,34.210,3.913,P<0.05),respectively.The differences of cerebral blood flow values(1.5s and 2.5s)between compensatory group and uncompensated group were significant(t=5.584,4.090,P<0.05),respectively.The results of logistic regression analysis showed that age,stroke,cerebral infarction area and cerebral blood flow values(1.5 s and 2.5 s)were influencing factors on LMA compensation of CMCAO patients(OR=4.187,6.604,0.482,5.681,5.807,P<0.05),respectively.The ROC values showed that the area under curve(AUC)of 3D-ASL were respectively 0.720 and 0.812 in diagnosing LMA when PLD were respectively 1.5s and 2.5s.The proportion of normal and lacunar infarctions in the compensatory group was significantly higher than that in the uncompensated group,while the proportions of middle and small infarction,and large area infarctions of the compensatory group were significantly lower than those of the uncompensated group,and the difference was statistically significant(t=28.062,P<0.05).The difference in cerebral blood flow values(1.5s)among patients with different infarct areas was statistically significant(t=0.202,P<0.05).The cerebral blood flow value(1.5s)of 3D-ASL was negatively correlated with the area of cerebral infarction(r=-0.261,P<0.05).Conclusion:Dual parameter 3D-ASL can non-invasively and visually assess the compensatory status of LMA of patients with unilateral CMCAO.The blood flow perfusion of middle cerebral artery(MCA)at the side of lesion is related to the area of cerebral infarction.When the PLD is 1.5s,the sensitive response can be conducted on this,so as to provide objective and reliable basis for clinical diagnosis and treatment and curative effect.

Prescription of off-label and unlicensed medication for newborns hospitalized in the Intensive Care Unit / Prescrição de medicamentos off-label e não licenciados para neonatos hospitalizados na Unidade de Terapia Intensiva

ABSTRACT Objective: To analyze the prevalence of off-label and unlicensed prescriptions for a population of neonates admitted to the Neonatal Intensive Care Unit in a hospital in southern Santa Catarina. Methods: Observational study with a cross-sectional design. All neonates admitted to the Intensive Care Unit during the period from March 2020 to March 2021 were included. Data collection was performed through a questionnaire made by the authors and the classification of drugs based on the Electronic Drug Description (Bulário Eletrônico) of the Brazilian Health Regulatory Agency and Drug Dex-Micromedex. Results: Data from 296 neonates were evaluated. The prevalence was 50,7% for prescribing off-label medications and 37,2% for unlicensed medications. The use of drugs was higher in preterm neonates, with low birth weight, 1st minute Apgar between 6-8, 5th minute Apgar between 7-8, and in need of invasive procedures. The most used off-label drugs were ampicillin, gentamicin and fentanyl (92.6, 92.0 and 26.6%, respectively), whereas the most used unlicensed drugs were caffeine, phenobarbital and bromopride (78.1, 16.3 and 10.9%, respectively). Conclusions: This study showed a large percentage of prescriptions made in the off-label (50.7%) and unlicensed (37.2%) form in the Neonatal Intensive Care Unit, corroborating the worrying world scenario. The most exposed neonates were precisely the most vulnerable ones and, among the most commonly prescribed medications, ampicillin and gentamicin stood out in off-label form and caffeine in unlicensed form.

RESUMO Objetivo: Analisar a prevalência de prescrições off-label e não licenciadas uma população de neonatos internados na Unidade de Terapia Intensiva Neonatal em um hospital ao sul de Santa Catarina. Métodos: Estudo observacional com delineamento transversal. Foram incluídos todos os neonatos admitidos na Unidade de Terapia Intensiva durante o período de março de 2020 a março de 2021. A coleta de dados foi realizada a partir de questionário elaborado pelos autores, e a classificação dos medicamentos, com base no Bulário Eletrônico da Agência Nacional de Vigilância Sanitária e no Drug Dex-Micromedex. Resultados: Foram avaliados dados de 296 neonatos. A prevalência foi de 50,7% para prescrição de medicações off-label e 37,2% para medicações não licenciadas. O uso dos fármacos foi maior em neonatos pré-termo, com baixo peso ao nascer, Apgar de 1o minuto entre 6-8, Apgar de 5o minuto entre 7-8, e com necessidade de procedimentos invasivos. Os fármacos off-label mais utilizados foram a ampicilina, gentamicina e fentanil (92,6, 92 e 26,6%, respectivamente), já os fármacos não licenciados mais utilizados foram a cafeína, fenobarbital e bromoprida (78,1, 16,3 e 10,9%, respectivamente). Conclusões: O estudo demonstrou grande porcentagem de prescrições realizadas de forma off-label (50,7%) e não licenciada (37,2%) na Unidade de Terapia Intensiva Neonatal de análise, corroborando o preocupante cenário mundial. Os neonatos mais expostos foram justamente aqueles mais vulneráveis e, entre as medicações mais utilizadas, destacam-se a ampicilina e a gentamicina de modo off-label e a cafeína de modo não licenciado.

Detection of Amantadine by Label-free Fluorescence Method Based on Truncated Aptamer and Molybdenum Disulfide Nanosheet Signal Enhancement Strategy / 分析化学

Amantadine(AMD)residue can accumulate in organisms through the food chain and cause serious harm to human body.AMD can specifically bind to AMD specific aptamer and cause its conformation to change from a random single strand to a stem-loop structure.To avoid the influence of excess nucleotides on binding of aptamer to AMD,the truncation of the AMD original aptamer J was optimized by retaining an appropriate stem-loop structure,and a new type of truncation aptamers was developed in this work.By comparing the truncated aptamer with the original aptamer,it was found that the truncated aptamer J-7 had better affinity and specificity with AMD.The detection limit of AMD was 0.11 ng/mL by using J-7 as specific recognition element and molybdenum disulfide nanosheet(MoS2Ns)as signal amplification element.The developed method base on truncated aptamer J-7 was used for detection of AMD in milk,yogurt and SD rat serum samples for the first time with recoveries of 86.6%-108.2%.This study provided a reference for truncating other long sequence aptamers and provided a more sensitive detection method for monitoring AMD residues in food.

Estado de las Políticas de regulación para el consumo de azúcar y para la comida chatarra en 3 países de América Latina / Regulatory policies for sugar consumption and junk food in 3 Latin American countries

Introducción: El consumo de bebidas azucaradas y alimentos no saludables es un problema de Salud Pública y de las Políticas Públicas que buscan reducir el impacto de las Enfermedades No Trasmisibles (ENT) en América Latina. Objetivo: identificar las Políticas Públicas generadas en Colombia, Argentina y Chile para la regulación del consumo de azúcar y comida chatarra. Materiales y Métodos: Análisis exploratorio a través de una revisión de literatura y revisión de documentos normativos. Resultados: Colombia en el año 2021 sancionó la Ley 2120 denominada "Ley de Comida Chatarra", que promueve el acceso a información necesaria para fomentar entornos alimentarios saludables y prevenir las ENT, que incluye nuevas normas para el etiquetado de alimentos y describir sus características al consumidor y así limitar el consumo de alimentos procesados y ultraprocesados. Chile fue pionero en el desarrollo de los sellos de advertencia y desde el año 2014, aplica un impuesto adicional a las bebidas no alcohólicas. Argentina en 2021, sancionó la ley que obliga a la industria de alimentos a disponer de etiquetas en los envases que alerten al consumidor sobre los excesos de azúcares, grasas y sodio Conclusiones: Los tres países investigados cuentan con políticas de etiquetado de alimentos procesados, y en Chile existen impuestos a las bebidas azucaradas. Es importante estudiar el impacto de dichas políticas en la prevalencia y severidad de las ENT y de la caries.

Abstract: The consumption of sugar-sweetened beverages and unhealthy foods is a public health problem that has become a regulatory issue for the public policies aimed at reducing the impact of Non Communicable Diseases (NCDs) in Latin America. Objective: to identify the Public Policies in Colombia, Argentina and Chile for the regulation of the consumption of sugar and junk food. Materials and methods. Exploratory analysis through a literature and policy documents review. Results: In 2021, Colombia approved the Law 2120 called "Junk Food Law" promoting public access to information for a healthy food environment to prevent NCDs. It includes food labeling for overweight and obesity prevention and establishes a specific labeling regulation for processed and ultra-processed food and sweet drink products. Chile was pioneer in the development of warning stamps on food packages and since 2014 also taxes sweet non-alcoholic beverages. In 2021, Argentina approved a law to add labels on food packages to alert consumers about excess of sugars, fats and sodium. Conclusions: The three investigated countries have labeling policies for processed food, and Chile puts taxes on sugary drinks. It is important to study the impact of these policies on NCD prevalence, severity and on dental caries.

Use of off-label drugs in the neonatal intensive care unit in India

Background: Off-label use of drugs is widespread in pediatrics and almost all neonates hospitalized in NICU are affected by the use of off-label drugs regardless of gestational age and birth weight. This is because of the lack of regulation for medications in the neonatal population and the delays in updating drug instructions. This is mainly due to the ethical difficulty in the research and difficulties in conducting clinical trials in this vulnerable population. Hence, the study was planned to assess the extent of the use of off-label drugs in the NICU. Methods: An observational study was carried out in the NICU of a tertiary care center from May 2021 to Oct 2022 and case records of neonates admitted to the NICU were evaluated. Results: Among 1745 drug prescriptions in 360 neonates, 1208 (69.22%) were off-label. Anti-infectives were the most commonly used off-label class of drug, Piperacillin+tazobactam was the most commonly used off-label drug and most common reason for off-label prescriptions was indication and administration. It was found that 79.44% of neonates received at least one off-label drug. Conclusions: Off-label use of drugs, specifically anti-infective drugs, is common in NICUs of India as in other countries. So, more research should be done to generate evidence-based guidelines for the rational use of drugs in neonates.

A comparative evaluation of placebo effect on pain perception parameters in open-label versus double-blind groups: a prospective randomized pilot study in healthy volunteers

Background: Considerable placebo response rate is commonly observed in placebo-controlled trials involving analgesics. However, there is paucity of evidence with regard to comparison of effect of open-label placebo versus double-blind placebo on pain perception. Methods: In this study, cold water maintained at 4±1°C was used to induce experimental pain. Enrolled subjects were randomized to receive either 2% lignocaine gel as active drug or K-Y jelly as placebo as per the groups in open-label (two groups) and double-blind (two groups) study. Pain perception was evaluated using pain threshold time and pain tolerance time after immersion of subject’s hand in the cold water. Pain intensity was assessed using visual analogue scale (VAS). Results: Sixty-nine subjects were randomized into 4 study groups namely open-label lignocaine (OLL; N=17), open-label placebo (OLP; N=18), double-blind lignocaine (DBL; N=17) and double-blind placebo (DBP; N=17). OLP application increased pain intensity on VAS from 67 (47, 84) to 72 (39, 88) mm (p=0.018). OLL application reduced pain perception pain threshold time from 20.4 (4.0, 45.1) to 24.1 (6.3, 124.2) seconds (p=0.049) and pain tolerance time from 32.7 (6.8, 110.2) to 40.0 (7.7, 156.7) seconds (p=0.019). The change in pain parameters (before and after application of study intervention) was comparable without any significant difference among the four study groups (p=0.257 for pain threshold time, p=0.165 for pain tolerance time and p=0.563 for pain intensity score). Conclusions: Lignocaine and placebo gel application showed comparable change in pain perception irrespective of blinding.

Effects of nutritional profile system and front labeling in food selection during purchases: a systematic review / Efecto de los sistemas de perfilado nutricional y etiquetado frontal en la selección de alimentos durante la compra: una revisión sistemática

Introduction. Nutritional profiling systems (NPS) are mainly used in front-end labeling policies in order to make the purchase and consumption choice conscious and healthy. Objetive. This study systematically reviewed evidence from interventions on the effect of NPS in the front-of- package on food purchases. Materials and methods. A bibliographic search was carried out in electronic sources from Medline, Elsevier, Scielo and Lilacs, of experimental studies and intervention between 2012 and 2022. A total of 14 articles were included in the review. They were analyzed according to the intervention modality used: 4 studies analyzed the effect of NPS in a real purchase situation and 10 evaluated purchase perception/intention. Results. According to the modality of intervention, the 6 studies that analyzed the NPS-warning system, all recorded healthier purchases compared to the control groups. While for the NPS-NutriScore, Health Star Rating and Multiple Traffic Lights were effective in the decision to purchase healthier foods, in 5 of 7 studies for the first NPS, in 4 of 7 for the second and in 4 of 8 for the third, compared with control groups. Conclusions. Findings of this study suggest that NPSs may be effective for healthy purchase choices, even so it is necessary to strengthen the system and policies with nutritional food education campaigns(AU)

Introducción. Los sistemas de perfilado nutricional (SPN) son utilizados principalmente en políticas de etiquetado frontal con la finalidad de que la elección de compra y consumo sea consciente y saludable. Objetivo. Este estudio revisó sistemáticamente la evidencia de las intervenciones sobre el efecto de SPN en el frente del paquete en las compras de alimentos. Materiales y métodos. Se realizó una búsqueda bibliográfica en fuentes electrónicas de Medline, Elsevier, Scielo y Lilacs, de estudios experimentales e intervenciones entre 2012 y 2022. Se incluyeron un total de 14 artículos en la revisión. Fueron analizados según la modalidad de intervención utilizada: 4 estudios analizaron el efecto de los SPN en una situación de compra real y 10 evaluaron percepción/intención de compra. Resultados. Según la modalidad de intervención, los 6 estudios que analizaron el SPN-sistema de advertencia, todos registraron compras más saludables en comparación con grupo controles. Mientras que para los SPN-NutriScore, Estrellas de Salud y Semáforo Tricolor Múltiple fueron efectivas en la decisión de compra de alimentos más saludables, en 5 de 7 estudios para el primer SPN, en 4 de 7 para el segundo y en 4 de 8 para el tercero, comparados con grupo controles. Conclusiones. Los hallazgos de este estudio sugieren que los SPN pueden ser efectivos para elecciones de compras saludables, aun así, es necesario reforzar el sistema y las políticas con campañas de educación alimentaria nutricional(AU)

Naltrexona em baixa dose (LDN): tendência de consumo nas capitais brasileiras e Distrito Federal, 2014-2020 / Low-dose naltrexone (LDN): consumption trend in Brazilian capitals and the Federal District, 2014-2020

Resumo Estudo ecológico com objetivo de determinar o consumo de naltrexona em baixa dose (LDN) nas 26 capitais brasileiras e Distrito Federal e acompanhar a tendência entre os anos de 2014 e 2020. A coleta de dados da dispensação de naltrexona manipulada, se deu por meio do Sistema Nacional de Gerenciamento de Produtos Controlados, publicizado em 2020, considerando-se baixa dose prescrições de até 5 mg. O cálculo dos coeficientes de dispensação utilizou as estimativas populacionais do Instituto Brasileiro de Pesquisa Geografia e Estatística. Utilizou-se análise estatística descritiva e de regressão generalizada de Prais-Winsten para a série temporal. As tendências observadas foram classificadas em crescentes, estáveis ou decrescentes, com intervalo de confiança de 95% e nível de significância de 5%. Os resultados demonstraram maiores coeficientes de consumo de LDN nas regiões Centro-Oeste, Sul e Sudeste e menores nas Norte e Nordeste. Observou-se dispensação de LDN crescente em 55,6% das capitais, estacionária em 44,4% e ausência de coeficientes decrescentes. Apesar das evidências limitadas quanto à farmacoterapia de LDN e da sua prescrição off-label, os dados demonstram que a prescrição, dispensação e consumo vem crescendo no Brasil, com ênfase nas regiões centro-sul do país.

Abstract The scope of this paper is an ecological study to determine the consumption of low-dose naltrexone (LDN) in the 26 Brazilian capitals and the Federal District and monitor the trend between the years 2014 to 2020. Data collection on the dispensation of manipulated naltrexone was done through the National Management System of Controlled Products, published in 2020, considering low-dose prescriptions of up to 5 mg. The calculation of the dispensation coefficients used the population estimates of the Brazilian Institute of Geography and Statistics. Descriptive statistical analysis and generalized Prais-Winsten regression analysis were used for the time series analysis. The trends observed were classified as increasing, stable, or decreasing, with a 95% confidence interval and 5% significance level. The results showed higher LDN consumption coefficients in the Mid-West, South and Southeast regions and lower coefficients in the North and Northeast. Increasing dispensation of LDN was observed in 55.6% of the capitals, being stationary in 44.4%, with no decreasing coefficients. Despite the limited evidence regarding LDN pharmacotherapy and its off-label prescription, the data show that prescription, dispensing, and consumption have been on the increase in Brazil, with emphasis on the central-south regions of the country.

Utilización de medicamentos off-label y unlicensed en una unidad de cuidados intensivos pediátricos de un hospital de alta complejidad español. Estudio descriptivo / Off-label and unlicensed drug use in a pediatric intensive care unit of a tertiary care Spanish hospital. A descriptive study

Introducción. En las unidades de cuidados intensivos pediátricos, se utiliza gran cantidad de medicamentos, muchos prescritos fuera de las condiciones establecidas en su ficha técnica (prescripciones off-label y unlicensed). El objetivo de este estudio fue describir el uso de medicamentos y estimar la prevalencia de fármacos off-label y unlicensed en una unidad de cuidados intensivos pediátricos de un hospital de tercer nivel español. Población y métodos. Estudio transversal, observacional, de una cohorte de niños ingresados en una unidad de cuidados intensivos pediátricos. El estudio se llevó a cabo en 2017. Se revisó cada fármaco prescrito, sus condiciones de uso y administración. Además, se analizaron las fichas técnicas de los fármacos implicados con la finalidad de identificar si el uso de los medicamentos se realizaba según sus condiciones de autorización, o bien se hacía fuera de prospecto (off-label) o como unlicensed. Resultados. La muestra fue de 97 pacientes. El 74,2 % (n = 72) de los pacientes recibieron algún fármaco off-label o unlicensed. El 23,8 % (n = 243) de las prescripciones fueron off-label y el 8,7 % (n = 89), unlicensed. El subanálisis realizado por grupos de edad mostró que el grupo de edad que recibió mayor número de prescripciones totales (n = 611) y el mayor porcentaje de fármacos prescritos en condiciones off-label y/o unlicensed (38,4 %) fue el de menores de 2 años. Conclusiones. La prescripción de fármacos off-label y/o unlicensed es una práctica habitual en la unidad de cuidados intensivos pediátricos. Este estudio permite documentar la complejidad de la terapéutica en niños.

Introduction. In pediatric intensive care units, a large number of drugs are used, many of which are prescribed for condition beyond those established in their summary of product characteristics (off-label and unlicensed drug prescriptions). The objective of this study was to describe drug use and estimate the prevalence of off-label and unlicensed drugs in a pediatric intensive care unit of a tertiary care Spanish hospital. Population and methods. Cross-sectional, observational study with a single cohort of children admitted to a pediatric intensive care unit. The study was conducted in 2017. Each drug prescription, its conditions of use and administration were reviewed. In addition, the summary of product characteristics of drugs used were analyzed in order to identify whether they were used according to their conditions of authorization, or whether they were used in an off-label or unlicensed manner. Results. The sample included 97 patients. At least one off-label or unlicensed drug was administered to 74.2% (n = 72) of patients; 23.8% (n = 243) corresponded to off-label prescriptions and 8.7% (n = 89), unlicensed prescriptions. A sub-analysis by age group showed that the age group that received a higher number of total prescriptions (n = 611) and a higher percentage of off-label and/or unlicensed drug prescriptions (38.4%) was under 2 years of age. Conclusions. Off-label and/or unlicensed drug prescription is a common practice in the pediatric intensive care unit. This study allowed us to document the complexity of therapeutics in children.

Label-free target identification for natural products based on proteomics / 药学学报

Target identification and verification of natural products is an important and challenging work in the field of chemical biology. It is also an important job for researchers to apply chemical proteomics technology to biomedicine in order to identify target proteins of natural products. Target identification is critical to understanding its mechanisms and developing natural products as molecular probes and potential therapeutic drugs. Traditional approaches of small molecule target identification based on affinity have been shown to be successful, such as click-chemical probes, radioisotope labeling or photosensitized small-molecule probes. Nevertheless, these technologies require purified candidate target proteins, and modified small molecules with probes or linkers, such as adding agarose beads, biotin labels, fluorescent labeling or photo-affinity labeling. Many structure-activity relationship studies should be performed to ensure that the addition of small molecule labels undisturbed the original biological activity of the small molecules. Unfortunately, all these modifications are likely to alter their biological activity or binding specificity. To overcome the bottleneck of "target recognition", researchers have developed a series of new techniques for unmodified drug target identification. In this article, we reviewed the target identification techniques of natural product without structural modification in order to provide reference for the development of natural products.

Expert consensus on off-label drug use in the three Northeastern provinces of China（solid tumors and hematology） / 中国药房

OBJECTIVE To provide theoretical basis for the rational use of drugs in medical institutions， assist in improving the quality of pharmaceutical services， and thus meet clinical drug demands. METHODS Adopting consensus meetings， Liaoning Pharmaceutical Association，Jilin Pharmaceutical Association and Heilongjiang Pharmaceutical Association collaborated with clinical and pharmaceutical experts in the region to compile the expert consensus on off-label drug use in the three Northeastern provinces of China after many votes and discussions by collecting and collating the information related to off-label drug use in medical institutions from the three northeastern provinces of China，and referring to and citing off-label drug use stated in some expert consensus and medication catalog. RESULTS Finally， a total of 198 pieces of off-label drug use information for 70 drugs were included in the two sections of solid tumors and hematological diseases in Consensus of Experts on Drug Use beyond the Instructions in the Three Provinces of Northeast China. CONCLUSIONS Consensus of Experts on Off-label Drug Use in the Three Northeastern Provinces of Northeast China （solid tumors and hematology）offers a theoretical foundation for rational drug use in the treatment of solid tumors and hematological diseases within medical institutions，and has a positive significance in improving the effectiveness and safety of drug treatment.

Acceptance and effectiveness of the Healthier Choice Logo (HCL) among food industries in Malaysia

@#Introduction: The Healthier Choice Logo (HCL) was introduced in 2017 by the Ministry of Health Malaysia. This paper analysed acceptance of HCL, effectiveness of HCL in encouraging healthier product reformulation, and factors affecting reformulation among food industries. Methods: An online self-administered questionnaire consisting of four sections utilising multiple choice and 5-point Likert scale questions was distributed to food industries in Malaysia. Sample size calculation yielded 100 respondents. Results: Food industries had a higher acceptance of the processes and requirements involved in HCL implementation. HCL was highly effective in encouraging product reformulation among food industries in Malaysia. Meeting consumer demand, improving brand image, public health, more awareness around nutrition labelling, logo and national nutrition target, more technical knowledge and budget were found to motivate healthier product reformulation. However, product suitability, consumer acceptability, difficulties maintaining taste and shelf life, and limited budget were the challenges faced in product reformulation. There was no correlation between HCL acceptance and factors encouraging or inhibiting reformulation. Conclusion: These findings are expected to help relevant authorities or stakeholders make changes, if necessary, towards processes and requirements involved in HCL application to ensure wider HCL implementation. Future research should identify the relationship between HCL implementation and public health improvement among the Malaysian population.

Analysis on Ethical Issues in Off-label Use of Antitumor Drugs / 中国医学伦理学

The phenomenon of off-label use of antitumor drugs in the treatment of malignant tumors is relatively common. Although it is conducive to the development of clinical medical practice, but it is still necessary to pay attention to ethical issues such as medication risks and inadequate implementation of informed consent. Therefore, to effectively avoid ethical risks and standardize the rational use of off-label antitumor drugs, this paper proposed that pharmacists should actively participate in the process of off-label use of antitumor drugs, improve the evidence level of evidence-based medicine, implement patients’ right to informed consent, and improve the hospital’s supervision system of off-label drug use, so as to ensure the reasonable and legal use of drugs by patients.

Evaluation of health warning labels for commercial locations vending sugar-sweetened beverages / 环境与职业医学

Background Long-term excessive consuming sugar-sweetened beverages have a negative impact on health. In order to decrease the consumption of sugar-sweetened beverages and create a healthy food environment, the Health Commission of Shenzhen Municipality pioneered to enforce health warning labels presented in commercial locations vending sugar-sweetened beverages based on relevant provisions of the Health Regulations of Shenzhen Special Economic Zone，but its effect has not yet been evaluated. Objective To evaluate the impact of presenting health warning labels in commercial locations vending sugar-sweetened beverages in Shenzhen. Methods A multi-stage stratified sampling method was used to randomly select one street in each of the 10 districts (excluding the Shenzhen Shantou Special Cooperation Zone) of Shenzhen followed by a convenience sampling to select sampling sites to conduct an undercover investigation on the presentation of health warning labels for sugar-sweetened beverages in six different types of venues (n=232) such as shopping malls, ordinary supermarkets/convenience stores, self-service vending machines, catering service places, medical institutions, and venues serving minors' education and activities. At the same time, 238 site managers, 1002 adult consumers, and 7396 child and adolescent consumers were interviewed. Results Among 213 commercial locations vending sugar-sweetened beverages, the rate of health warning label installation was 26.3%, with the highest installation rate in shopping malls (55.0%). Among site managers, 47.8% were aware that commercial locations were required to install health warning labels, and 50.0% were aware of the standards for setting up health warning labels. The higher the awareness of relevant regulations, the higher the rate of installation of health warning labels. More than half of site managers (55.3%) believed that after installing health warning labels, the sales of sugar-sweetened beverages and sugar-sweetened beverages in large-volume packages had decreased compared to the same period in previous years. Most of the interviewed consumers indicated that if they saw the health warning labels for sugar-sweetened beverages, they would buy less, give up purchasing, or choose low-sugar or sugar-free beverages, and also discourage their family members or friends from drinking such beverages. Compared with participants without awareness of the health warning labels, both adult and child and adolescent consumers with awareness of the health warning labels believed that the installation is beneficial to their good eating habits and reported a higher proportion of discouraging family members or friends from drinking such beverages, with a lower frequency of consuming sugar-sweetened beverages. Conclusion Health warning labels for sugar-sweetened beverages have a significant effect on promoting behavior changes, and both site managers and citizens have a high level of support for them. However, in view of the low voluntary compliance rate of commercial locations and the installation rate of health warning labels, the publicity and enforcement of the Health Regulations of Shenzhen Special Economic Zone should be enhanced.