Pharmaceutical and drug delivery applications of chitosan biopolymer and its modified nanocomposite: A review

Due to their improved structural and functional properties as well as biocompatibility, biodegradability, and nontoxicity, chitosan and its nanoparticles are currently grasping the interest of researchers. Although numerous attempts have been made to apply chitosan and its derivatives to biological applications, few have reported in achieving its pharmacological and drug delivery. The goal of the current work is to provide a summary of the chitosan biopolymer's physical, chemical, and biological properties as well as its synthesis of nanoparticles and characterization of its modified nanocomposites. The drug delivery method and pharmaceutical applications of chitosan biopolymer and its modified nanocomposites are examined in further detail in this research. We will introduce also about the most current publications in this field of study as well as its recent expansion.

Fluorescence switchable sensor enabled by a calix[4]arene-Cu(II) complex system for selective determination of itraconazole in human serum and aqueous solution

A switchable fluorescence sensor based on a calix (Monapathi et al., 2021) [4]arene:Cu²⁺ complex (FLCX/Cu) has been developed for the detection of itraconazole (ITZ) with high sensitivity and specificity. For the development of the sensor, the selective complexation of a fluorescent calix (Monapathi et al., 2021) [4]arene derivative (FL-CX) with the Cu²⁺ ion causing fluorescence quenching was utilized. In addition, the sensor properties of the FLCX/Cu prepared were investigated. For this purpose, various substances (selected anions, cations, and drugs) with which ITZ can be found together were studied in an aqueous solution. Limit of detection (LOD) and limit of quantification (LOQ) values were determined in the range of 1.00-60.0 μg/L as 3.34 μg/L and 11.1 μg/L for ITZ, respectively. Moreover, the real sample analyses were performed in human serum and tablet form. Furthermore, the effect of some possible serum contents on sensor performance was also studied. All these studies confirmed the development of a simple, precise, accurate, reproducible, highly sensitive, and very stable fluorescence sensor.

Transformation products of sulfonamides in aquatic systems: Lessons learned from available environmental fate and behaviour data

Sulfonamides (SUAs) and their transformation products (TPs) contribute to environmental pollution. Importance of research on TPs' properties has been emphasised, e.g. allowing a comprehensive environmental risk assessment of their parent compounds. However, TPs' properties have been discussed in reviews on SUAs only marginally, if at all. For the first time, a scientific literature review aims to discuss the current state of knowledge on SUA-TPs including research gaps, and commonalities of SUA-TPs and TPs in general. Literature on SUA-TPs was consulted systematically to collect data on occurrence, physicochemical properties, degradability, and (eco)toxicity. TPs of 14 SUAs were reviewed, and aspects applicable for TPs in general were identified to guide future handling of TPs as a complex category of compounds. The data of sulfamethoxazole (SMX), the main representative, was analysed in more detail to discuss insights on a chemical level. Literature search resulted in 607 SUA-TPs reported in 222 publications. Only for 4%, 31%, and 35% of these TPs, data on occurrence in aquatic systems, on degradation, and (eco)toxicity, respectively, was found. Several mixtures of SUA-TPs were more ecotoxic than their parent compounds, e.g. 10 of 15 mixtures of SMX-TPs. Only few TPs were tested as single substance. Although several TPs could be eliminated experimentally, their mineralisation rate remained often unknown. Thus, further transformation to persistent TPs could not be ruled out. Standardised biodegradability tests of individual TPs would monitor their mineralisation rate, but are almost completely lacking. Reasons are likely poor availability of TPs, but also the focus on abiotic water treatment. Data assessment demonstrated that data of high significance according to standard methods, e.g. OECD methods for chronic (eco)toxicity and ready biodegradability, is needed to assess environmental risks of prioritised TPs, but also to redesign their parent pharmaceutical for complete environmental mineralisation in a long-term (Benign by Design).

Pharmaceutical pricing in Europe: time to take the right direction

A price stems from the intersection between supply and demand curves in any common market. However, there are special markets where consumers do not pay for goods directly, and prescription drugs are a well-known example in healthcare. Drugs are mainly funded by public expenditure in well-established welfare systems like those of the Western European countries. However, the present era of austerity in public funding has made financial resources scarce in most European nations. Currently, the leading tendency for pharmaceutical pricing in Europe is direct negotiation with pharma companies. However, these negotiations are administratively burdensome, with costs not necessarily offsetting savings. Moreover, since any trade negotiation implies some degree of confidentiality to be effective these strategies are scantily transparent. When prices are set for many products through unavoidably arbitrary decisions, the final consequence is an irrational allocation of financial resources. Here, we raise a proposal to restore a reasonable balance between public equity objectives of health authorities and private profit incentives of the pharma industry in Europe, switching from pricing to budgeting. The underlying rationale of our proposal is to stop setting arbitrary prices in a context of market failure.

Ibuprofen exposure in Europe; ePiE as an alternative to costly environmental monitoring

The EU Water Framework Directive and Priority Substance Directive provide a framework to identify substances that potentially pose a risk to surface waters and provide a legal basis whereby member states are required to monitor and comply with environmental quality standards (EQSs) set for those substances. The cost and effort to continuously measure and analyse real world concentrations in all water bodies across Europe are high. Establishing the reliability of environmental exposure models to predict concentrations of priority substances is key, both to fill data gaps left by monitoring campaigns, and to predict the outcomes of actions that might be taken to reduce exposure. In this study, we aimed to validate the ePiE model for the pharmaceutical ibuprofen by comparing predictions made using the best possible consumption data with measured river concentrations. The results demonstrate that the ePiE model makes useful, conservative exposure predictions for ibuprofen, typically within a factor of 3 of mean measured values. This exercise was performed across a number of basins within Europe, representative of varying conditions, including consumption rates, population densities and climates. Incorporating specific information pertaining to the basin or country being assessed, such as custom WWTP removal rates, was found to improve the realism and accuracy of predictions. We found that the extrapolation of consumption data between countries should be kept to a minimum when modelling the exposure of pharmaceuticals, with the per capita consumption of ibuprofen varying by nearly a factor of 10.

Pharmaceutical and nutraceutical activation of FOXO3 for healthy longevity

Life expectancy has increased substantially over the last 150 years. Yet this means that now most people also spend a greater length of time suffering from various age-associated diseases. As such, delaying age-related functional decline and extending healthspan, the period of active older years free from disease and disability, is an overarching objective of current aging research. Geroprotectors, compounds that target pathways that causally influence aging, are increasingly recognized as a means to extend healthspan in the aging population. Meanwhile, FOXO3 has emerged as a geroprotective gene intricately involved in aging and healthspan. FOXO3 genetic variants are linked to human longevity, reduced disease risks, and even self-reported health. Therefore, identification of FOXO3-activating compounds represents one of the most direct candidate approaches to extending healthspan in aging humans. In this work, we review compounds that activate FOXO3, or influence healthspan or lifespan in a FOXO3-dependent manner. These compounds can be classified as pharmaceuticals, including PI3K/AKT inhibitors and AMPK activators, antidepressants and antipsychotics, muscle relaxants, and HDAC inhibitors, or as nutraceuticals, including primary metabolites involved in cell growth and sustenance, and secondary metabolites including extracts, polyphenols, terpenoids, and other purified natural compounds. The compounds documented here provide a basis and resource for further research and development, with the ultimate goal of promoting healthy longevity in humans.

Identification of novel polar aryl hydrocarbon receptor agonists accumulated in liver of black-tailed gulls in Korea using advanced effect-directed analysis

Although bioaccumulation of persistent organic pollutants in seabirds has been examined, few studies have been conducted to identify previously unidentified substances. Here, aryl hydrocarbon receptor (AhR) agonists were identified in livers of black-tailed gulls from South Korea using effect-directed analysis combined with full-scan screening analysis. Significant AhR-mediated potencies were observed in the polar fractions of liver extracts using H4IIE-luc bioassay. Eight known polar AhR agonists accounted for 11-20% of the total AhR-mediated potencies in the polar fractions; hydrocortisone and rutaecarpine were the major contributors. Twenty-two AhR agonist candidates in the polar fractions were identified using liquid chromatography-quadrupole time-of-flight mass spectrometry during a six-step selection process. Of these, [10]-gingerol, angelicin, corticosterone, eupatilin, etofenprox, oxadixyl, and tretinoin were identified as novel AhR agonists. The contribution to potencies increased with inclusion of novel AhR agonists (27-52%); corticosterone and [10]-gingerol contributed significantly. Quantitative structure-activity relationship suggested that the novel AhR agonists have other potential toxic effects, including carcinogenicity and mutagenicity. Polar AhR agonists have been used for pharmaceuticals and pesticides. Some novel AhR agonists have log K_OW > 2 and log K_OA ≥ 6, which indicates that these compounds can be biomagnified in air-breathing organisms, such as seabirds.

A critical look at challenges and future scopes of bioactive compounds and their incorporations in the food, energy, and pharmaceutical sector

Bioactive compounds refer to secondary metabolites extracted from plants, fungi, microbes, or animals. Besides having pharmacological or toxicological effects on organisms leading to utilization in food and pharmaceutical industries, the discovery of novel properties of such compounds has led to the diversification of their applications, ranging from cosmetics and functionalized biomaterials to bioremediation and alternate fuels. Conventional time-consuming and solvent-intensive methods of extraction are increasingly being replaced by green solvents such as ionic liquids, supercritical fluids, and deep eutectic solvents, as well as non-conventional methods of extraction assisted by microwaves, pulse electric fields, enzymes, ultrasound, or pressure. These methods, along with advances in characterization and optimization strategies, have boosted the commercial viability of extraction especially from agrowastes and organic residues, promoting a sustainable circular economy. Further development of microfluidics, optimization models, nanoencapsulation, and metabolic engineering are expected to overcome certain limitations that restrict the growth of this field, in the context of improving screening, extraction, and economy of processes, as well as retaining biodiversity and enhancing the stability and functionality of such compounds. This review is a compilation of the various extraction and characterization methods employed for bioactive compounds and covers major applications in food, pharmacy, chemicals, energy, and bioremediation. Major limitations and scope of improvement are also discussed.

Clozapine modulation of zebrafish swimming behavior and gene expression as a case study to investigate effects of atypical drugs on aquatic organisms

Mental illnesses affect more than 150 million people in Europe and lead to an increasing consumption of neuroactive drugs during the last twenty years. The antipsychotic compound, clozapine, is one of the most used psychotropic drugs worldwide, with potentially negative consequences for the aquatic environment. Hence, the objectives of the study presented here were the quantification of clozapine induced changes in swimming behavior of exposed Danio rerio embryos and the elucidation of the molecular effects on the serotonergic and dopaminergic systems. Yolk-sac larvae were exposed to different concentrations (0.2 mg/L, 0.4 mg/L, 0.8 mg/L, 1.6 mg/L, 3.2 mg/L and 6.4 mg/L) of clozapine for 116 h post-fertilization, and changes in the swimming behavior of the larvae were assessed. Further, quantitative real-time PCR was performed to analyze the expression of selected genes. The qualitative evaluation of changes in the swimming behavior of D. rerio larvae revealed a significant decrease of the average swimming distance and velocity in the light-dark transition test, with more than a 36% reduction at the highest exposure concentration of 6.4 mg/L. Furthermore, the total larval body length was reduced at the highest concentration. An in-depth analysis based on expression of selected target genes of the serotonin (slc6a4a) and dopamine (drd2a) system showed an upregulation at a concentration of 1.6 mg/L and above. In addition, a lower increase in expression was detected for biomarkers of general stress (adra1a and cyp1a2). Our data show that exposure to clozapine during development inhibits swimming activity of zebrafish larvae, which could, in part, be due to disruption of the serotonin- and dopamine system.

Analysis of the clinical practice of the pharmacist in a community pharmacy: A Cross-sectional Study from Brazil

Background:

The pharmaceutical profession has experienced renewals over time. In community pharmacies, pharmaceutical services contribute to the public health system in Brazil. The development of these tasks, in collaboration with professionals from the multidisciplinary team, demonstrates the involvement with the well-being, health and improvement of the patient’s life.

Objectives:

This study aimed to identify the professional practice of pharmacists, their understandings and attitudes towards clinical practice in community pharmacies in northern Brazil.

Methods:

This is a cross-sectional descriptive study, based on a questionnaire carried out with pharmacists for seven months in the municipality of Belém, in the state of Pará. Data were expressed using descriptive statistics and the results were shown as a percentage.

Results:

182 pharmacists participated. Females were predominant (80.2%) and the average age of participants was 34.2 years. 77.4% graduated from private institutions and 59.3% already have a specialization. 38.4% hold the position of technical director. 50.5% of respondents say that community pharmacies have a reserved place for service. The most used clinical services were pharmacotherapy review (89.5%), health education (60.9%), dispensing (34%), therapeutic monitoring (25.8%) and pharmacotherapeutic follow-up (4.9%). In the study, it was realized that community pharmacies should not be seen as a commercial place but rather as a health care facility.

Conclusions:

Therefore, these establishments must adapt at a structural and professional level, to meet an increasingly growing demand of a population in need of services offered with quality health care.

Nuclear magnetic resonance-based metabolomics and cytotoxicity (HT-29 and HCT-116 cell lines) studies insight the potential of less utilized parts of Camellia sinensis (Kangra tea)

Camellia sinensis (tea) is an evergreen plant having bioactive compounds associated with various pharmacological effects, including anti-cancerous activity. These phytochemicals are variedly distributed in plant tissues. A detailed study to understand chemical composition within the economically underutilized tea tissues is required to generate value. Therefore, a comprehensive chemical profiling of underutilized C. sinensis parts [coarse leaves, flowers, fruits (immature);n = 9] was performed by NMR techniques. NMR (1D and 2D) spectroscopy ambiguously identified and quantified fifty-seven metabolites (Coarse leaves: 35, flowers; 42, immature fruits; 45). The statistical analysis showed apparent tissue-specific similarities (26 metabolites) and variations. Further, HPLC-DAD revealed absolute quantification of catechins, caffeine and theanine among the different parts of C. sinensis. Moreover, cytotoxicity studies of tea tissues against colorectal cancer cell lines showed anticancer potentials. This chemical information and anticancer activity of underutilized C. sinensis parts will help to develop value added nutraceutical and cosmeceutical products.

Occurrences and removal of pharmaceutical and personal care products from aquatic systems using advanced treatment- A review

Pharmaceuticals, personal care items, steroid hormones, and agrochemicals are among the synthetic and indigenous products that make up micropollutants, also known as emerging contaminants. Pharmaceutical and personal care products (PPPs) are a class of developing micropollutants that can harm living organisms even at low concentrations. Many are detected in surface water and wastewater from the treatment process, with quantities ranging from ng L-1 to gL-1; however, residual PPPs at dangerously high levels have indeed recently been recognized in the ecosystem. Residential sewage treatment plant (STP) dump the largest majority of these pollutants into the environment on a regular basis. As a result of its robust structure, it has a longer lifespan in the environment. This review article discusses how surface water pollutants such pesticides, petroleum hydrocarbons, and perfluorinated compounds affect water quality, as well as the most cost-effective adsorbents for removing these PPPs. The goal of this study is to provide information about the origins of PPP, as well as diagnostic procedures and treatment options. Research on developing contaminants is also aimed at evaluating the efficacy and affordability of adsorption.

Long-term exposure to environmental diclofenac concentrations impairs growth and induces molecular changes in Lymnaea stagnalis freshwater snails

As pharmaceutical substances are highly used in human and veterinary medicine and subsequently released in the environment, they represent emerging contaminants in the aquatic compartment. Diclofenac (DCF) is one of the most commonly detected pharmaceuticals in water and little research has been focused on its long-term effects on freshwater invertebrates. In this study, we assessed the chronic impacts of DCF on the freshwater gastropod Lymnaea stagnalis using life history, behavioral and molecular approaches. These organisms were exposed from the embryo to the adult stage to three environmentally relevant DCF concentrations (0.1, 2 and 10 μg/L). The results indicated that DCF impaired shell growth and feeding behavior at the juvenile stage, yet no impacts on hatching, locomotion and response to light stress were noted. The molecular findings (metabolomics and transcriptomic) suggested that DCF may disturb the immune system, energy metabolism, osmoregulation and redox balance. In addition, prostaglandin synthesis could potentially be inhibited by DCF exposure. The molecular findings revealed signs of reproduction impairment but this trend was not confirmed by the physiological tests. Combined omics tools provided complementary information and enabled us to gain further insight into DCF effects in freshwater organisms.

A review on electrocoagulation process for the removal of emerging contaminants: theory, fundamentals, and applications

Electrocoagulation (EC) is an excellent and promising technology in wastewater treatment, as it combines the benefits of coagulation, flotation, and electrochemistry. During the last decade, extensive researches have focused on removal of emerging contaminants by using electrocoagualtion, due to its several advantages like compactness, cost-effectiveness, efficiency, low sludge production, and eco-friendness. Emerging contaminants (ECs) are micropollutants found in trace amounts that discharging into conventional wastewater treatment (WWT) plants entering surface waters and imposing a high threat to human and aquatic life. Various studies reveal that about 90% of emerging contaminants are disposed unscientifically into water bodies, creating problems to public health and environment. The studies on removal of emerging contaminants from wastewater are by global researchers are critically reviewed. The core findings proved that still more research required into optimization of parameters, system design, and economic feasibility to explore the potential of EC combined systems. This review has introduced an innovative collection of current knowledge on electro-coagulation for the removal of emerging contaminants.

Photodegradation of norfloxacin in ice: Role of the fluorine substituent

Ice is an important medium in cold regions, because it regulates the environmental behaviors and the fate of pollutants. The photodegradation of fluoroquinolone (FQ) antibiotics as emerging contaminants of concern in ice remains poorly understood. Here, the photodegradation of fluorine-containing norfloxacin (NOR) as one model of FQs in ice formed from freezing solutions was investigated. Pipemidic acid (PPA) as a structural analogue of NOR was selected to compare the effect of molecular structure on the antibiotic photodegradation in the ice. Results suggested that the photodegradation rate constant of NOR in ice relative to pure water increased by 40.0%. Both the absorbance in the absorption spectra and quantum yields of NOR in ice over water increased by 1.4 times. Direct photodegradation mainly caused the defluorination of NOR, which was more important than cleavage and oxidation of the piperazine ring by self-sensitized photooxidation in ice. The defluorination rate of NOR in the ice relative to water increased by about 12.7%. The fluorine substituent played a more important role in the NOR photodegradation in the ice, resulting in a 1.6-fold increase in the photodegradation rate constant of NOR relative to PPA. This work provides a new insight into the role of fluorine substituents in the photodegradation of fluorinated pharmaceuticals in cold regions.

Reproducibility, relevance and reliability as barriers to efficient and credible biomedical technology translation

Biomedical research accuracy and relevance for improving healthcare are increasingly identified as costly problems. Basic research data quality, reporting and methodology, and reproducibility are common factors implicated in this challenge. Preclinical models of disease and therapy, largely conducted in rodents, have known deficiencies in replicating most human conditions. Their translation to human results is acknowledged to be poor for decades. Clinical data quality and quantity is also recognized as deficient; gold standard randomized clinical trials are expensive. Few solid conclusions from clinical studies are replicable and many remain unpublished. The translational pathway from fundamental biomedical research through to innovative solutions handed to clinical practitioners is therefore highly inefficient and costly in terms of wasted resources, early claims from fundamental discoveries never witnessed in humans, and few new, improved solutions available clinically for myriad diseases. Improving this biomedical research strategy and resourcing for reliability, translational relevance, reproducibility and clinical impact requires careful analysis and consistent enforcement at both funding and peer review levels.

The Potential Use of Propolis as a Primary or an Adjunctive Therapy in Respiratory Tract-Related Diseases and Disorders: A Systematic Scoping Review

Propolis is a resinous beehive product that is collected by the bees from plant resin and exudates, to protect and maintain hive homeostasis. Propolis has been used by humans therapeutically to treat many ailments including respiratory tract-related diseases and disorders. The aim of the present systematic scoping review is to evaluate the experimental evidence to support the use of propolis as a primary or an adjunctive therapy in respiratory tract-related diseases and disorders. After applying the exclusion criteria, 158 research publications were retrieved and identified from Scopus, Web of Science, Pubmed, and Google Scholar. The key themes of the included studies were pathogenic infection-related diseases and disorders, inflammation-related disorders, lung cancers, and adverse effects. Furthermore, the potential molecular and biochemical mechanisms of action of propolis in alleviating respiratory tract-related diseases and disorders are discussed. In conclusion, the therapeutic benefits of propolis have been demonstrated by various in vitro studies, in silico studies, animal models, and human clinical trials. Based on the weight and robustness of the available experimental and clinical evidence, propolis is effective, either as a primary or an adjunctive therapy, in treating respiratory tract-related diseases.

The attitude and acceptability towards medical promotional tools and their influence on physicians' prescribing practices in Jordan and Iraq: a cross-sectional study

Background

Pharmaceutical companies spend more than one-third of their sales revenue on marketing and promotion directed toward healthcare professionals. There has been a focus on the relationship between healthcare professionals and the pharmaceutical industry in recent years. This study aims to explore the attitude toward and acceptability of medical promotional tools and their influence on physicians’ prescribing practices in Jordan and Iraq.

Methods

A cross-sectional survey study was conducted to explore the influence of visits by medical representatives (MRs) and medical promotions on physicians’ prescribing practices between June and October 2020 in Jordan and Iraq. Previously validated questionnaires were used.

Results

A total of 801 physicians completed the questionnaires. Face-to-face visits, followed by the dispensing of medical samples, were the two most common promotional methods used by MRs. 48% of participating physicians reported that they would accept the promotional marketing tools offered to them. MRs focused on the key selling points of their product during medical promotions, and 39.6% of the physicians reported that MRs had a negative attitude toward their competitors’ products. 69.9% of the physicians reported that they would change their practice after participating in conferences or meetings.

Conclusion

Medical promotional tools have a clear influence on physicians’ prescribing practices in Jordan and Iraq. Therefore, medical promotion should be controlled and guided by clear and country-specific ethical guidelines. This will ensure safe medical promotion to physicians and optimise the healthcare practices provided to patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07525-1.

Therapeutic prospects of endophytic Bacillus species from Berberis lycium against oxidative stress and microbial pathogens

Endophytes are microorganisms residing within plant tissues. Bacterial endophytes are important sources for production of pharmaceutically important metabolites. Berberis lycium is an important medicinal plant and there exist no report regarding isolation and determination of bioactive potential of its bacterial endophytes. Therefore the present study was aimed to isolate and identify bacterial endophytes from Berberis lycium. The study resulted in isolation of 20 strains of bacterial endophytes. Based on their antibacterial activity three strains were identified as Bacillus cereus (LBL6), Bacillus thuringiensis (SBL3) and Bacillus anthracis (SBL4) on basis of 16SrRNA gene using universal primers. Crude ethyl acetate extracts of LBL6, SBL3 and SBL4 were further evaluated for antioxidant and antifungal activities. Moderate antioxidant activity (56 %) at a concentration of 1000 µg/mL was observed for LBL6 followed by 45 and 43 % activity by SBL4 and SBL3 respectively. Significant antifungal activity was observed against Aspergillus niger (60 %) and Aspergillus flavus (56 %) at concentration of 4 mg/mL of SBL3 and SBL4 respectively. GCMS analysis of extract (LBL6) exhibited presence of 12 bioactive secondary metabolites corresponding to antimicrobial, antifungal, antioxidant, antitumor and anticancer activities. In conclusion, present study highlighted the importance of Berberis lycium to host diverse bacterial endophytes of pharmaceutical importance.

A hydrophilic interaction liquid chromatography - Tandem mass spectrometry method for the determination of phenylephrine in dried blood spots from preterm infants

A sensitive and accurate hydrophilic interaction liquid chromatography - tandem mass spectrometry method (HILIC-MS/MS) was developed and validated for the determination of phenylephrine concentration in Dried Blood Spot (DBS) samples from preterm infants, after ocular administration of an ophthalmic solution with phenylephrine. Sample preparation involved the extraction of the analyte from an 85 μL DBS sample with methanol - acetonitrile (50:50, v/v). Chromatographic separation was achieved on an ACQUITY UPLC BEH AMIDE column, under isocratic conditions within a 5 min run. Detection was achieved with a triple quadrupole MS applying electrospray ionization in positive mode. The method was fully validated and proved precise and accurate with in a linear range of 0.59-3.53 ng/ml in blood. The method was developed to provide insights on the level of exposure of infant population to phenylephrine after ocular administration.

The Effect of Market Competition on the Price of Topical Eye Drops

PURPOSE

To describe the relationship between the number of Federal Drug Administration (FDA)-approved manufacturers and the price change of generic and branded topical eye drops.

METHODS

Retrospective analysis of topical eye drop medications with formulations listed in the FDA Orange Book and the National Average Drug Acquisition Cost database from 2013 to 2017.

RESULTS

The most frequently prescribed generic topical drugs were glaucoma medications (34%), antimicrobials (32%), anti-inflammatories (24%), mydriatics (5%), and anesthetics (5%). The most frequently prescribed branded topical drugs were anti-inflammatories (45%), glaucoma medications (32%), antimicrobials (21%) and dry eye medications (3%). From 2013 to 2017, generic eye drops had a median price decrease of 20% (IQR 32%) while branded eye drops had a median price increase of 44% (IQR 28%) (P < .001). A significant inverse association was identified between the price change of generic eye drops and the total number of all manufacturers (r = -.41, P = .010), generic drug manufacturers (r = -.32, P = .0496), and alternative branded drug manufacturers (r = -.57, P = .002). There was no significant association between the price change of branded eye drops and number of manufacturers. Glaucoma (r = -.58, P = .039) and anti-inflammatory (r = -.69, P = .047) eye drops also had significant inverse associations with the number of generic manufacturers.

CONCLUSION

From 2013 to 2017, the price of generic eye drops decreased whereas the price of branded eye drops increased. Market competition was significantly inversely associated with price changes of generic eye drops but not branded eye drops.

Regulation of Molecular Farming Products

The regulation of molecular farming is a complex topic because plants and plant-based systems are relative newcomers among the many production platforms available for recombinant proteins. The regulations specific for different types of product (human/veterinary pharmaceuticals and medical devices, cosmetics, diagnostics, and research reagents) must therefore be overlaid with the regulations governing hitherto unfamiliar production platforms, and this must be achieved in different jurisdictions that handle genetically modified organisms (and genetically modified plants in particular) in very different ways. This chapter uses examples of different product types and production methods in three different jurisdictions (the USA, the EU, and Canada) to demonstrate some of the challenges facing the regulatory authorities.

Implementation of the circular supply chain management in the pharmaceutical industry

The ever-increasing levels of pollution and waste creation have subjected industries around the world to incorporate the concept of circular economy (CE) in their supply chains. The amalgamation of the CE approach along with supply chain management is called circular supply chain management (CSCM). Among other industries, the pharmaceutical industry is also involved in damaging the ecosystem. Hence, an effective framework for the adoption of CSCM in a particular industry is very essential. Therefore, this paper aims to devise a model that will help the pharmaceutical industries to adopt CSCM in their organizations. For this purpose, the study in the first phase identifies ten barriers that are working as an impediment in the adoption of the CSCM approach. To counter those barriers, the study in the second phase identifies a set of twelve enablers. To analyse the barriers and enablers, the study uses a new hybrid methodology. For allocating weights and prioritizing the barriers, the fuzzy multi-criteria decision-making (MCDM) technique, i.e. fuzzy full consistency method (F-FUCOM) is used, whereas the total quality management tool, i.e. fuzzy quality function deployment (FQFD) is used to rank the enablers. The results from F-FUCOM suggest "lack of financial resources and funding", "market challenges", and "lack of coordination and collaboration among the entire supply chain network" to be the top-most barriers, respectively, whereas the results achieved from the FQFD suggest "industrial symbiosis", "Reverse Logistic (RL) infrastructure", and "block chain technology" to be the top-ranked enablers, respectively. The provision of a facilitating framework for the adoption of CSCM in the pharmaceutical industry and the newly developed hybrid methodology are both novelties of this study.

Achieving end-to-end success in the clinic: Pfizer's learnings on R&D productivity

Over the past decade, Pfizer has focused efforts to improve its research and development (R&D) productivity. By the end of 2020, Pfizer had achieved an industry-leading clinical success rate of 21%, a tenfold increase from 2% in 2010 and well above the industry benchmark of ∼11%. The company had also maintained the quality of innovation, because 75% of its approvals between 2016 and 2020 had at least one expedited regulatory designation (e.g., Breakthrough Therapy). Pfizer’s Signs of Clinical Activity (SOCA) paradigm enabled better decision-making and, along with other drivers (biology and modality), contributed to this productivity improvement. These laid a strong foundation for the rapid and effective development of the Coronavirus 2019 (COVID-19) vaccine with BioNTech, as well as the antiviral candidate Paxlovid™, under the company’s ‘lightspeed’ paradigm.

Sensitivity enhancement in capillary electrophoresis and their applications for analyses of pharmaceutical and related biochemical substances

This review aims to illustrate sensitivity enhancement methods in capillary electrophoresis (CE) and their applications for pharmaceutical and related biochemical substance analyses. The first two parts of the article describe the introduction and principle of CE. The main part focuses on strategies for sensitivity improvement in CE including detector and capillary technologies and pre-concentration techniques. Applications of these techniques for pharmaceutical and biomedical substance analyses are surveyed during the years 2018-2021. This article is protected by copyright. All rights reserved.

Pharmacists' perceptions and attitudes toward drug importation into the State of Florida

BACKGROUND

The Department of Health and Human Services and the Food and Drug Administration released the Safe Importation Action Plan in July 2020 detailing methods to import medicines from Canada to combat increasing drug costs. In November 2020, Florida became the first state in the United States to create and propose an importation plan from Canada. This study examines the proposal submitted by Florida, Florida pharmacists' perceptions of the program on patient safety, and Florida pharmacists' thoughts on the pharmacy operational impact.

METHODS

This was a cross-sectional study utilizing an electronic questionnaire sent to pharmacist members of the Florida Pharmacy Association. The survey incorporated closed-ended and open-ended questions. The results from the study were reported and analyzed through descriptive statistics, qualitative and quantitative data.

RESULTS

Two-hundred and forty-four pharmacists responded to the survey. Of those respondents, 25% stated they had no knowledge about Florida's drug importation plan. Less than 12% of respondents stated they would trust the safety and quality of imported medicines. Seventy percent of pharmacists expressed concerns regarding the changes required in pharmacy operations to increase medicine safety. About half of the respondents questioned whether this plan would promote cost-savings as intended.

CONCLUSION

Florida pharmacists believe the drug importation plan does not address all aspects of patient and medicine safety and expressed concerns regarding logistical operations of a pharmacy. This article highlights those concerns and acts as a summons to action.

Baseline concentrations of pharmaceuticals in Kuwait's coastal marine environment

This study was carried out to provide baseline information on the concentrations of pharmaceuticals in Kuwait's coastal waters. Samples were collected over four sampling campaigns from various outfalls that occasionally discharged water into the marine environment and analyzed for a range of pharmaceuticals including analgesic/anti-inflammatories, antibiotics, anticoagulant, antidiabetic, antihelmintics, antihypertensives, antiplatelet agent, asthma medication, β-blocking agent, calcium channel blocker, diuretic, histamine H1 and H2 receptor antagonist, lipid regulators/cholesterol-lowering, prostatic hyperplasia, psychiatric drug, sedation and muscle relaxant, synthetic glucocorticoid, tranquilizer and x-ray contrast media. The levels varied between the detection limits of the method and a maximum of 28,183 ng/L for analgesics/anti-inflammatories. The highest pharmaceutical concentrations were in samples collected during the September campaign, possibly linked to the increased prescription of these medications to treat infectious diseases and flu prevalent in Kuwait during the winter months. The spatial variation is concentration is evident with KISR site being most polluted as hospital wastewater is discharged at the site. This study provides the first dataset on the concentrations of pharmaceuticals in the seawater in Kuwait and possibly the wider Arabian Gulf. Kuwait's coastal water pharmaceutical concentrations derived from this study exceed those reported from the Spanish coast, the Hong Kong harbour, the Bohai and the Yellow seas. More studies are needed to evaluate the environmental impact that these residues may have on non-target organisms.

The occurrence of opioid compounds in wastewater treatment plants and their receiving water bodies in Gauteng province, South Africa

The continuous influx of opioid compounds into aquatic environments has become an increasing and persistent concern, due to their extensive use. This is especially alarming as wastewater treatment plants (WWTPs) are unable to completely remove them. Despite the reported health concerns, the occurrence of opioid compounds in the environment has not received much attention. The present study investigates the occurrence of 19 opioids in four WWTPs and their respective receiving water bodies. All wastewater samples revealed opioids at concentration ranging from ng/L to μg/L with most influents having higher concentrations than effluents. WWTPs appeared to perform poorly (p > 0.05 between influents and effluents), and were unable to remove some opioids including Methadone (-27.3%) from the Leeuwkuil WWTP, Codeine (-21.7%) and Thebaine (-3.77%) from the Sandspruit WWTP, and Hydrocodone (-1.06%) from the Meyerton WWTP, respectively. Samples collected from the Leeuwkuil WWTP were the most contaminated, with eighteen out of nineteen opioid analogues exceeding 1 μg/L. Upstream surface water contained less opioids (most < LOQ) than downstream (p < 0.05), with Hydrocodone, Oxycodone, Hydromorphone, Fentanyl, Ketamine and Dihydrocodeine not detected. The occurrence of high concentrations of opioid analogues in downstream surface water (298 ng/L -10.8 μg/L for Klip River, 4.49 ng/L -13.1 μg/L for Vaal River, 70.5 ng/L -10.0 μg/L for Soutspruit River and 8.0 ng/L - 2.43 μg/L for Sun Spruit River) was directly linked to their mass loads in the respective wastewater effluent samples.

Frontiers in antibiotic alternatives for Clostridioides difficile infection

Clostridioides difficile (C. difficile) is a gram-positive, anaerobic spore-forming bacterium and a major cause of antibiotic-associated diarrhea. Humans are naturally resistant to C. difficile infection (CDI) owing to the protection provided by healthy gut microbiota. When the gut microbiota is disturbed, C. difficile can colonize, produce toxins, and manifest clinical symptoms, ranging from asymptomatic diarrhea and colitis to death. Despite the steady-if not rising-prevalence of CDI, it will certainly become more problematic in a world of antibiotic overuse and the post-antibiotic era. C. difficile is naturally resistant to most of the currently used antibiotics as it uses multiple resistance mechanisms. Therefore, current CDI treatment regimens are extremely limited to only a few antibiotics, which include vancomycin, fidaxomicin, and metronidazole. Therefore, one of the main challenges experienced by the scientific community is the development of alternative approaches to control and treat CDI. In this Frontier article, we collectively summarize recent advances in alternative treatment approaches for CDI. Over the past few years, several studies have reported on natural product-derived compounds, drug repurposing, high-throughput library screening, phage therapy, and fecal microbiota transplantation. We also include an update on vaccine development, pre- and pro-biotics for CDI, and toxin antidote approaches. These measures tackle CDI at every stage of disease pathology via multiple mechanisms. We also discuss the gaps and concerns in these developments. The next epidemic of CDI is not a matter of if but a matter of when. Therefore, being well-equipped with a collection of alternative therapeutics is necessary and should be prioritized.

Effect of superfine pulverization of powdered activated carbon on adsorption of carbamazepine in natural source waters

The purpose of this study is to investigate adsorptive removal of carbamazepine from natural source waters by superfine pulverized powdered activated carbon. Superfine pulverization is becoming an increasingly attractive approach to decrease the diffusion path of a target adsorbate molecule and improve the overall the kinetics of activated carbon adsorption. Here we report the impact of pulverization on powdered activated carbon characteristics, and carbamazepine adsorption behavior in distilled and deionized water and natural organic matter solutions. The superfine pulverization decreased the particle size of activated carbon by 50 folds and the specific surface area by 24%. In addition, the micropore volume of the activated carbon decreased from 0.23 cm³/g to 0.14 cm³/g, while mesopore and macropore volumes increased from 0.15 cm³/g and 0.11 cm³/g to 0.18 cm³/g and 0.48 cm³/g, respectively. In terms of surface chemistry, the oxygen and iron contents of the activated carbon increased notably after pulverization. Despite the decrease in surface area and increase in surface polarity, the pulverization improved the adsorption kinetics especially for short contact times i.e., < 6-h. In general, the dissolved organic carbon concentration negatively influenced the kinetic advantage of superfine pulverized activated carbon. Isotherm results indicated that the parent adsorbent has a higher adsorption capacity than superfine activated carbon in distilled and deionized water and in natural waters. This was attributed to the losses in specific surface area and favorable sorption sites inside micropores. Our literature analysis indicated that unlike the small molecular weight hydrophilic organic compounds, the pseudo-equilibrium adsorption capacity could be increased or at least not deteriorated for hydrophobic molecules (K_ow > 3). Therefore, superfine pulverization of PAC can serve as a promising approach to remove micropollutants from natural source waters with a kinetic advantage.

A new approach on synergistic effect and chemical stability of graphene oxide-magnetic nanocomposite in the heterogeneous Fenton degradation of caffeine

Two compositions of graphene oxide-magnetite nanocomposites were studied as catalysts in the heterogeneous Fenton process. Transmission electron microscopy and X-ray diffraction revealed that the graphene oxide sheets were covered with nanoparticles of magnetite, with an average crystallite size of 7 nm. Infrared spectroscopy analysis indicated that the phases interacted through covalent Fe-O-C bonds. The composites presented significantly improved catalytic activity, compared to pure magnetite, with a synergistic effect of up to a factor of 17.1 for the Fenton degradation of caffeine, achieving total removal after 90 min. This synergistic effect was a consequence of the interaction between the phases, resulting in improved mass transfer of caffeine to the catalyst surface, adsorption and efficient degradation, with enhanced HO^• generation. The surface reaction constant increased by up to three orders of magnitude, demonstrating the important role of graphene oxide in the degradation kinetics of the heterogeneous Fenton process. The surface-bonded hydroxyl radicals were responsible for caffeine degradation, achieving 9.4 μmol L^-1. After five degradation cycles, a loss of Fe-O-C bonds and increase in oxygenated groups were associated with a small decrease of caffeine removal efficiency, from 98 to 82%, without significant iron leaching, in the dark, and with low consumption of hydrogen peroxide.

Computational Modeling of Fluidized Beds with a Focus on Pharmaceutical Applications: A Review

The fluidized bed is an essential and standard equipment in the field of process development. It has a wide application in various areas and has been extensively studied. This review paper aims to discuss computational modeling of a fluidized bed with a focus on pharmaceutical applications. Eulerian, Lagrangian, and combined Eulerian-Lagrangian models have been studied for fluid bed applications with the rise of modeling capabilities. Such models assist in optimizing the process parameters and expedite the process development cycle. This paper discusses the background of modeling and then summarizes research papers relevant to pharmaceutical unit operations.

Evaluating Metrics Applied to the Medical Science Liaison (MSL) Role: A Survey-Based Study of Canadian MSL Leaders

INTRODUCTION

Metrics utilized within the Medical Science Liaison (MSL) role are plentiful and traditionally quantitative. We sought to understand the current use and value of metrics applied to the MSL role, including the use of qualitative metrics.

METHODS

We developed a list of 70 MSL leaders working in Canada, spanning 29 companies. Invitations were emailed Jun 16, 2020 and the 25-question online survey was open for 3 weeks. Questions were designed to assess demographics as well as how and why metrics are applied to the MSL role. Data analyses were descriptive.

RESULTS

Responses were received from 44 leaders (63%). Of the 42 eligible, 45% had ≤ 2 years of experience as MSL leaders and 86% supported specialty care products over many phases of the product lifecycle. A majority (69%) agreed or strongly agreed that metrics are critical to understanding whether an MSL is delivering value, and 98% had used metrics in the past year. The most common reason to use metrics was 'to show value/impact of MSLs to leadership' (66%). The most frequently used metric was 'number of health-care professional (HCP) interactions', despite this being seen as having moderate value. Quantitative metrics were used more often than qualitative, although qualitative were more often highly valued.

CONCLUSION

The data collected show a lack of agreement between the frequency of use for some metrics and their value in demonstrating the contribution of an MSL. Overall, MSL leaders in our study felt qualitative metrics were a better means of showing the true impact of MSLs.

Advances in antimicrobial activity analysis of fluoroquinolone, macrolide, sulfonamide, and tetracycline antibiotics for environmental applications through improved bacteria selection

The widespread use of antibiotics has led to their ubiquitous presence in water and wastewater and raised concerns about antimicrobial resistance. Clinical antibiotic susceptibility assays have been repurposed to measure removal of antimicrobial activity during water and wastewater treatment processes. The corresponding protocols have mainly employed growth inhibition of Escherichia coli. The present work focused on optimizing bacteria selection to improve the sensitivity of residual antimicrobial activity measurements by broth microdilution assays. Thirteen antibiotics from four classes (i.e., fluoroquinolones, macrolides, sulfonamides, tetracyclines) were investigated against three gram-negative organisms, namely E. coli, Mycoplasma microti, and Pseudomonas fluorescens. The minimum inhibitory concentration (MIC) and half-maximal inhibitory concentration (IC₅₀) were calculated for each antibiotic-bacteria pair. P. fluorescens produces a fluorescent siderophore, pyoverdine, that was used to assess sublethal effects and further enhance the sensitivity of antimicrobial activity measurements. The optimal antibiotic-bacteria pairs were as follows: fluoroquinolone-E. coli (growth inhibition); macrolide- and sulfonamide-M. microti (growth inhibition); and, tetracycline-P. fluorescens (pyoverdine inhibition). Compared to E. coli growth inhibition, the sensitivity of antimicrobial activity analysis was improved by up to 728, 19, and 2.7 times for macrolides (tylosin), sulfonamides (sulfamethoxazole), and tetracyclines (chlortetracycline), facilitating application of these bioassays at environmentally-relevant conditions.

Opportunities and challenges of three-dimensional printing technology in pharmaceutical formulation development

Three-dimensional printing is a technology that prints the products layer-by-layer, in which materials are deposited according to the digital model designed by computer aided design (CAD) software. This technology has competitive advantages regarding product design complexity, product personalization, and on-demand manufacturing. The emergence of 3D technology provides innovative strategies and new ways to develop novel drug delivery systems. This review summarizes the application of 3D printing technologies in the pharmaceutical field, with an emphasis on the advantages of 3D printing technologies for achieving rapid drug delivery, personalized drug delivery, compound drug delivery and customized drug delivery. In addition, this article illustrates the limitations and challenges of 3D printing technologies in the field of pharmaceutical formulation development.

Pharmaceutical removal at low energy consumption using membrane capacitive deionization

The performance of the membrane capacitive deionization (MCDI) system was evaluated during the removal of three selected pharmaceuticals, neutral acetaminophen (APAP), cationic atenolol (ATN), and anionic sulfamethoxazole (SMX), in batch experiments (feed solution: 2 mM NaCl and 0.01 mM of each pharmaceutical). Upon charging, the cationic ATN showed the highest removal rate of 97.65 ± 1.71%, followed by anionic SMX (93.22 ± 1.66%) and neutral APAP (68.08 ± 5.24%) due to the difference in electrostatic charge and hydrophobicity. The performance parameters (salt adsorption capacity, specific capacity, and cycling efficiency) and energy factors (specific energy consumption and recoverable energy) were further evaluated over ten consecutive cycles depending on the pharmaceutical addition. A significant decrease in the specific adsorption capacity (from 24.6 to ∼3 mg-NaCl g^-1) and specific capacity (from 17.6 to ∼2.5 mAh g^-1) were observed mainly due to the shortened charging and discharging time by pharmaceutical adsorption onto the electrode. This shortened charging time also led to an immediate drop in specific energy consumption from 0.41 to 0.04 Wh L^-1. Collectively, these findings suggest that MCDI can efficiently remove pharmaceuticals at a low energy demand; however, its performance changes dramatically as the pharmaceuticals are present in the target water.

Ecotoxicological risk assessment of contaminants of emerging concern identified by "suspect screening" from urban wastewater treatment plant effluents at a territorial scale

Urban wastewater treatment plants (WWTP) are a major vector of highly ecotoxic contaminants of emerging concern (CECs) for urban and sub-urban streams. Ecotoxicological risk assessments (ERAs) provide essential information to public environmental authorities. Nevertheless, ERAs are mainly performed at very local scale (one or few WWTPs) and on pre-selected list of CECs. To cope with these limits, the present study aims to develop a territorial-scale ERA on CECs previously identified by a "suspect screening" analytical approach (LC-QToF-MS) and quantified in the effluents of 10 WWTPs of a highly urbanized territory during three periods of the year. Among CECs, this work focused on pharmaceutical residue and pesticides. ERA was conducted following two complementary methods: (1) a single substance approach, based on the calculation for each CEC of risk quotients (RQs) by the ratio of Predicted Environmental Concentration (PEC) and Predicted No Effect Concentration (PNEC), and (2) mixture risk assessment ("cocktail effect") based on a concentration addition model (CA), summing individual RQs. Chemical results led to an ERA for 41 CEC (37 pharmaceuticals and 4 pesticides) detected in treated effluents. Single substance ERA identified 19 CECs implicated in at least one significant risk for streams, with significant risks for DEET, diclofenac, lidocaine, atenolol, terbutryn, atorvastatin, methocarbamol, and venlafaxine (RQs reaching 39.84, 62.10, 125.58, 179.11, 348.24, 509.27, 1509.71 and 3097.37, respectively). Mixture ERA allowed the identification of a risk (RQmix > 1) for 9 of the 10 WWTPs studied. It was also remarked that CECs leading individually to a negligible risk could imply a significant risk in a mixture. Finally, the territorial ERA showed a diversity of risk situations, with the highest concerns for 3 WWTPs: the 2 biggest of the territory discharging into a large French river, the Rhône, and for the smallest WWTP that releases into a small intermittent stream.

Systematic risk identification and assessment using a new risk map in pharmaceutical R&D

Delivering transformative therapies to patients while maintaining growth in the pharmaceutical industry requires an efficient use of research and development (R&D) resources and technologies to develop high-impact new molecular entities (NMEs). However, increasing global R&D competition in the pharmaceutical industry, growing impact of generics and biosimilars, more stringent regulatory requirements, as well as cost-constrained reimbursement frameworks challenge current business models of leading pharmaceutical companies. Big data-based analytics and artificial intelligence (AI) approaches have disrupted various industries and are having an increasing impact in the biopharmaceutical industry, with the promise to improve and accelerate biopharmaceutical R&D processes. Here, we systematically analyze, identify, assess, and categorize key risks across the drug discovery and development value chain using a new risk map approach, providing a comprehensive risk-reward analysis for pharmaceutical R&D.

Exposure via biotransformation: Oxazepam reaches predicted pharmacological effect levels in European perch after exposure to temazepam

It is generally expected that biotransformation and excretion of pharmaceuticals occurs similarly in fish and mammals, despite significant physiological differences. Here, we exposed European perch (Perca fluviatilis) to the benzodiazepine drug temazepam at a nominal concentration of 2 µg L^-1 for 10 days. We collected samples of blood plasma, muscle, and brain in a time-dependent manner to assess its bioconcentration, biotransformation, and elimination over another 10 days of depuration in clean water. We observed rapid pharmacokinetics of temazepam during both the exposure and depuration periods. The steady state was reached within 24 h of exposure in most individuals, as was complete elimination of temazepam from tissues during depuration. Further, the biologically active metabolite oxazepam was produced via fish biotransformation, and accumulated significantly throughout the exposure period. In contrast to human patients, where a negligible amount of oxazepam is created by temazepam biotransformation, we observed a continuous increase of oxazepam concentrations in all fish tissues throughout exposure. Indeed, oxazepam accumulated more than its parent compound, did not reach a steady state during the exposure period, and was not completely eliminated even after 10 days of depuration, highlighting the importance of considering environmental hazards posed by pharmaceutical metabolites.

Elimination of selected heterocyclic aromatic emerging contaminants from water using soybean peroxidase

Widespread occurrence of various heterocyclic aromatic compounds is reported in concentrations from 1 to 20 μg/L in surface and groundwater as well as influents and effluents of wastewater treatment plants around the world. These so-called emerging contaminants and their metabolites can cause adverse effects on the environment and humans, even at very low concentration, hence raised environmental concerns. In this study, feasibility of soybean peroxidase-catalyzed removal of three selected heterocyclic aromatics from water was investigated, including sensitivity to the most important operational conditions, pH (range 3.6-9.0), H2O2 concentration (range 0.10-1.50 mM), and enzyme activity (range 0.001-5.0 U/mL). 3-Hydroxycoumarin and 2-aminobenzoxaozle were found to be substrates for the enzyme, having ≥95% and 45% removal efficiency with most effective pHs of 7.0 and 6.0, respectively. Time course study was also conducted to determine the initial first-order rate constants and half-lives; half-lives normalized for enzyme activity (0.0257 and 452 min for the respective substrates) are compared with those of 21 other compounds reactive with soybean peroxidase. High-resolution mass spectrometry was employed to characterize the plausible oligomerization products of enzymatic treatment, which revealed formation of dimers and trimers of the two substrates.

Toxicity and remediation of pharmaceuticals and pesticides using metal oxides and carbon nanomaterials

The worldwide development of agriculture and industry has resulted in contamination of water bodies by pharmaceuticals, pesticides and other xenobiotics. Even at trace levels of few micrograms per liter in waters, these contaminants induce public health and environmental issues, thus calling for efficient removal methods such as adsorption. Recent adsorption techniques for wastewater treatment involve metal oxide compounds, e.g. Fe2O3, ZnO, Al2O3 and ZnO-MgO, and carbon-based materials such as graphene oxide, activated carbon, carbon nanotubes, and carbon/graphene quantum dots. Here, the small size of metal oxides and the presence various functional groups has allowed higher adsorption efficiencies. Moreover, carbon-based adsorbents exhibit unique properties such as high surface area, high porosity, easy functionalization, low price, and high surface reactivity. Here we review the cytotoxic effects of pharmaceutical drugs and pesticides in terms of human risk and ecotoxicology. We also present remediation techniques involving adsorption on metal oxides and carbon-based materials.

Qualitative validation of audiovisual educational material for use on rheumatoid arthritis patients

Medication compliance is critical to achieve therapeutic efficacy in patients with rheumatoid arthritis; however, among other factors, low patient-health literacy plays a negative role. Therefore, the development and validation of audiovisual educational material with the participation of health specialists and patients could lead to an improved level of compliance with treatment, while favoring its acceptance. To design and validate audiovisual educational material generated by a multidisciplinary and participative group of patients and health specialists. This study was carried out using a sequential methodology, including qualitative and quantitative techniques: (1) a non-participative observational study with patients and a non-systematic literature search were performed to identify conceptual topics. (2) Pilot videos were qualitatively assessed by patients and health specialists (focus groups and expert committees). (3) Improved versions of seven videos were quantitatively evaluated by patients and specialists following qualitative criteria of attraction, understanding, involvement, acceptance and induction of action. 74 patients with RA, 10 rheumatologists, 4 pharmacists and 2 medical anthropologists participated in the different phases of validation. A total of seven videos lasting 3 min each were generated, incorporating the most relevant suggestions by patients and healthcare professionals. The final version of the videos led to a mean compliance of 96.04 ± 5.2%, according to a representative group of patients and a mean 89.6 ± 9.4%, according to health professionals. With the participation of both patients and health specialists, seven audiovisual educational video recordings were developed and validated, reaching high levels of compliance in accordance with international criteria.

Removal efficiency, kinetic, and behavior of antibiotics from sewage treatment plant effluent in a hybrid constructed wetland and a layered biological filter

Sewage treatment plant (STP) is the major point source of antibiotic contamination, yet the advanced treatment of antibiotic polluted STP effluent has not been given necessary attention. This study is conducted to evaluate the removal efficiency, kinetic, and behavior of sulfonamides, quinolones, tetracyclines, and macrolides antibiotics from STP effluent in a hybrid constructed wetland (HCW) and a layered biological filter (LBF) at different hydraulic loading rates (HLRs). The results showed that the removal efficiency of antibiotics in all the HLRs was ranked as follow: quinolones of HCW (70-95%) > macrolides of HCW (58-77%) > tetracyclines of both systems (59-67%) > quinolones of LBF (28-64%) > macrolides of LBF (13-25%) > sulfonamides of both systems (<0%). The optimal HLR is 1.0 m/day for quinolones and 2.0 m/day for tetracyclines-macrolides in the HCW, and 6.4 m/day for quinolones-tetracyclines in the LBF, respectively. Although HCW performed better on the removal of most antibiotics, LBF exhibited stronger total loading toleration and higher removal loading ability to antibiotics. Among them, quinolones were markedly removed by multiple effect of substrate adsorption, microbial anaerobic degradation, and photolysis in the HCW (planted), and by filter sorption and interception in the LBF (unplanted); adsorption is the dominant elimination approach for tetracyclines in both systems; plant uptake plays a significant role on the removal of macrolides in the HCW.

Recent Opportunities and Challenges in Selective C-H Functionalization of Methyl Azaarenes: a Highlight from 2010 to 2020 Literatures

Azaarenes are unique scaffolds frequently found in pharmaceuticals. Herein, we have summarized the recent synthetic available methods in C-H functionalization of methylazaarenes from 2010 to 2020. Multiple approaches involving halogenation and alkylation via different methods, such as alkenylation, oxidative functionalization, and cyclization of the methylazaarenes will be discussed in this review.

Risks to aquatic environments posed by 14 pharmaceuticals as illustrated by their effects on zebrafish behaviour

The presence of pharmaceutical residues in aquatic ecosystems is a worldwide problem that may pose serious threats and challenges to the environment, especially to the safety of aquatic biota. In the present study, we investigated the effects of 14 environmentally relevant pharmaceutical compounds on individual and collective-related behaviours in juvenile zebrafish (Danio rerio) for 21 days. The tested concentrations of the compounds spanned three orders of magnitude. This study also compared the potential risks of these compounds in Chinese surface waters based on the data on their toxic effects or only on behavioural effects. In the case of individual behaviours, most antidepressants, but not anti-inflammatory agents or blood lipid-lowering agents, decreased fish locomotor activity (LMA) and individual social activity (IDS); however, all three classes of compounds induced significant disruptions in the light/dark transition locomotor response (LMR-L/D) performance, even at lower treatment levels (0.1-1 μg/L). Furthermore, collective behaviour (CLB) analysis suggested that most of the compounds significantly altered the group sociability of fish and frequently occurred at environmentally relevant concentrations. Finally, a risk assessment suggested that the presence of ibuprofen, fluoxetine, and venlafaxine in the surface waters of China poses a relatively high risk to fish, regardless of the risk ranking based on the data of the toxic or behavioural effects.

A 5-Year Analysis of Physician-Industry Interactions, Physician Gender, and Anti-VEGF Use in US Ophthalmologists

Purpose: To explore physician gender, industry payments, and prescribing habits of anti-vascular endothelial growth factor (VEGF) agents.Methods: Retrospective review of U.S. ophthalmologists prescribing and receiving industry payments for aflibercept and/or ranibizumab (brand anti-VEGF injections) between August 2013 to December 2017.Results: Men receiving industry payments were older and had longer post-residency experience than women (both P < .001). Men were more likely to receive industry payments (P = .01), receive >5 payments (P = .003), and receive payments totaling >$1000 (P = .008). Men administered more injections on average than women when receiving >3 industry payments (P < .001) or when receiving >$100 (P < .01). On multivariate analysis, years in practice, male gender, number of payments, and total value of payments were independent factors associated with the number of brand injections administered (all P < .001).Conclusions: A positive association between industry payments and brand anti-VEGF use was identified, however, causality was not determined. Gender bias may be present in physician-industry relationships.

Is there evidence for the racialization of pharmaceutical regulation? Systematic comparison of new drugs approved over five years in the USA and the EU

Recent decades have seen much interest in racial and ethnic differences in drug response. The most emblematic example is the heart drug BiDil, approved by the US Food and Drug Administration in 2005 for "self-identified blacks." Previous social science research has explored this "racialization of pharmaceutical regulation" in the USA, and discussed its implications for the "pharmaceuticalization of race" in terms of reinforcing certain taxonomic schemes and conceptualizations. Yet, little is known about the racialization of pharmaceutical regulation in the USA after BiDil, and how it compares with the situation in the EU, where political and regulatory commitment to race and ethnicity in pharmaceutical medicine is weak. We have addressed these gaps by investigating 397 product labels of all novel drugs approved in the USA (n = 213) and the EU (n = 184) between 2014 and 2018. Our analysis considered statements in labeling and the racial/ethnic categories used. Overall, it revealed that many labels report race/ethnicity demographics and subgroup analyses, but that there are important differences between the USA and the EU. Significantly more US labels specified race/ethnicity demographics, as expected given the USA's greater commitment to race and ethnicity in pharmaceutical medicine. Moreover, we found evidence that reporting of race/ethnicity demographics in EU labels was driven, in part, by statements in US labels, suggesting the spillover of US regulatory standards to the EU. Unexpectedly, significantly more EU labels reported differences in drug response, although no drug was restricted to a racial/ethnic population in a manner similar to BiDil. Our analysis also noted variability and inconsistency in the racial/ethnic taxonomy used in labels. We discuss implications for the racialization of pharmaceutical regulation and the pharmaceuticalization of race in the USA and EU.

Overview of "The Study in Risk-Based Manufacturing Environmental Control for Non-Sterile Drug Products"

To develop a guide of best practices for establishing appropriate controls on nonsterile manufacturing environments for pharmaceutical manufacturers, the Kansai Study Group of the Parenteral Drug Association Japan Chapter explored relevant issues in-depth and published the results of their study, "The Study in Risk-Based Manufacturing Environmental Control for Non-Sterile Drug Products" in the PDA Journal of GMP and Validation in Japan. This review summarizes the background of that study and the structure of the published article and, to help readers make the most of the contents, provides a table displaying the category, subject, problem statement, and points to consider of each topic discussed in the article, as well as examples of central topics (Appendices 1-3).

Detection of endocrine disrupting chemicals in Danio rerio and Daphnia pulex: Step-one, behavioral screen

Anthropogenic surface and ground water contamination by chemicals is a global problem, and there is an urgent need to develop tools to identify and elucidate biological effects. Contaminants of emerging concern (CECs) are not typically monitored or regulated and those with known or suspected endocrine disrupting potential have been termed endocrine disrupting chemicals (EDCs). Many CECs are known to be neurotoxic (e.g., insecticides) and many are incompletely characterized. Behavioral responses can identify chemicals with neuroactive properties, which can be relevant to EDC mechanisms (e.g., neuroendocrine disturbances). Two freshwater species, Daphnia pulex and Danio rerio, were evaluated for swimming behavior alterations resulting from 24-hr exposure to 9 CECs: triclosan, triclocarban, chlorpyrifos, dieldrin, 4-nonylphenol, bisphenol-A, atrazine, metformin, and estrone. This is the first step in the development of a bioassay for detecting estrogenic and/or anti-androgenic activity with the goal to evaluate complex mixtures of uncharacterized contaminants in water samples. The second step, described in a subsequent report, examines transcriptome alterations following chemical exposure. Significant differences in the swimming behavior response and sensitivity were found across chemicals within a species and across species for a given chemical in this unique optical bioassay system. In the concentration ranges studied, significant behavioral alterations were detected for 6 of 9 CECs for D. pulex and 4 of 9 CECs for D. rerio. These results underscore the utility of this bioassay to identify behavioral effects of sublethal concentrations of CECs before exploration of transcriptomic alterations for EDC detection.