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Asano M, Imai S, Shimizu Y, Kizaki H, Ito Y, Tsuchiya M, Kuriyama R, Yoshida N, Shimada M, Sando T, Ishijima T, Hori S. Factor Analysis of Patients Who Find Tablets or Capsules Difficult to Swallow Due to Their Large Size: Using the Personal Health Record Infrastructure of Electronic Medication Notebooks. J Med Internet Res 2024; 26:e54645. [PMID: 38657229 DOI: 10.2196/54645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/22/2023] [Accepted: 03/19/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Understanding patient preference regarding taking tablet or capsule formulations plays a pivotal role in treatment efficacy and adherence. Therefore, these preferences should be taken into account when designing formulations and prescriptions. OBJECTIVE This study investigates the factors affecting patient preference in patients who have difficulties swallowing large tablets or capsules and aims to identify appropriate sizes for tablets and capsules. METHODS A robust data set was developed based on a questionnaire survey conducted from December 1, 2022, to December 7, 2022, using the harmo smartphone app operated by harmo Co, Ltd. The data set included patient input regarding their tablet and capsule preferences, personal health records (including dispensing history), and drug formulation information (available from package inserts). Based on the medication formulation information, 6 indices were set for each of the tablets or capsules that were considered difficult to swallow owing to their large size and concomitant tablets or capsules (used as controls). Receiver operating characteristic (ROC) analysis was used to evaluate the performance of each index. The index demonstrating the highest area under the curve of the ROC was selected as the best index to determine the tablet or capsule size that leads to swallowing difficulties. From the generated ROCs, the point with the highest discriminative performance that maximized the Youden index was identified, and the optimal threshold for each index was calculated. Multivariate logistic regression analysis was performed to identify the risk factors contributing to difficulty in swallowing oversized tablets or capsules. Additionally, decision tree analysis was performed to estimate the combined risk from several factors, using risk factors that were significant in the multivariate logistic regression analysis. RESULTS This study analyzed 147 large tablets or capsules and 624 control tablets or capsules. The "long diameter + short diameter + thickness" index (with a 21.5 mm threshold) was identified as the best indicator for causing swallowing difficulties in patients. The multivariate logistic regression analysis (including 132 patients with swallowing difficulties and 1283 patients without) results identified the following contributory risk factors: aged <50 years (odds ratio [OR] 1.59, 95% CI 1.03-2.44), female (OR 2.54, 95% CI 1.70-3.78), dysphagia (OR 3.54, 95% CI 2.22-5.65), and taking large tablets or capsules (OR 9.74, 95% CI 5.19-18.29). The decision tree analysis results suggested an elevated risk of swallowing difficulties for patients with taking large tablets or capsules. CONCLUSIONS This study identified the most appropriate index and threshold for indicating that a given tablet or capsule size will cause swallowing difficulties, as well as the contributory risk factors. Although some sampling biases (eg, only including smartphone users) may exist, our results can guide the design of patient-friendly formulations and prescriptions, promoting better medication adherence.
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Affiliation(s)
- Masaki Asano
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Shungo Imai
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Yuri Shimizu
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Hayato Kizaki
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | | | | | | | | | | | | | | | - Satoko Hori
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
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McCartney F. Industry news update: December 2023. Ther Deliv 2024. [PMID: 38639645 DOI: 10.4155/tde-2024-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Affiliation(s)
- Fiona McCartney
- School of Veterinary Medicine, University College Dublin, Ireland
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3
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Barton HJ, Maru A, Leaf MA, Hekman DJ, Wiegmann DA, Shah MN, Patterson BW. Academic Detailing as a Health Information Technology Implementation Method: Supporting the Design and Implementation of an Emergency Department-Based Clinical Decision Support Tool to Prevent Future Falls. JMIR Hum Factors 2024; 11:e52592. [PMID: 38635318 DOI: 10.2196/52592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/08/2024] [Accepted: 03/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation. OBJECTIVE This study aimed to assess academic detailing as a method for simultaneously ensuring the correct understanding of an emergency department-based CDS tool to prevent future falls and identifying factors impacting clinicians' use of the tool through an analysis of the resultant qualitative data. METHODS Previously, our team designed a CDS tool to identify patients aged 65 years and older who are at the highest risk of future falls and prompt an interruptive alert to clinicians, suggesting the patient be referred to a mobility and falls clinic for an evidence-based preventative intervention. We conducted 10-minute academic detailing interviews (n=16) with resident emergency medicine physicians and advanced practice providers who had encountered our CDS tool in practice. We conducted an inductive, team-based content analysis to identify factors that influenced clinicians' use of the CDS tool. RESULTS The following categories of factors that impacted clinicians' use of the CDS were identified: (1) aspects of the CDS tool's design (2) clinicians' understanding (or misunderstanding) of the CDS or referral process, (3) the busy nature of the emergency department environment, (4) clinicians' perceptions of the patient and their associated fall risk, and (5) the opacity of the referral process. Additionally, clinician education was done to address any misconceptions about the CDS tool or referral process, for example, demonstrating how simple it is to place a referral via the CDS and clarifying which clinic the referral goes to. CONCLUSIONS Our study demonstrates the use of academic detailing for supporting the implementation of health information technologies, allowing us to identify factors that impacted clinicians' use of the CDS while concurrently educating clinicians to ensure the correct understanding of the CDS tool and intervention. Thus, academic detailing can inform both real-time adjustments of a tool's implementation, for example, refinement of the language used to introduce the tool, and larger scale redesign of the CDS tool to better fit the dynamic work environment of clinicians.
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Affiliation(s)
- Hanna J Barton
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Apoorva Maru
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Margaret A Leaf
- Department of Information Services, UW Health, Madison, WI, United States
| | - Daniel J Hekman
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Douglas A Wiegmann
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, United States
| | - Manish N Shah
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Brian W Patterson
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, United States
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Nkoy FL, Stone BL, Zhang Y, Luo G. A Roadmap for Using Causal Inference and Machine Learning to Personalize Asthma Medication Selection. JMIR Med Inform 2024; 12:e56572. [PMID: 38630536 DOI: 10.2196/56572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/12/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
Inhaled corticosteroid (ICS) is a mainstay treatment for controlling asthma and preventing exacerbations in patients with persistent asthma. Many types of ICS drugs are used, either alone or in combination with other controller medications. Despite the widespread use of ICSs, asthma control remains suboptimal in many people with asthma. Suboptimal control leads to recurrent exacerbations, causes frequent ER visits and inpatient stays, and is due to multiple factors. One such factor is the inappropriate ICS choice for the patient. While many interventions targeting other factors exist, less attention is given to inappropriate ICS choice. Asthma is a heterogeneous disease with variable underlying inflammations and biomarkers. Up to 50% of people with asthma exhibit some degree of resistance or insensitivity to certain ICSs due to genetic variations in ICS metabolizing enzymes, leading to variable responses to ICSs. Yet, ICS choice, especially in the primary care setting, is often not tailored to the patient's characteristics. Instead, ICS choice is largely by trial and error and often dictated by insurance reimbursement, organizational prescribing policies, or cost, leading to a one-size-fits-all approach with many patients not achieving optimal control. There is a pressing need for a decision support tool that can predict an effective ICS at the point of care and guide providers to select the ICS that will most likely and quickly ease patient symptoms and improve asthma control. To date, no such tool exists. Predicting which patient will respond well to which ICS is the first step toward developing such a tool. However, no study has predicted ICS response, forming a gap. While the biologic heterogeneity of asthma is vast, few, if any, biomarkers and genotypes can be used to systematically profile all patients with asthma and predict ICS response. As endotyping or genotyping all patients is infeasible, readily available electronic health record data collected during clinical care offer a low-cost, reliable, and more holistic way to profile all patients. In this paper, we point out the need for developing a decision support tool to guide ICS selection and the gap in fulfilling the need. Then we outline an approach to close this gap via creating a machine learning model and applying causal inference to predict a patient's ICS response in the next year based on the patient's characteristics. The model uses electronic health record data to characterize all patients and extract patterns that could mirror endotype or genotype. This paper supplies a roadmap for future research, with the eventual goal of shifting asthma care from one-size-fits-all to personalized care, improve outcomes, and save health care resources.
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Affiliation(s)
- Flory L Nkoy
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Bryan L Stone
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Yue Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
- Division of Biostatistics, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - Gang Luo
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States
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Hu C, Jiang L, Guo Z, Mumtaz Y, Liu J, Qin J, Chen Y, Lin Z, Yi W. Synthesis of N-Difluoromethyl Carbonyl Compounds from N-Difluoromethylcarbamoyl Fluorides. Angew Chem Int Ed Engl 2024; 63:e202319758. [PMID: 38353649 DOI: 10.1002/anie.202319758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Indexed: 03/06/2024]
Abstract
Fluorinated small molecules are commonly used in functional small-molecule chemistry, and N-difluoromethyl (N-CF2H) compounds are particularly intriguing due to their unique and unexplored physiochemical properties. However, despite limited progress, a general methodological approach to the synthesis of N-CF2H compounds remains elusive. Here, guided by computation, we present a simple and practical protocol to access N-CF2H amides and related carbonyl derivatives. The protocol involves a one-pot conversion of thioformamides through desulfurization-fluorination and acylation, providing N-difluoromethylcarbamoyl fluoride building blocks that can be further diversified to a variety of unexplored N-CF2H carbonyl compounds with rich functionality. Additionally, preliminary studies on their properties and stability showcased their potential application in pharmaceuticals and agrochemicals.
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Affiliation(s)
- Chunyang Hu
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Lvqi Jiang
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Zihao Guo
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Yasir Mumtaz
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Jie Liu
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Jiarong Qin
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Yixing Chen
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Zhongquan Lin
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - Wenbin Yi
- School of Chemistry and Chemical Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
- Key Laboratory of Organofluorine Chemistry, Shanghai Institute Organic Chemistry, Chinese Academy of Sciences, Shanghai, 200032, China
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6
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Tkachenko N, Pankevych O, Mahanova T, Hromovyk B, Lesyk R, Lesyk L. Human Healthcare and Its Pharmacy Component from a Safety Point of View. Pharmacy (Basel) 2024; 12:64. [PMID: 38668090 PMCID: PMC11053725 DOI: 10.3390/pharmacy12020064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
Healthcare plays a crucial role in public and national safety as a significant part of state activity and a component of national safety, whose mission is to organize and ensure affordable medical care for the population. The four stages of the genesis of healthcare safety development with the corresponding safety models of formation were defined: technical, human factor or security management, systemic security management, and cognitive complexity. It was established that at all stages, little attention is paid to the issues of the formation of the pharmaceutical sector's safety. Taking into account the development of safety models that arise during the four stages of the genesis of safety science, we have proposed a model of the evolution of pharmaceutical safety formation. At the same time, future research is proposed to focus on new holistic concepts of safety, such as "Safety II", evaluation and validation methods, especially in the pharmaceutical sector, where the development of this topic remained in the second stage of the evolution of science, the search for pharmaceutical errors related to drugs.
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Affiliation(s)
- Natalia Tkachenko
- Department of Pharmacy Management and Economics, Zaporizhzhia State Medical and Pharmaceutical University, 26 Maiakovskoho Ave., 69035 Zaporizhzhia, Ukraine; (N.T.); (T.M.)
| | - Ostap Pankevych
- Department of Organization and Economics of Pharmacy, Danylo Halytsky Lviv National Medical University, 69 Pekarska, 79010 Lviv, Ukraine; (O.P.); (B.H.)
| | - Tamara Mahanova
- Department of Pharmacy Management and Economics, Zaporizhzhia State Medical and Pharmaceutical University, 26 Maiakovskoho Ave., 69035 Zaporizhzhia, Ukraine; (N.T.); (T.M.)
| | - Bohdan Hromovyk
- Department of Organization and Economics of Pharmacy, Danylo Halytsky Lviv National Medical University, 69 Pekarska, 79010 Lviv, Ukraine; (O.P.); (B.H.)
| | - Roman Lesyk
- Department of Pharmaceutical, Organic and Bioorganic Chemistry, Danylo Halytsky Lviv National Medical University, 69 Pekarska, 79010 Lviv, Ukraine;
| | - Lilia Lesyk
- Department of Business Economics and Investment, Institute of Economics and Management, Lviv Polytechnic National University, 5 Metropolian Andrey Str., Building 4, 79005 Lviv, Ukraine
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Chamouard V, Freyssenge J, Clairaz-Mahiou B, Ferrera Bibas F, Fraticelli L. Evaluation of an e-Learning Program for Community Pharmacists for Dispensing Emicizumab (Hemlibra) in France: Nationwide Cross-Sectional Study. JMIR Form Res 2024; 8:e54656. [PMID: 38574351 PMCID: PMC11027057 DOI: 10.2196/54656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/05/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Since June 2021, patients with hemophilia A with antifactor VIII inhibitors and those with severe hemophilia A without antifactor VIII inhibitors treated with Hemlibra have had to choose between a community or hospital pharmacy. The French reference center for hemophilia developed the HEMOPHAR e-learning program for community pharmacists for dispensing emicizumab. OBJECTIVE This study aims to evaluate the efficiency and safety of this new care pathway by assessing the HEMOPHAR e-learning program. METHODS The methodology is based on Kirkpatrick's model for evaluating the immediate reaction of trained community pharmacists (level 1), their level of acquired knowledge (level 2), and their professional practice after 3 months of dispensation (level 3). RESULTS The HEMOPHAR e-learning program reached a large audience, with 67% (337/502) of the eligible community pharmacists following it. The immediate reaction was overall satisfying. High rates of engagement were reported with 63.5% (214/337) to 73.3% (247/337) of completed training modules, along with high rates of success with quizzes of 61.5% (174/337) to 95.7% (244/337). We observed that 83.9% (193/230) of the community pharmacists needed less than 2 attempts to pass the quiz of the module related to professional practice, while the other quizzes required more attempts. Advice on compliance and drug interactions were most frequently provided to patients by the community pharmacists. CONCLUSIONS This study suggests ways to improve the training of community pharmacists and to optimize coordination with treatment centers. This study also reports on the feasibility of switching to a community pharmacy in a secure pharmaceutical circuit, including in the context of a rare bleeding disease. TRIAL REGISTRATION ClinicalTrials.gov NCT05449197; https://clinicaltrials.gov/study/NCT05449197. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/43091.
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Affiliation(s)
- Valérie Chamouard
- Louis Pradel Hospital, Groupement Hospitalier Est, Hospices Civils de Lyon, French Reference Center of Hemophilia, Bron, France
| | - Julie Freyssenge
- University Claude Bernard Lyon 1, INSERM U1290 Research on Healthcare Performance RESHAPE, Lyon, France
| | | | | | - Laurie Fraticelli
- Laboratory P2S (Health Systemic Process), UR 4129, University Claude Bernard Lyon 1, Lyon, France
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Quinn J, Bodenstab HM, Wo E, Parrish RH. Medication Management Through Collaborative Practice for Children With Medical Complexity: A Prospective Case Series. J Pediatr Pharmacol Ther 2024; 29:119-129. [PMID: 38596413 PMCID: PMC11001202 DOI: 10.5863/1551-6776-29.2.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/08/2023] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Care coordination for children and youth with special health care needs and medical complexity (CYSHCN-CMC), especially medication management, is difficult for providers, parents/caregivers, and -patients. This report describes the creation of a clinical pharmacotherapy practice in a pediatric long-term care facility (pLTCF), application of standard operating procedures to guide comprehensive medication management (CMM), and establishment of a collaborative practice agreement (CPA) to guide drug therapy. METHODS In a prospective case series, 102 patients characterized as CYSHCN-CMC were included in this pLTCF quality improvement project during a 9-month period. RESULTS Pharmacists identified, prevented, or resolved 1355 drug therapy problems (DTP) with an average of 13 interventions per patient. The patients averaged 9.5 complex chronic medical conditions with a -median length of stay of 2815 days (7.7 years). The most common medications discontinued due to pharmacist assessment and recommendation included diphenhydramine, albuterol, sodium phosphate enema, ipratropium, and metoclopramide. The average number of medications per patient was reduced from 23 to 20. A pharmacoeconomic analysis of 244 of the interventions revealed a monthly direct cost savings of $44,304 ($434 per patient per month) and monthly cost avoidance of $48,835 ($479 per patient per month). Twenty-eight ED visits/admissions and 61 clinic and urgent care visits were avoided. Hospital -readmissions were reduced by 44%. Pharmacist recommendations had a 98% acceptance rate. CONCLUSIONS Use of a CPA to conduct CMM in CYSHCN-CMC decreased medication burden, resolved, and prevented adverse events, reduced health care-related costs, reduced hospital readmissions and was well-accepted and implemented collaboratively with pLTCF providers.
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Affiliation(s)
- Jena Quinn
- Perfecting Peds (JQ, HMB, EW), Haddon Heights, NJ
| | - Heather Monk Bodenstab
- Perfecting Peds (JQ, HMB, EW), Haddon Heights, NJ
- Medical Affairs (HMB), Sobi, Waltham, MA
| | - Emily Wo
- Perfecting Peds (JQ, HMB, EW), Haddon Heights, NJ
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Lee MK, Jeong HH, Kim MJ, Seo JS, Hwang JY, Jung WK, Moon KM, Lee I, Lee B. The Beneficial Roles of Sargassum spp. in Skin Disorders. J Med Food 2024; 27:359-368. [PMID: 38526569 DOI: 10.1089/jmf.2023.k.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
As the body's largest organ, the skin is located at the internal and external environment interface, serving as a line of defense against various harmful stressors. Recently, marine-derived physiologically active ingredients have attracted considerable attention in the cosmeceutical industry due to their beneficial effects on skin health. Sargassum, a genus of brown macroalgae, has traditionally been consumed as food and medicine in several countries and is rich in bioactive compounds such as meroterpenoids, sulfated polysaccharides, fucoidan, fucoxanthin, flavonoids, and terpenoids. Sargassum spp. have various beneficial effects on skin disorders. They help with atopic dermatitis by improving skin barrier protection and reducing inflammation. Several species show potential in treating acne by inhibiting bacterial growth and reducing inflammation. Some species, such as Sargassum horneri, demonstrate antiallergic effects by modulating mast cell activity. Certain Sargassum species exhibit anticancer activity by inhibiting tumor growth and promoting apoptosis, and some species help with wound healing by promoting angiogenesis and reducing oxidative stress. Overall, Sargassum spp. demonstrate potential for treating and managing various skin conditions. Therefore, the bioactive compounds of Sargassum spp. may be natural ingredients with a wide range of functional properties for preventing and treating skin disorders. The present review focused on the various biological effects of Sargassum extracts and derived compounds on skin disorders.
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Affiliation(s)
- Min-Kyeong Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
- Biotechnology Research Division, National Institute of Fisheries Science, Busan, Republic of Korea
| | - Hyeon Hak Jeong
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
| | - Myeong-Jin Kim
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
| | - Jae Seong Seo
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
| | - Ji Young Hwang
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
| | - Won-Kyo Jung
- Division of Biomedical Engineering and Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, Korea
| | - Kyoung Mi Moon
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
| | - Incheol Lee
- Department of Ocean Engineering, Pukyong National University, Busan, Korea
| | - Bonggi Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
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He Y, Yang T, Li J, Li K, Zhuang C, Zhang M, Li R, Zhao Y, Song Q, Jiang M, Mao S, Song XG, Guo Y, Li X, Tan F, Jitkaew S, Zhang W, Cai Z. Identification of a marine-derived sesquiterpenoid, Compound-8, that inhibits tumour necrosis factor-induced cell death by blocking complex II assembly. Br J Pharmacol 2024. [PMID: 38555910 DOI: 10.1111/bph.16364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND AND PURPOSE Tumour necrosis factor (TNF) is a pleiotropic inflammatory cytokine that not only directly induces inflammatory gene expression but also triggers apoptotic and necroptotic cell death, which leads to tissue damage and indirectly exacerbates inflammation. Thus, identification of inhibitors for TNF-induced cell death has broad therapeutic relevance for TNF-related inflammatory diseases. In the present study, we isolated and identified a marine fungus-derived sesquiterpenoid, 9α,14-dihydroxy-6β-p-nitrobenzoylcinnamolide (named as Cpd-8), that inhibits TNF receptor superfamily-induced cell death by preventing the formation of cytosolic death complex II. EXPERIMENTAL APPROACH Marine sponge-associated fungi were cultured and the secondary metabolites were extracted to yield pure compounds. Cell viability was measured by ATP-Glo cell viability assay. The effects of Cpd-8 on TNF signalling pathway were investigated by western blotting, immunoprecipitation, and immunofluorescence assays. A mouse model of acute liver injury (ALI) was employed to explore the protection effect of Cpd-8, in vivo. KEY RESULTS Cpd-8 selectively inhibits TNF receptor superfamily-induced apoptosis and necroptosis. Cpd-8 prevents the formation of cytosolic death complex II and subsequent RIPK1-RIPK3 necrosome, while it has no effect on TNF receptor I (TNFR1) internalization and the formation of complex I in TNF signalling pathway. In vivo, Cpd-8 protects mice against TNF-α/D-GalN-induced ALI. CONCLUSION AND IMPLICATIONS A marine fungus-derived sesquiterpenoid, Cpd-8, inhibits TNF receptor superfamily-induced cell death, both in vitro and in vivo. This study not only provides a useful research tool to investigate the regulatory mechanisms of TNF-induced cell death but also identifies a promising lead compound for future drug development.
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Affiliation(s)
- Yuan He
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tingting Yang
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Tongji University School of Medicine, Shanghai, China
| | - Jiao Li
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Kaiying Li
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Tongji University School of Medicine, Shanghai, China
| | - Chunlin Zhuang
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Meng Zhang
- Tongji University School of Medicine, Shanghai, China
| | - Ran Li
- School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Yaxing Zhao
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qianqian Song
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Tongji University School of Medicine, Shanghai, China
| | - Mengyuan Jiang
- School of Pharmacy, Nanchang University, Nanchang, China
| | - Shuichun Mao
- School of Pharmacy, Nanchang University, Nanchang, China
| | | | - Yufeng Guo
- Shanghai Power Hospital, Shanghai, China
| | - Xuran Li
- Department of ORL-HNS, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fei Tan
- Department of ORL-HNS, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai, China
- The Royal College of Surgeons in Ireland, Dublin, Ireland
- The Royal College of Surgeons of England, London, UK
| | - Siriporn Jitkaew
- Center of Excellence for Cancer and Inflammation, Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Wen Zhang
- Tongji University School of Medicine, Shanghai, China
- School of Pharmacy, Second Military Medical University, Shanghai, China
- Ningbo Institute of Marine Medicine, Peking University, Beijing, China
| | - Zhenyu Cai
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Tongji University School of Medicine, Shanghai, China
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Ashraf AR, Mackey TK, Fittler A. Search Engines and Generative Artificial Intelligence Integration: Public Health Risks and Recommendations to Safeguard Consumers Online. JMIR Public Health Surveill 2024; 10:e53086. [PMID: 38512343 PMCID: PMC10995787 DOI: 10.2196/53086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/27/2023] [Accepted: 01/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The online pharmacy market is growing, with legitimate online pharmacies offering advantages such as convenience and accessibility. However, this increased demand has attracted malicious actors into this space, leading to the proliferation of illegal vendors that use deceptive techniques to rank higher in search results and pose serious public health risks by dispensing substandard or falsified medicines. Search engine providers have started integrating generative artificial intelligence (AI) into search engine interfaces, which could revolutionize search by delivering more personalized results through a user-friendly experience. However, improper integration of these new technologies carries potential risks and could further exacerbate the risks posed by illicit online pharmacies by inadvertently directing users to illegal vendors. OBJECTIVE The role of generative AI integration in reshaping search engine results, particularly related to online pharmacies, has not yet been studied. Our objective was to identify, determine the prevalence of, and characterize illegal online pharmacy recommendations within the AI-generated search results and recommendations. METHODS We conducted a comparative assessment of AI-generated recommendations from Google's Search Generative Experience (SGE) and Microsoft Bing's Chat, focusing on popular and well-known medicines representing multiple therapeutic categories including controlled substances. Websites were individually examined to determine legitimacy, and known illegal vendors were identified by cross-referencing with the National Association of Boards of Pharmacy and LegitScript databases. RESULTS Of the 262 websites recommended in the AI-generated search results, 47.33% (124/262) belonged to active online pharmacies, with 31.29% (82/262) leading to legitimate ones. However, 19.04% (24/126) of Bing Chat's and 13.23% (18/136) of Google SGE's recommendations directed users to illegal vendors, including for controlled substances. The proportion of illegal pharmacies varied by drug and search engine. A significant difference was observed in the distribution of illegal websites between search engines. The prevalence of links leading to illegal online pharmacies selling prescription medications was significantly higher (P=.001) in Bing Chat (21/86, 24%) compared to Google SGE (6/92, 6%). Regarding the suggestions for controlled substances, suggestions generated by Google led to a significantly higher number of rogue sellers (12/44, 27%; P=.02) compared to Bing (3/40, 7%). CONCLUSIONS While the integration of generative AI into search engines offers promising potential, it also poses significant risks. This is the first study to shed light on the vulnerabilities within these platforms while highlighting the potential public health implications associated with their inadvertent promotion of illegal pharmacies. We found a concerning proportion of AI-generated recommendations that led to illegal online pharmacies, which could not only potentially increase their traffic but also further exacerbate existing public health risks. Rigorous oversight and proper safeguards are urgently needed in generative search to mitigate consumer risks, making sure to actively guide users to verified pharmacies and prioritize legitimate sources while excluding illegal vendors from recommendations.
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Affiliation(s)
- Amir Reza Ashraf
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Tim Ken Mackey
- Global Health Program, Department of Anthropology, University of California, La Jolla, CA, United States
- Global Health Policy and Data Institute, San Diego, CA, United States
- S-3 Research, San Diego, CA, United States
| | - András Fittler
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
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Cho J, Yoo S, Lee EE, Lee HY. Impact of a Nationwide Medication History Sharing Program on the Care Process and End-User Experience in a Tertiary Teaching Hospital: Cohort Study and Cross-Sectional Study. JMIR Med Inform 2024; 12:e53079. [PMID: 38533775 PMCID: PMC11004625 DOI: 10.2196/53079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 03/28/2024] Open
Abstract
Background Timely and comprehensive collection of a patient's medication history in the emergency department (ED) is crucial for optimizing health care delivery. The implementation of a medication history sharing program, titled "Patient's In-home Medications at a Glance," in a tertiary teaching hospital aimed to efficiently collect and display nationwide medication histories for patients' initial hospital visits. Objective As an evaluation was necessary to provide a balanced picture of the program, we aimed to evaluate both care process outcomes and humanistic outcomes encompassing end-user experience of physicians and pharmacists. Methods We conducted a cohort study and a cross-sectional study to evaluate both outcomes. To evaluate the care process, we measured the time from the first ED assessment to urgent percutaneous coronary intervention (PCI) initiation from electronic health records. To assess end-user experience, we developed a 22-item questionnaire using a 5-point Likert scale, including 5 domains: information quality, system quality, service quality, user satisfaction, and intention to reuse. This questionnaire was validated and distributed to physicians and pharmacists. The Mann-Whiteny U test was used to analyze the PCI initiation time, and structural equation modeling was used to assess factors affecting end-user experience. Results The time from the first ED assessment to urgent PCI initiation at the ED was significantly decreased using the patient medication history program (mean rank 42.14 min vs 28.72 min; Mann-Whitney U=346; P=.03). A total of 112 physicians and pharmacists participated in the survey. Among the 5 domains, "intention to reuse" received the highest score (mean 4.77, SD 0.37), followed by "user satisfaction" (mean 4.56, SD 0.49), while "service quality" received the lowest score (mean 3.87, SD 0.79). "User satisfaction" was significantly associated with "information quality" and "intention to reuse." Conclusions Timely and complete retrieval using a medication history-sharing program led to an improved care process by expediting critical decision-making in the ED, thereby contributing to value-based health care delivery in a real-world setting. The experiences of end users, including physicians and pharmacists, indicated satisfaction with the program regarding information quality and their intention to reuse.
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Affiliation(s)
- Jungwon Cho
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Eunkyung Euni Lee
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Ho-Young Lee
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
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13
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Maxwell E, Moore R, Niendorf K, Field T. Further defining the roles and impact of genetic counselors in the biotechnology and pharmaceutical industry. J Genet Couns 2024. [PMID: 38477026 DOI: 10.1002/jgc4.1861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/15/2023] [Accepted: 12/10/2023] [Indexed: 03/14/2024]
Abstract
As personalized medicine has gained traction, drug development models in the biotechnology and pharmaceutical industry (BPI) have increasingly sought to address medical conditions with a genetic component, creating an opportunity for genetic counselors (GCs) to fill new roles and utilize their unique training to contribute to drug development. Despite the potential for GCs in BPI, literature around the role of GCs in this industry has been limited. Our mixed methods study aimed to assess how the roles of GCs in BPI have evolved since 2016, investigate the value of and opportunity for GCs in this industry, and further characterize their motivation and job satisfaction. Participants were recruited via social media advertising, snowball sampling, and email listservs from the National Society of Genetic Counseling (NSGC), the Canadian Association of Genetic Counselors (CAGC), and the American Board of Genetic Counseling (ABGC). Survey (n = 20) and interview (n = 6) data indicates many aspects of GC roles in BPI are consistent with the 2016 study. However, there is evidence of roles becoming more varied and with increasing recognition of the value of GCs, opportunities for involvement in BPI are growing. Furthermore, combined study data found that GCs are motivated by the flexibility of BPI roles as well as the opportunity to contribute to rare disease treatment development and that they are overall satisfied with most aspects of their jobs. Interview data also found that genetic counseling training has the potential to improve clinical trial design and outcomes by making drug development more patient-centric. Finally, combined study data found that while GCs continue to utilize Accreditation Council of Genetic Counseling (ACGC) practice-based competencies (PBCs), business-related training may benefit GCs seeking to enter BPI. Together, these findings are critical for informing genetic counseling training programs, employers within BPI, and GCs interested in entering these positions.
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Affiliation(s)
- Emily Maxwell
- Genetic Counseling Program, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Fred Hutchinson Cancer Institute, Seattle, Washington, USA
| | - Rebekah Moore
- AstraZeneca Pharmaceuticals, One MedImmune Way, Gaithersburg, Maryland, USA
| | - Kristin Niendorf
- Genetic Counseling Program, Indiana State University, Terre Haute, Indiana, USA
| | - Tessa Field
- Spark Therapeutics, Philadelphia, Pennsylvania, USA
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14
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Mello FV, Marmelo I, Fogaça FHS, Déniz FL, Alonso MB, Maulvault AL, Torres JPM, Marques A, Fernandes JO, Cunha SC. Behavior of diclofenac from contaminated fish after cooking and in vitro digestion. J Sci Food Agric 2024. [PMID: 38437521 DOI: 10.1002/jsfa.13430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/01/2024] [Accepted: 03/05/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Seafood consumers are widely exposed to diclofenac due to the high contamination levels often present in aquatic organisms. It is a potential risk to public health due its endocrine disruptor properties. Limited information is available about diclofenac behavior after food digestion to enable a more realistic scenario of consumer exposure. This study aimed to evaluate cooking effects on diclofenac levels, and determine diclofenac bioaccessibility by an in vitro digestion assay, using commercial fish species (seabass and white mullet) as models. The production of the main metabolite 4'-hydroxydiclofenac was also investigated. Fish hamburgers were spiked at two levels (150 and 1000 ng g-1 ) and submitted to three culinary treatments (roasting, steaming and grilling). RESULTS The loss of water seems to increase the diclofenac levels after cooking, except in seabass with higher levels. The high bioaccessibility of diclofenac (59.1-98.3%) observed in both fish species indicates that consumers' intestines are more susceptible to absorption, which can be worrisome depending on the level of contamination. Contamination levels did not affect the diclofenac bioaccessibility in both species. Seabass, the fattest species, exhibited a higher bioaccessibility of diclofenac compared to white mullet. Overall, cooking decreased diclofenac bioaccessibility by up to 40% in seabass and 25% in white mullet. The main metabolite 4'-hydroxydiclofenac was not detected after cooking or digestion. CONCLUSION Thus, consumption of cooked fish, preferentially grilled seabass and steamed or baked white mullet are more advisable. This study highlights the importance to consider bioaccessibility and cooking in hazard characterization studies. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
- Flávia V Mello
- Laboratory of Radioisotopes Eduardo Penna Franca, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Micropollutants, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Porto, Portugal
- IPMA, Instituto Português do Mar e da Atmosfera, Divisão de Aquacultura e Valorização, I.P, Lisboa, Portugal
| | - Isa Marmelo
- IPMA, Instituto Português do Mar e da Atmosfera, Divisão de Aquacultura e Valorização, I.P, Lisboa, Portugal
- 4UCIBIO-REQUIMTE, Applied Molecular Biosciences Unit, Department of Chemistry, NOVA School of Science and Technology - NOVA University of Lisbon, Caparica, Portugal
- CIIMAR, Universidade do Porto, Porto, Portugal
| | - Fabíola H S Fogaça
- Laboratory of Bioaccessibility, Embrapa Food Agroindustry, Rio de Janeiro, Brazil
| | - Fernando Lafont Déniz
- SCAI, Mass Spectrometry and Chromatography Lab, Campus Universitario de Rabanales. Edificio Ramón y Cajal, Córdoba, Spain
| | - Mariana B Alonso
- Laboratory of Radioisotopes Eduardo Penna Franca, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Luísa Maulvault
- IPMA, Instituto Português do Mar e da Atmosfera, Divisão de Aquacultura e Valorização, I.P, Lisboa, Portugal
- 4UCIBIO-REQUIMTE, Applied Molecular Biosciences Unit, Department of Chemistry, NOVA School of Science and Technology - NOVA University of Lisbon, Caparica, Portugal
| | - João Paulo M Torres
- Laboratory of Radioisotopes Eduardo Penna Franca, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Micropollutants, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antônio Marques
- IPMA, Instituto Português do Mar e da Atmosfera, Divisão de Aquacultura e Valorização, I.P, Lisboa, Portugal
- CIIMAR, Universidade do Porto, Porto, Portugal
| | - José O Fernandes
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Sara C Cunha
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Porto, Portugal
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15
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Jiang Y, Li M, Jiang S, Si L, Gu Y. Patient Welfare Implications of Indication-Specific Value-Based Pricing of Multi-Indication Drugs. Value Health 2024; 27:273-277. [PMID: 38042332 DOI: 10.1016/j.jval.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVES Indication-specific value-based pricing (ISVBP) is a mechanism that allows the prices of multi-indication drugs to vary across indications by aligning the drug prices with value. However, the overall impact of ISVBP on patients across indications is uncertain. This study examines the theoretical welfare effects of ISVBP for multi-indication drugs and compares consumer surplus under ISVBP and single pricing, the latter of which is based on the weighted average value. METHODS We considered a healthcare system with government-negotiated drug prices based on the value of drugs. We assumed a drug with 2 indications and 1 relevant comparator for each indication. The value of the drug was uniformly distributed among the patients of each indication in the base case. We also considered alternative scenarios with exponentially and Pareto distributed drug values. Numerical simulations were conducted to explore potential settings where ISVBP was welfare-improving for patients compared with single pricing. RESULTS The theoretical analysis showed that the consumer surplus change was strictly non-positive from single pricing to ISVBP. Therefore, it was not welfare-improving for patients in the settings of interest. Numerical simulations confirmed this result across various scenarios of value distributions. CONCLUSIONS This study provides insights into the patient welfare implications of ISVBP for multi-indication drugs. We did not identify conditions under which ISVBP can enhance overall patient well-being, suggesting that it should be implemented cautiously. Future research should examine dynamic welfare implications related to innovation incentives because they may significantly affect population health in the future.
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Affiliation(s)
- Yawen Jiang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
| | - Meng Li
- The Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, Boston, MA
| | - Shan Jiang
- Macquarie University Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia
| | - Lei Si
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia; Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Yuanyuan Gu
- Macquarie University Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia.
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16
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Li V, Yap GPA, Ni C. Crystal structure of ( S)-5-(3-acetyl-5-chloro-2-ethoxy-6-fluorophenyl)-2-oxazolidinone. Acta Crystallogr E Crystallogr Commun 2024; 80:375-377. [PMID: 38584728 PMCID: PMC10993593 DOI: 10.1107/s2056989024001920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/27/2024] [Indexed: 04/09/2024]
Abstract
The structure of (S)-5-(3-acetyl-5-chloro-2-ethoxy-6-fluorophenyl)-2-oxazolidinone, C13H13ClFNO4, at 100 K has monoclinic (P21) symmetry. The compound has a polymeric structure propagated by a screw axis parallel to the b axis with N-H⋯O hydrogen bonding. It is of inter-est with respect to efforts in the synthesis of a candidate anti-cancer drug, parsaclisib.
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Affiliation(s)
- Victor Li
- W. M. Keck Center for Advanced Microscopy and Microanalysis, University of Delaware, Newark, DE 19716, USA
| | - Glenn P. A. Yap
- Department of Chemistry and Biochemistry, University of Delaware, Newark, DE 19716, USA
| | - Chaoying Ni
- Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA
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17
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Henary E, Casa S, Dost TL, Sloop JC, Henary M. The Role of Small Molecules Containing Fluorine Atoms in Medicine and Imaging Applications. Pharmaceuticals (Basel) 2024; 17:281. [PMID: 38543068 PMCID: PMC10975950 DOI: 10.3390/ph17030281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/12/2024] [Accepted: 02/17/2024] [Indexed: 04/01/2024] Open
Abstract
The fluorine atom possesses many intrinsic properties that can be beneficial when incorporated into small molecules. These properties include the atom's size, electronegativity, and ability to block metabolic oxidation sites. Substituents that feature fluorine and fluorine-containing groups are currently prevalent in drugs that lower cholesterol, relieve asthma, and treat anxiety disorders, as well as improve the chemical properties of various medications and imaging agents. The dye scaffolds (fluorescein/rhodamine, coumarin, BODIPY, carbocyanine, and squaraine dyes) reported will address the incorporation of the fluorine atom in the scaffold and the contribution it provides to its application as an imaging agent. It is also important to recognize radiolabeled fluorine atoms used for PET imaging in the early detection of diseases. This review will discuss the many benefits of incorporating fluorine atoms into small molecules and give examples of fluorinated molecules used in the pharmaceutical industry and imaging techniques.
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Affiliation(s)
- Emily Henary
- School of Science and Technology, Georgia Gwinnett College, 1000 University Center Lane, Lawrenceville, GA 30043, USA; (E.H.); (J.C.S.)
| | - Stefanie Casa
- Department of Chemistry, Petit Science Center, Georgia State University, 100 Piedmont Avenue SE, Atlanta, GA 30303, USA; (S.C.); (T.L.D.)
| | - Tyler L. Dost
- Department of Chemistry, Petit Science Center, Georgia State University, 100 Piedmont Avenue SE, Atlanta, GA 30303, USA; (S.C.); (T.L.D.)
| | - Joseph C. Sloop
- School of Science and Technology, Georgia Gwinnett College, 1000 University Center Lane, Lawrenceville, GA 30043, USA; (E.H.); (J.C.S.)
| | - Maged Henary
- Department of Chemistry, Petit Science Center, Georgia State University, 100 Piedmont Avenue SE, Atlanta, GA 30303, USA; (S.C.); (T.L.D.)
- Center for Diagnostics and Therapeutics, Georgia State University, 100 Piedmont Avenue SE, Atlanta, GA 30303, USA
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18
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Layer JP, Layer K, Glasmacher AR, Sarria GR, Böhner AMC, Layer YL, Dejonckheere CS, Wiegreffe S, Nour Y, Caglayan L, Grau F, Feyer P, Baumert BG, Baumann R, Krug D, Scafa D, Leitzen C, Landsberg J, Giordano FA, Schmeel LC. Pharmaceutical management of acute radiation dermatitis in the German speaking radiation oncology community. J Dtsch Dermatol Ges 2024; 22:198-207. [PMID: 38092687 DOI: 10.1111/ddg.15279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/20/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Radiation dermatitis (RD) remains the most common side effect in radiation therapy (RT) with various pharmaceutical options available for prevention and treatment. We sought to determine pharmaceutical management patterns of radiation dermatitis among radiation oncology professionals. METHODS We conducted a survey on RD among the German-speaking community of radiation oncologists inquiring for their opinion on preventive and therapeutic pharmaceutical approaches for acute RD. RESULTS 244 health professionals participated. Dexpanthenol lotion is the agent most widely used both for prevention (53.0%) and treatment (76.9%) of RD, followed by urea (29.8%) for prevention and corticosteroids (46.9%) for treatment. A wide range of substances is used by participants, though the overall experience with them is rather limited. 32.5% of participants do generally not recommend any preventative treatment. 53.4% of participants recommend alternative medicine for RD management. While seldomly used, corticosteroids were considered most effective in RD therapy, followed by dexpanthenol and low-level laser therapy. A majority of participants prefers moist over dry treatment of moist desquamation and 43.8% prescribe antiseptics. CONCLUSIONS Pharmaceutical management of RD in the German-speaking radiation oncology community remains controversial, inconsistent, and partially not supported by evidence-based medicine. Stronger evidence level and interdisciplinary consensus is required amongst practitioners to improve these care patterns.
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Affiliation(s)
- Julian P Layer
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
- Institute of Experimental Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Katharina Layer
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Andrea R Glasmacher
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Alexander M C Böhner
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Yonah L Layer
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Cas S Dejonckheere
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Shari Wiegreffe
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Youness Nour
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Lara Caglayan
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Franziska Grau
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Petra Feyer
- Department of Radiation Oncology, Vivantes Hospital Neukölln, Berlin, Germany
| | - Brigitta G Baumert
- Institute of Radiation Oncology, Cantonal Hospital Graubünden, Chur, Switzerland
| | - René Baumann
- Department of Radiation Oncology, St. Marien Hospital Siegen, Siegen, Germany
| | - David Krug
- Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Davide Scafa
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Christina Leitzen
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Jennifer Landsberg
- Department of Dermatology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Frank A Giordano
- Department of Radiation Oncology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany
- DKFZ Hector Cancer Institute, University Medical Center Mannheim, Mannheim, Germany
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19
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Layer JP, Layer K, Glasmacher AR, Sarria GR, Böhner AMC, Layer YL, Dejonckheere CS, Wiegreffe S, Nour Y, Caglayan L, Grau F, Feyer P, Baumert BG, Baumann R, Krug D, Scafa D, Leitzen C, Landsberg J, Giordano FA, Schmeel LC. Pharmazeutische Behandlung der akuten Radiodermatitis in der deutschsprachigen strahlentherapeutischen Gemeinschaft: Pharmaceutical management of acute radiation dermatitis in the German speaking radiation oncology community. J Dtsch Dermatol Ges 2024; 22:198-209. [PMID: 38361198 DOI: 10.1111/ddg.15279_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/20/2023] [Indexed: 02/17/2024]
Abstract
ZusammenfassungHintergrundDie Radiodermatitis (RD) ist die häufigste Nebenwirkung der Strahlentherapie (RT), wobei verschiedene pharmazeutische Optionen zur Vorbeugung/Behandlung zur Verfügung stehen. Unser Ziel war, die pharmazeutischen Behandlungsmuster für die RD unter strahlentherapeutischen Fachleuten zu ermitteln.MethodikWir haben eine Umfrage zum Thema RD in der deutschsprachigen radioonkologischen Gemeinschaft durchgeführt und ihre Meinung zu präventiven und therapeutischen pharmazeutischen Therapieansätzen betreffend die akute RD erfragt.Ergebnisse244 Angehörige zugehöriger Gesundheitsberufe nahmen teil. Dexpanthenol‐Lotion ist das am häufigsten verwendete Mittel sowohl zur Vorbeugung (53%) als auch zur Behandlung (76,9%) der RD, gefolgt von Harnstoff (29,8%) zur Vorbeugung und Kortikosteroiden (46,9%) zur Behandlung. Die Teilnehmer verwenden eine breite Palette an Substanzen, haben aber insgesamt wenig Erfahrung mit diesen. 32,5% der Teilnehmer empfehlen generell keine präventive Behandlung. 53,4% der Teilnehmer empfehlen Alternativmedizin. Obwohl selten eingesetzt, wurden Kortikosteroide als wirksamstes Behandlungsmittel angesehen, gefolgt von Dexpanthenol und Low‐Level‐Lasertherapie. Die Mehrheit der Teilnehmer bevorzugt die feuchte gegenüber der trockenen Behandlung der feuchten Desquamation und 43,8% verschreiben Antiseptika.SchlussfolgerungenDie pharmazeutische Behandlung der RD in der deutschsprachigen strahlentherapeutischen Fachwelt ist nach wie vor umstritten, sowie mitunter inkonsistent und nicht durch evidenzbasierte Medizin gestützt. Ein interdisziplinärer Konsens ist erforderlich, um die bestehenden Behandlungskonzepte zu verbessern.
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Affiliation(s)
- Julian P Layer
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
- Institut für Experimentelle Onkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Katharina Layer
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Andrea R Glasmacher
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Gustavo R Sarria
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Alexander M C Böhner
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Yonah L Layer
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Cas S Dejonckheere
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Shari Wiegreffe
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Youness Nour
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Lara Caglayan
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Franziska Grau
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Petra Feyer
- Abteilung für Strahlenonkologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | | | - René Baumann
- Abteilung für Strahlenonkologie, St. Marien-Krankenhaus Siegen, Siegen, Deutschland
| | - David Krug
- Abteilung für Strahlenonkologie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - Davide Scafa
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Christina Leitzen
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Jennifer Landsberg
- Abteilung für Dermatologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
| | - Frank A Giordano
- Abteilung für Strahlenonkologie, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim, Deutschland
- DKFZ Hector Cancer Institute am Universitätsklinikum Mannheim, Mannheim, Germany
| | - Leonard Christopher Schmeel
- Abteilung für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn, Universität Bonn, Bonn, Deutschland
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Iqbal H, Fernandes Q, Idoudi S, Basineni R, Billa N. Status of Polymer Fused Deposition Modeling (FDM)-Based Three-Dimensional Printing (3DP) in the Pharmaceutical Industry. Polymers (Basel) 2024; 16:386. [PMID: 38337275 DOI: 10.3390/polym16030386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Additive manufacturing (AM) or 3D printing (3DP) is arguably a versatile and more efficient way for the production of solid dosage forms such as tablets. Of the various 3DP technologies currently available, fused deposition modeling (FDM) includes unique characteristics that offer a range of options in the production of various types of tablets. For example, amorphous solid dispersions (ASDs), enteric-coated tablets or poly pills can be produced using an appropriate drug/polymer combination during FDM 3DP. The technology offers the possibility of evolving personalized medicines into cost-effective production schemes at pharmacies and hospital dispensaries. In this review, we highlight key FDM features that may be exploited for the production of tablets and improvement of therapy, with emphasis on gastrointestinal delivery. We also highlight current constraints that must be surmounted to visualize the deployment of this technology in the pharmaceutical and healthcare industries.
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Affiliation(s)
- Heba Iqbal
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Queenie Fernandes
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Sourour Idoudi
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Renuka Basineni
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Nashiru Billa
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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21
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Toure M, Shaffer JG, Sanogo D, Keita S, Keita M, Kane F, Traore B, Dabitao D, Kone A, Doumbia CO, Keating J, Yukich J, Hansson HH, Barry AE, Diakité M, Alifrangis M, Doumbia S. Seasonal Malaria Chemoprevention Therapy in Children Up To 9 Years of Age: Protocol for a Cluster-Randomized Trial Study. JMIR Res Protoc 2024; 13:e51660. [PMID: 38252481 PMCID: PMC10845024 DOI: 10.2196/51660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Seasonal malaria chemoprevention (SMC) is recommended by the World Health Organization for the sub-Sahel region in sub-Saharan Africa for preventing malaria in children 3 months old to younger than 5 years. Since 2016, the Malian National Malaria Control Program has deployed SMC countrywide during its high malaria transmission season at a rate of 4 monthly cycles annually. The standard SMC regimen includes sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ). Resistance against SP is suspected to be rising across West Africa; therefore, assessing the effectiveness of an alternative antimalarial drug for SMC is needed to provide a second-line regimen when it is ultimately needed. It is not well understood whether SMC effectively prevents malaria in children aged 5 years or older. OBJECTIVE The primary goal of the study is to compare 2 SMC regimens (SP-AQ and dihydroartemisinin-piperaquine [DHA-PQ]) in preventing uncomplicated Plasmodium falciparum malaria in children 3 months to 9 years old. Secondly, we will assess the possible use of DHA-PQ as an alternative SMC drug in areas where resistance to SP or AQ may increase following intensive use. METHODS The study design is a 3-arm cluster-randomized design comparing the SP-AQ and DHA-PQ arms in 2 age groups (younger than 5 years and 5-9 years) and a control group for children aged 5-9 years. Standard SMC (SP-AQ) for children younger than 5 years was provided to the control arm, while SMC with SP-AQ was delivered to children aged 3 months to 9 years (arm 2), and SMC with DHA-PQ will be implemented in study arm 3 for children up to 9 years of age. The study was performed in Mali's Koulikoro District, a rural area in southwest Mali with historically high malaria transmission rates. The study's primary outcome is P falciparum incidence for 2 SMC regimens in children up to 9 years of age. Should DHA-PQ provide an acceptable alternative to SP-AQ, a plausible second-line prevention option would be available in the event of SP resistance or drug supply shortages. A significant byproduct of this effort included bolstering district health information systems for rapid identification of severe malaria cases. RESULTS The study began on July 1, 2019. Through November 2022, a total of 4556 children 3 months old to younger than 5 years were enrolled. Data collection ended in spring 2023, and the findings are expected to be published later in early 2024. CONCLUSIONS Routine evaluation of antimalarial drugs is needed to establish appropriate SMC age targets. The study goals here may impact public health policy and provide alternative therapies in the event of drug shortages or resistance. TRIAL REGISTRATION ClinicalTrials.gov NCT04149106, https://clinicaltrials.gov/ct2/show/NCT04149106. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51660.
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Affiliation(s)
- Mahamoudou Toure
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Jeffrey G Shaffer
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Daouda Sanogo
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Soumba Keita
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Moussa Keita
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Fousseyni Kane
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Bourama Traore
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Djeneba Dabitao
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Aissata Kone
- Mali National Malaria Control Program, Bamako, Mali
| | - Cheick Oumar Doumbia
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Joseph Keating
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Joshua Yukich
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Helle H Hansson
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Alyssa E Barry
- Institute for Mental and Physical Health and Clinical Translation (IMPACT) and School of Medicine, Deakin University, Geelong, Melbourne, Australia
- Life Sciences Discipline, Burnet Institute, Melbourne, Australia
| | - Mahamadou Diakité
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
| | - Michael Alifrangis
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Seydou Doumbia
- University Clinical Research Center, Universite des Sciences, des Techniques et des Technologies, Bamako, Mali
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Lau EY, Cragg A, Small SS, Butcher K, Hohl CM. Characterizing and Comparing Adverse Drug Events Documented in 2 Spontaneous Reporting Systems in the Lower Mainland of British Columbia, Canada: Retrospective Observational Study. JMIR Hum Factors 2024; 11:e52495. [PMID: 38236629 PMCID: PMC10835584 DOI: 10.2196/52495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Robust adverse drug event (ADE) reporting systems are crucial to monitor and identify drug safety signals, but the quantity and type of ADEs captured may vary by system characteristics. OBJECTIVE We compared ADEs reported in 2 different reporting systems in the same jurisdictions, the Patient Safety and Learning System-Adverse Drug Reaction (PSLS-ADR) and ActionADE, to understand report variation. METHODS This retrospective observational study analyzed reports entered into PSLS-ADR and ActionADE systems between December 1, 2019, and December 31, 2022. We conducted a comprehensive analysis including all events from both reporting systems to examine coverage and usage and understand the types of events captured in both systems. We calculated descriptive statistics for reporting facility type, patient demographics, serious events, and most reported drugs. We conducted a subanalysis focused on adverse drug reactions to enable direct comparisons between systems in terms of the volume and events reported. We stratified results by reporting system. RESULTS We performed the comprehensive analysis on 3248 ADE reports, of which 12.4% (375/3035) were reported in PSLS-ADR and 87.6% (2660/3035) were reported in ActionADE. Distribution of all events and serious events varied slightly between the 2 systems. Iohexol, gadobutrol, and empagliflozin were the most common culprit drugs (173/375, 46.2%) in PSLS-ADR, while hydrochlorothiazide, apixaban, and ramipril (308/2660, 11.6%) were common in ActionADE. We included 2728 reports in the subanalysis of adverse drug reactions, of which 12.9% (353/2728) were reported in PSLS-ADR and 86.4% (2357/2728) were reported in ActionADE. ActionADE captured 4- to 6-fold more comparable events than PSLS-ADR over this study's period. CONCLUSIONS User-friendly and robust reporting systems are vital for pharmacovigilance and patient safety. This study highlights substantial differences in ADE data that were generated by different reporting systems. Understanding system factors that lead to varying reporting patterns can enhance ADE monitoring and should be taken into account when evaluating drug safety signals.
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Affiliation(s)
- Erica Y Lau
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada
| | - Amber Cragg
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada
| | - Serena S Small
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada
| | - Katherine Butcher
- Pharmaceutical Science, Vancouver General Hospital, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Corinne M Hohl
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
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23
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Dhir R, Chauhan S, Subham P, Kumar S, Sharma P, Shidiki A, Kumar G. Plant-mediated synthesis of silver nanoparticles: unlocking their pharmacological potential-a comprehensive review. Front Bioeng Biotechnol 2024; 11:1324805. [PMID: 38264582 PMCID: PMC10803431 DOI: 10.3389/fbioe.2023.1324805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024] Open
Abstract
In recent times, nanoparticles have experienced a significant upsurge in popularity, primarily owing to their minute size and their remarkable ability to modify physical, chemical, and biological properties. This burgeoning interest can be attributed to the expanding array of biomedical applications where nanoparticles find utility. These nanoparticles, typically ranging in size from 10 to 100 nm, exhibit diverse shapes, such as spherical, discoidal, and cylindrical configurations. These variations are not solely influenced by the manufacturing processes but are also intricately linked to interactions with surrounding stabilizing agents and initiators. Nanoparticles can be synthesized through physical or chemical methods, yet the biological approach emerges as the most sustainable and eco-friendly alternative among the three. Among the various nanoparticle types, silver nanoparticles have emerged as the most encountered and widely utilized due to their exceptional properties. What makes the synthesis of silver nanoparticles even more appealing is the application of plant-derived sources as reducing agents. This approach not only proves to be cost-effective but also significantly reduces the synthesis time. Notably, silver nanoparticles produced through plant-mediated processes have garnered considerable attention in recent years due to their notable medicinal capabilities. This comprehensive review primarily delves into the diverse medicinal attributes of silver nanoparticles synthesized using plant-mediated techniques. Encompassing antimicrobial properties, cytotoxicity, wound healing, larvicidal effects, anti-angiogenesis activity, antioxidant potential, and antiplasmodial activity, the paper extensively covers these multifaceted roles. Additionally, an endeavor is made to provide an elucidated summary of the operational mechanisms underlying the pharmacological actions of silver nanoparticles.
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Affiliation(s)
- Rajan Dhir
- Department of Microbiology, School of Bioengineering and Biosciences, Lovely Professional University, Punjab, India
| | - Sakshi Chauhan
- Department of Microbiology, School of Bioengineering and Biosciences, Lovely Professional University, Punjab, India
| | - Praddiuman Subham
- Department of Microbiology, School of Bioengineering and Biosciences, Lovely Professional University, Punjab, India
| | - Saksham Kumar
- Department of Microbiology, School of Bioengineering and Biosciences, Lovely Professional University, Punjab, India
| | - Pratham Sharma
- Department of Microbiology, School of Bioengineering and Biosciences, Lovely Professional University, Punjab, India
| | - Amrullah Shidiki
- Department of Microbiology, National Medical College and Teaching Hospital, Birgunj, Nepal
| | - Gaurav Kumar
- Department of Microbiology, School of Bioengineering and Biosciences, Lovely Professional University, Punjab, India
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Younis HA, Eisa TAE, Nasser M, Sahib TM, Noor AA, Alyasiri OM, Salisu S, Hayder IM, Younis HA. A Systematic Review and Meta-Analysis of Artificial Intelligence Tools in Medicine and Healthcare: Applications, Considerations, Limitations, Motivation and Challenges. Diagnostics (Basel) 2024; 14:109. [PMID: 38201418 PMCID: PMC10802884 DOI: 10.3390/diagnostics14010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024] Open
Abstract
Artificial intelligence (AI) has emerged as a transformative force in various sectors, including medicine and healthcare. Large language models like ChatGPT showcase AI's potential by generating human-like text through prompts. ChatGPT's adaptability holds promise for reshaping medical practices, improving patient care, and enhancing interactions among healthcare professionals, patients, and data. In pandemic management, ChatGPT rapidly disseminates vital information. It serves as a virtual assistant in surgical consultations, aids dental practices, simplifies medical education, and aids in disease diagnosis. A total of 82 papers were categorised into eight major areas, which are G1: treatment and medicine, G2: buildings and equipment, G3: parts of the human body and areas of the disease, G4: patients, G5: citizens, G6: cellular imaging, radiology, pulse and medical images, G7: doctors and nurses, and G8: tools, devices and administration. Balancing AI's role with human judgment remains a challenge. A systematic literature review using the PRISMA approach explored AI's transformative potential in healthcare, highlighting ChatGPT's versatile applications, limitations, motivation, and challenges. In conclusion, ChatGPT's diverse medical applications demonstrate its potential for innovation, serving as a valuable resource for students, academics, and researchers in healthcare. Additionally, this study serves as a guide, assisting students, academics, and researchers in the field of medicine and healthcare alike.
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Affiliation(s)
- Hussain A. Younis
- College of Education for Women, University of Basrah, Basrah 61004, Iraq
| | | | - Maged Nasser
- Computer & Information Sciences Department, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Malaysia;
| | - Thaeer Mueen Sahib
- Kufa Technical Institute, Al-Furat Al-Awsat Technical University, Kufa 54001, Iraq;
| | - Ameen A. Noor
- Computer Science Department, College of Education, University of Almustansirya, Baghdad 10045, Iraq;
| | | | - Sani Salisu
- Department of Information Technology, Federal University Dutse, Dutse 720101, Nigeria;
| | - Israa M. Hayder
- Qurna Technique Institute, Southern Technical University, Basrah 61016, Iraq;
| | - Hameed AbdulKareem Younis
- Department of Cybersecurity, College of Computer Science and Information Technology, University of Basrah, Basrah 61016, Iraq;
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25
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Fu B, Chen Q, Sleiman M, Ferronato C, Fine L, Meunier F, Ferro Fernandez VR, Valverde JL, Giroir-Fendler A, Wu Y, Wang H, Ma Y, Chovelon JM. Comparative removal of pharmaceuticals in aqueous phase by agricultural waste-based biochars. Water Environ Res 2024; 96:e10967. [PMID: 38154789 DOI: 10.1002/wer.10967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023]
Abstract
The intensification of pharmaceutical use globally has led to an increase in the number of water bodies contaminated by drugs, and an effective strategy must be developed to address this issue. In this work, several biochars produced from Miscanthus straw pellets (MSP550, MSP700) and wheat straw pellets (WSP550, WSP700) at 550 and 700°C, respectively, were selected as adsorbents for removing various pharmaceuticals, such as pemetrexed (PEME), sulfaclozine (SCL), and terbutaline (TBL), from the aqueous phase. The biochar characterizations (physicochemical properties, textural properties, morphological structures, and zeta potentials) and adsorptive conditions (contact times, temperatures, and pH effect) were investigated. The infrared and Raman spectra of biochars before and after pharmaceutical adsorption, as well as quantum chemical computations, were carried out to explore the adsorption mechanisms. The results showed that the general adsorption abilities of biochars for pharmaceuticals were in the order of WSP700 > MSP700 > MSP550 > WSP550. Both the higher drug concentration and higher temperature improved biochar adsorption. By decreasing the pH, the adsorption amounts increased for PEME and SCL. However, TBL exhibited the best adsorption at pH 7, whereas a weakening of affinity occurred at lower or higher pH values. Electrostatic interactions and hydrogen bonding were the main adsorptive mechanisms between all biochars and pharmaceuticals. π-π interactions played a role in the adsorption process of low-temperature-prepared biochars (MSP550 and WSP550). This work can provide new insights into the control of pharmaceuticals from water with low-cost adsorbents. PRACTITIONER POINTS: Use of biochars for pharmaceuticals removal from aqueous phase. Characterization of biochars : physical and chemical properties, textural and surface properties. Simulation calculation for characterization of pharmaceuticals. Kinetic studies of pharmaceuticals adsorption on biochars. DRIFTS and Raman analysis for the understanding of adsorption process.
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Affiliation(s)
- Bomin Fu
- National Observation and Research Station of Coastal Ecological Environments in Macao, Macao Environmental Research Institute, Faculty of Innovation Engineering, Macau University of Science and Technology, Macao SAR, China
- Key Laboratory of Yangtze River Water Environment, Ministry of Education, College of Environmental Science and Engineering, Tongji University, Shanghai, China
- Universite Claude Bernard Lyon 1, IRCELYON UMR 5256 CNRS, Villeurbanne, France
| | - Qizhou Chen
- Key Laboratory for Advanced Materials, School of Chemistry and Molecular Engineering, East China University of Science and Technology, Shanghai, China
| | | | - Corinne Ferronato
- Universite Claude Bernard Lyon 1, IRCELYON UMR 5256 CNRS, Villeurbanne, France
| | - Ludovic Fine
- Universite Claude Bernard Lyon 1, IRCELYON UMR 5256 CNRS, Villeurbanne, France
| | - Frederic Meunier
- Universite Claude Bernard Lyon 1, IRCELYON UMR 5256 CNRS, Villeurbanne, France
| | | | - Jose Luis Valverde
- Department of Chemical Engineering, University of Castilla La Mancha, Ciudad Real, Spain
| | - Anne Giroir-Fendler
- Universite Claude Bernard Lyon 1, IRCELYON UMR 5256 CNRS, Villeurbanne, France
| | - Yang Wu
- National Observation and Research Station of Coastal Ecological Environments in Macao, Macao Environmental Research Institute, Faculty of Innovation Engineering, Macau University of Science and Technology, Macao SAR, China
| | - Hongtao Wang
- Key Laboratory of Yangtze River Water Environment, Ministry of Education, College of Environmental Science and Engineering, Tongji University, Shanghai, China
| | - Yibing Ma
- National Observation and Research Station of Coastal Ecological Environments in Macao, Macao Environmental Research Institute, Faculty of Innovation Engineering, Macau University of Science and Technology, Macao SAR, China
| | - Jean-Marc Chovelon
- Universite Claude Bernard Lyon 1, IRCELYON UMR 5256 CNRS, Villeurbanne, France
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Ersöz S, Nissen A, Schütte R. Risk, Trust, and Emotion in Online Pharmacy Medication Purchases: Multimethod Approach Incorporating Customer Self-Reports, Facial Expressions, and Neural Activation. JMIR Form Res 2023; 7:e48850. [PMID: 38145483 PMCID: PMC10775049 DOI: 10.2196/48850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Online pharmacies are used less than other e-commerce sites in Germany. Shopping behavior does not correspond to consumption behavior, as online purchases are predominantly made for over-the-counter (OTC) medications. OBJECTIVE The objective of this study was to understand the purchasing experiences of online pharmacy customers in terms of critical factors for online pharmacy adoption. METHODS This study examined the perceived risk, perceived trust, and emotions related to purchasing medications online and, consequently, the purchase intention toward online pharmacies. In a within-subjects design (N=37 participants), 2 German online pharmacies with different perceptions of risk and trust were investigated for their main business, namely OTC and prescription drugs. The results of a preliminary study led to 1 online pharmacy with high and 1 with significantly low self-reported risk by the prestudy sample. Emotions were measured with a multimethod approach during and after the purchase situation as follows: (1) neural evaluation processes using functional near-infrared spectroscopy, (2) the automated direct motor response during the use of the online pharmacy via facial expression analysis (FaceReader), and (3) subjective evaluations through self-reports. Following the shopping experiences at both pharmacies for both product types, risk, trust, and purchase intention toward the pharmacies were assessed using self-assessments. RESULTS The 2 online pharmacies were rated differently in terms of risk, trust, emotions, and purchase intention. The high-risk pharmacy was also perceived as having lower trust and vice versa. Significantly stronger negative emotional expressions on customers' faces and different neural activations in the ventromedial prefrontal cortex and dorsomedial prefrontal cortex were measured when purchasing prescription drugs from the high-risk pharmacy than from the low-risk pharmacy, combined with OTC medications. In line with this, customers' self-ratings indicated higher negative emotions for the high-risk pharmacy and lower negative emotions for the low-risk pharmacy. Moreover, the ratings showed lower purchase intention for the high-risk pharmacy. CONCLUSIONS Using multimethod measurements, we showed that the preceding neural activation and subsequent verbal evaluation of online pharmacies are reflected in the customers' immediate emotional facial expressions. High-risk online pharmacies and prescription drugs lead to stronger negative emotional facial expressions and trigger neural evaluation processes that imply perceived loss. Low-risk online pharmacies and OTC medications lead to weaker negative emotional facial expressions and trigger neural evaluation processes that signify certainty and perceived reward. The results may provide an explanation for why OTC medications are purchased online more frequently than prescription medications.
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Affiliation(s)
- Semra Ersöz
- Institute for Marketing and Retail, Faculty of Economic Sciences, University of Duisburg-Essen, Essen, Germany
| | - Anika Nissen
- Institute for Business Administration, Faculty of Economic Sciences, University of Hagen, Hagen, Germany
| | - Reinhard Schütte
- Institute for Computer Science and Business Information Systems, Faculty of Economic Sciences, University of Duisburg-Essen, Essen, Germany
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Holmfred E, Hirschberg C, Rantanen J. Compaction Properties of Particulate Proteins in Binary Powder Mixtures with Common Excipients. Pharmaceutics 2023; 16:19. [PMID: 38258030 PMCID: PMC10819481 DOI: 10.3390/pharmaceutics16010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/09/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
The increasing interest in protein- and peptide-based oral pharmaceuticals has culminated in the first protein-based products for oral delivery becoming commercially available. This study investigates the compaction properties of proteins in binary mixtures with common excipients up to 30% (w/w) of particulate protein. Two model proteins, lysozyme and bovine serum albumin, were compacted with either microcrystalline cellulose, spray-dried lactose monohydrate, or calcium hydrogen phosphate dihydrate at two different compaction pressures. Compared to the compacted pure materials, a significant increase in the tensile strength of the compacts was observed for the binary blends containing lysozyme together with the brittle excipients. This could be attributed to the increased bonding forces between the particles in the blend compared to the pure materials. The use of bovine serum albumin with a larger particle size resulted in a decrease in tensile strength for all the compacts. The change in the tensile strength with an increasing protein content was non-linear for both proteins. This work highlights the importance of considering the particulate properties of protein powders and that protein-based compacts can be designed with similar principles as small-molecules in terms of their mechanical tablet properties.
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Affiliation(s)
| | | | - Jukka Rantanen
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
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Henley P, Martins T, Zamani R. Assessing Ethnic Minority Representation in Fibromyalgia Clinical Trials: A Systematic Review of Recruitment Demographics. Int J Environ Res Public Health 2023; 20:7185. [PMID: 38131736 PMCID: PMC10742509 DOI: 10.3390/ijerph20247185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The under-representation of non-White participants in Western countries in clinical research has received increased attention, due to recognized physiological differences between ethnic groups, which may affect the efficacy and optimal dosage of some treatments. This review assessed ethnic diversity in pharmaceutical trials for fibromyalgia, a poorly understood chronic pain disorder. We also investigated longitudinal change to non-White participant proportions in trials and non-White participants' likelihood to discontinue with fibromyalgia research between trial stages (retention). First, we identified relevant trials conducted in the United States and Canada between 2000 and 2022, by searching PubMed, Web of Science, Scopus, and the Cochrane Library databases. In trials conducted both across the United States and Canada, and exclusively within the United States, approximately 90% of participants were White. A longitudinal analysis also found no change in the proportion of non-White participants in trials conducted across the United States and Canada between 2000 and 2022. Finally, we found no significant differences in trial retention between White and non-White participants. This review highlights the low numbers of ethnic minorities in fibromyalgia trials conducted in the United States and Canada, with no change to these proportions over the past 22 years. Furthermore, non-White participants were not more likely to discontinue with the fibromyalgia research once they were recruited.
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Affiliation(s)
| | | | - Reza Zamani
- Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 2LU, UK (T.M.)
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Ben-Aharon I, Rotem R, Melzer-Cohen C, Twig G, Cercek A, Half E, Goshen-Lago T, Chodik G, Kelsen D. Pharmaceutical Agents as Potential Drivers in the Development of Early-Onset Colorectal Cancer: Case-Control Study. JMIR Public Health Surveill 2023; 9:e50110. [PMID: 37933755 PMCID: PMC10753427 DOI: 10.2196/50110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/08/2023] [Accepted: 11/07/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The incidence of early-onset colorectal cancer (EOCRC) rose abruptly in the mid 1990s, is continuing to increase, and has now been noted in many countries. By 2030, 25% of American patients diagnosed with rectal cancer will be 49 years or younger. The large majority of EOCRC cases are not found in patients with germline cancer susceptibility mutations (eg, Lynch syndrome) or inflammatory bowel disease. Thus, environmental or lifestyle factors are suspected drivers. Obesity, sedentary lifestyle, diabetes mellitus, smoking, alcohol, or antibiotics affecting the gut microbiome have been proposed. However, these factors, which have been present since the 1950s, have not yet been conclusively linked to the abrupt increase in EOCRC. The sharp increase suggests the introduction of a new risk factor for young people. We hypothesized that the driver may be an off-target effect of a pharmaceutical agent (ie, one requiring regulatory approval before its use in the general population or an off-label use of a previously approved agent) in a genetically susceptible subgroup of young adults. If a pharmaceutical agent is an EOCRC driving factor, regulatory risk mitigation strategies could be used. OBJECTIVE We aimed to evaluate the possibility that pharmaceutical agents serve as risk factors for EOCRC. METHODS We conducted a case-control study. Data including demographics, comorbidities, and complete medication dispensing history were obtained from the electronic medical records database of Maccabi Healthcare Services, a state-mandated health provider covering 26% of the Israeli population. The participants included 941 patients with EOCRC (≤50 years of age) diagnosed during 2001-2019 who were density matched at a ratio of 1:10 with 9410 control patients. Patients with inflammatory bowel disease and those with a known inherited cancer susceptibility syndrome were excluded. An advanced machine learning algorithm based on gradient boosted decision trees coupled with Bayesian model optimization and repeated data sampling was used to sort through the very high-dimensional drug dispensing data to identify specific medication groups that were consistently linked with EOCRC while allowing for synergistic or antagonistic interactions between medications. Odds ratios for the identified medication classes were obtained from a conditional logistic regression model. RESULTS Out of more than 800 medication classes, we identified several classes that were consistently associated with EOCRC risk across independently trained models. Interactions between medication groups did not seem to substantially affect the risk. In our analysis, drug groups that were consistently positively associated with EOCRC included beta blockers and valerian (Valeriana officinalis). Antibiotics were not consistently associated with EOCRC risk. CONCLUSIONS Our analysis suggests that the development of EOCRC may be correlated with prior use of specific medications. Additional analyses should be used to validate the results. The mechanism of action inducing EOCRC by candidate pharmaceutical agents will then need to be determined.
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Affiliation(s)
- Irit Ben-Aharon
- Department of Gastroenterology, Rambam Healthcare Campus, Haifa, Israel
| | - Ran Rotem
- Harvard T Chan School of Public Health, Boston, MA, United States
| | - Cheli Melzer-Cohen
- KSM Research and Innovation Center, Maccabi Healthcare Services, Tel-Aviv, Israel
| | - Gilad Twig
- The Institute of Endocrinology Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Department of Preventive Medicine and Epidemiology, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Andrea Cercek
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Elizabeth Half
- Department of Gastroenterology, Rambam Healthcare Campus, Haifa, Israel
| | - Tal Goshen-Lago
- Department of Gastroenterology, Rambam Healthcare Campus, Haifa, Israel
| | - Gabriel Chodik
- Department of Preventive Medicine and Epidemiology, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Kelsen
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
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Lichtenberg FR. The Relationship Between Pharmaceutical Innovation and Cancer Mortality in Spain, From 1999 to 2016. Value Health 2023; 26:1711-1720. [PMID: 37741448 DOI: 10.1016/j.jval.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES To investigate the relationship across cancer sites between pharmaceutical innovation and changes in cancer mortality in Spain during the period between 1999 and 2016. METHODS I investigated whether the cancer sites for which more new drugs were authorized had larger reductions in mortality from 1999 to 2016 in Spain, controlling for the lagged change in cancer incidence. The principal measure of pharmaceutical innovation is the long-run change in the mean vintage (year of initial authorization in Spain) of the drugs for the treatment of a cancer previously authorized in Spain. RESULTS The 1999 to 2016 increase in mean age at death tended to be larger, and the 1999 to 2016 increase in the number of deaths and life-years lost before the ages 65 years, 75 years, and 85 years tended to be smaller for cancer sites that had larger current or lagged increases in drug vintage. Pharmaceutical innovation was associated with a 2.77-year increase in mean age at death from cancer from 1999 to 2016-96% of the observed increase. New drug authorization during the previous 17 years were associated with a reduction in the number of life-years lost before the age of 75 years in 2016 of 333 000. Under the assumption that the association between pharmaceutical innovation and mortality reduction is causal, estimated drug expenditure per life year before the age of 75 years gained in 2016 from new cancer drugs that were authorized between 2000 and 2016 was €3269. CONCLUSIONS The cancer sites for which there were more pharmaceutical innovation-more new drugs authorized-had larger 1999 to 2016 reductions in mortality in Spain, controlling for the lagged change in cancer incidence.
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Affiliation(s)
- Frank R Lichtenberg
- Columbia University, New York, NY, USA; National Bureau of Economic Research, Cambridge, MA, USA; CESifo, Munich, Germany.
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31
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Giffen PS, Buckley LA, Pinkstaff J. Pharmaceutical Industry Perspective on the Non-Clinical Evaluation of Novel Excipients: Results From an Industry Survey Conducted by the IQ Novel Excipient Working Group. Int J Toxicol 2023; 42:480-488. [PMID: 37450849 DOI: 10.1177/10915818231189703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Excipients are essential components within drug products that contribute significantly to their overall quality, effectiveness, and safety. There is a lack of global, harmonized guidance relating to the non-clinical testing of novel excipients which is perceived to create uncertainty and strategic risk, potentially hindering innovation and disincentivizing their use. To test these perceptions, the IQ Novel Excipient Working Group surveyed member companies regarding their main concerns and prior experience regarding the non-clinical evaluation of excipients. Of the 19 respondents, 13 provided, collectively, 33 non-clinical program examples supporting the development of novel excipients. Programs were distributed across a range of therapeutic areas and included a variety of drug modalities and administration routes. Package designs were variable, but where possible, employed the use of existing data, supplemented with new toxicology studies as appropriate. Of the programs which had submitted data to regional health authorities, only three received feedback requesting additional studies or that demonstrated differences in regional opinion. In addition, companies provided recommendations on how the current (or new) guidance related to non-clinical excipient evaluation (and other areas, such as Chemistry, Manufacturing, and Controls and databases) may be improved.
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Affiliation(s)
- Paul S Giffen
- Clinical Pharmacology and Safety Sciences, AstraZeneca Pharmaceuticals, Cambridge, UK
| | - Lorrene A Buckley
- Toxicology and Drug Disposition, Lilly Corporate Center, Eli Lilly and Co. Inc, Indianapolis, IN, USA
| | - Jason Pinkstaff
- Drug Safety Research and Development, Pfizer, Inc, La Jolla, CA, USA
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Cowans C, Love A, Tangiisuran B, Jacob SA. Uncovering the Hidden Burden of Pharmaceutical Poisoning in High-Income and Low-Middle-Income Countries: A Scoping Review. Pharmacy (Basel) 2023; 11:184. [PMID: 38133459 PMCID: PMC10747954 DOI: 10.3390/pharmacy11060184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/28/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Pharmaceutical poisoning is a significant global public health concern, causing approximately 190,000 deaths annually. This scoping review aims to comprehensively map the available literature on pharmaceutical poisoning and compare patterns between high-income countries (HICs) and low-middle-income countries (LMICs). A systematic search was performed across the following databases: Embase, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL. Studies included were from 1 January 2011 to 31 December 2020, in English, with full text available. Seventy-nine articles were included in the study; 21 were from LMICs and 58 were from HICs. Toxic exposure was largely intentional (77%) in LMICs and accidental (68%) in HICs. Drugs acting on the nervous system were responsible for 95% of toxicities worldwide with analgesics accounting for the largest subtherapeutic group in both LMICs (40%) and HICs (58%). Notable statistics were that HICs accounted for 99% of opioid overdoses, and LMICs accounted for 19% of anti-epileptic-induced toxicities. Overall, the medical outcomes due to poisonings were generally worse in LMICs. The review provides possible interventions to target specific geographic locations, based on the trends identified, to reduce the burden worldwide. Many gaps within the literature were recognised, calling for more robust analytical research.
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Affiliation(s)
- Claire Cowans
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
| | - Anya Love
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
| | - Balamurugan Tangiisuran
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia;
| | - Sabrina Anne Jacob
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor, Malaysia
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R G, M PE, A RK, S S, Krishna KR. Natural colour extraction from horticultural crops, advancements, and applications-a review. Nat Prod Res 2023:1-19. [PMID: 37977854 DOI: 10.1080/14786419.2023.2280796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
The scope for natural colours is increasing because of the awareness of allergic, toxic, and hazardous reactions associated with synthetic dyes. Natural colours are extracted from sources that are naturally available, such as flora, fauna, and minerals. Nature sourced us multiple possibilities of colours with varied shades and hues that are subtle and harmonious when combined. Reasons like the instability of natural colours during industrial processing, seasonal availability of raw materials, fading of colour over time, cost of the benefit, and struggles in attaining sustainability have reduced commercialisation success as synthetic colours. Some plants that yield natural colours are also included in crop rotation practice. Natural dye extraction is a source of employment for the countrified subdivisions of poor developing countries. Indigenous technologies on natural colour extraction are available and have been practiced over the years; due to a lack of documentation and information on colour-yielding plants or products from horticultural crops, and their extraction methods, the use of natural colours is diminishing day by day. Even in recent years, emerging techniques have been adopted in research and development, and the information has not been brought together for the use of industries and allied sectors. Several modern approaches, such as Ultrasonication, microwave, enzymatic, supercritical, pressurised liquid extraction, etc., have proven to give better results in extracting natural colours. Thereby, having instantaneous information will help to go green, be eco-friendly, and effectively utilise all the resources without compromising industrial benefits. Reviewing the availability of natural colours from horticultural crops, classifications, recent trends in their extraction process, and applications in various fields will help achieve the above.
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Affiliation(s)
- Gokiladevi R
- Department of Horticulture, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - P Ellampirai M
- Department of Horticulture, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Ramesh Kumar A
- Department of Horticulture, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Srivignesh S
- Department of Horticulture, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - K Rama Krishna
- Department of Horticulture, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
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Ando N, Mizushima D, Shimizu Y, Uemura Y, Takano M, Mitobe M, Kobayashi K, Kubota H, Miyake H, Suzuki J, Sadamasu K, Nakamoto T, Aoki T, Watanabe K, Oka S, Gatanaga H. Sitafloxacin- Versus Moxifloxacin-Based Sequential Treatment for Mycoplasma Genitalium Infections: Protocol for a Multicenter, Open-Label Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e52565. [PMID: 37962941 PMCID: PMC10685287 DOI: 10.2196/52565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Mycoplasma genitalium is an emerging sexually transmitted pathogen associated with increasing antibiotic resistance. The current treatment guidelines recommend moxifloxacin-sequential therapy for macrolide-resistant Mgenitalium or strains with unknown resistance profiles. However, it is unclear whether sitafloxacin, a 4th-generation fluoroquinolone antibiotic, is effective against resistant strains. OBJECTIVE This study aims to assess and compare the efficacy and safety of sitafloxacin- and moxifloxacin-based treatment regimens for managing Mgenitalium infections. METHODS We will conduct this randomized controlled trial at multiple centers in Japan. Eligible participants include adults aged 18 years or older with a confirmed Mgenitalium infection, as determined through the nucleic acid amplification test. Patients will be randomly assigned using a stratified approach based on the treatment facility and infection site. The interventions comprise oral sitafloxacin (200 mg) daily for 7 days (with optional pretreatment of oral doxycycline, 200 mg, daily for up to 7 days), with a control group receiving oral doxycycline (200 mg) daily for 7 days followed by moxifloxacin (400 mg) daily for another 7 days. The primary outcome is the treatment success rate with a superiority margin of 10%, as confirmed through the nucleic acid amplification test. Secondary outcomes encompass changes in the bacterial load at the urogenital or rectal sites and the emergence of posttreatment-resistant mutant strains. RESULTS Enrollment commenced in June 2023 and will conclude in December 2024, with findings anticipated by 2025. The expected success rates fall within the range of 80% for sitafloxacin and 42% for moxifloxacin against Mgenitalium carrying the G248T (S83I) mutation, based on previous studies. Accordingly, with a 5% significance level (2-sided) and 80% statistical power, we aim to recruit 50 participants per group, factoring in a 10% expected dropout rate. CONCLUSIONS This study will provide valuable insights into the efficacy and safety of sitafloxacin- versus moxifloxacin-based sequential therapy in treating Mgenitalium infections. These findings have the potential to influence clinical guidelines, favoring more effective therapeutic choices. The multicenter approach enhances the robustness of this study. However, a limitation is the potential insufficiency of statistical power to detect posttreatment-resistant mutant strains in each group, rendering posttreatment-resistance mutations a notable concern. In the future, we may need to increase the sample size to enhance power. TRIAL REGISTRATION Japan Registry of Clinical Trials (jRCTs031230111); https://jrct.niph.go.jp/en-latest-detail/jRCTs031230111. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52565.
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Affiliation(s)
- Naokatsu Ando
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daisuke Mizushima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yosuke Shimizu
- Biostatistics Section, Department of Data Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukari Uemura
- Biostatistics Section, Department of Data Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Misao Takano
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Morika Mitobe
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Kai Kobayashi
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Hiroaki Kubota
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Hirofumi Miyake
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Jun Suzuki
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Kenji Sadamasu
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Takato Nakamoto
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takahiro Aoki
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koji Watanabe
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
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Villafaña-Diaz L, Perez-Garcia JC, Barron-Villaverde D, Perez-Santos M. Patenting trends by Mexican pharmaceutical companies. Pharm Pat Anal 2023; 12:275-286. [PMID: 38197381 DOI: 10.4155/ppa-2023-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Aim: the activity of patent claims by Mexican pharmaceutical companies is unknown. Objective: analyse the trend in patents of Mexican pharmaceutical companies. Method: a search for patents was carried out in the patent database of the Mexican Institute of Industrial Property, using the list of Mexican pharmaceutical companies belonging to the Mexican Association of Pharmaceutical Research Industries, and the codes A61K, A61P and C07 of the International Patent Classification. Results: the leading companies in patent applications were Liomont, Senosiain and RIMSA; however, Mexican pharmaceutical companies claim very few patents, only 266 patent applications in the period 2000-2020, with a technological factor with a value of zero, and a commercial factor of little value. Conclusion: Mexican pharmaceutical companies lack a robust patent system, without growth, and with a low percentage of patents with high commercial value.
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Affiliation(s)
- Luis Villafaña-Diaz
- Posgrado en Planeación Estratégica y Dirección Tecnológica, Universidad Popular Autónoma del Estado de Puebla, Puebla, CP, 72410, México
| | - Juan C Perez-Garcia
- Posgrado en Planeación Estratégica y Dirección Tecnológica, Universidad Popular Autónoma del Estado de Puebla, Puebla, CP, 72410, México
| | - Diana Barron-Villaverde
- Posgrado en Planeación Estratégica y Dirección Tecnológica, Universidad Popular Autónoma del Estado de Puebla, Puebla, CP, 72410, México
| | - Martin Perez-Santos
- Dirección de Innovación y Transferencia de Conocimiento, Benemérita Universidad Autónoma de Puebla, Puebla, CP, 72570, México
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36
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Song K, Yu M, McLuckie R, O'Brien K, Harrison M, Nguyen V, Kraft M, Abdelghany O, Phillips MS, Roberts J, Johnston S, Young CA, Redic KA. Development of complexity categories for an investigational drug services complexity scoring tool to assess pharmacy effort in clinical trial initiation and maintenance. Am J Health Syst Pharm 2023; 80:1557-1563. [PMID: 37335865 DOI: 10.1093/ajhp/zxad138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE Research pharmacy effort required to safely and compliantly manage investigational products (IP) varies between studies. No validated tool exists in the United States to evaluate these differences in effort. The Vizient Pharmacy Research Committee Investigational Drug Services (IDS) Subcommittee previously developed a systematic complexity scoring tool (CST) through expert consensus to assign a complexity score for pharmacy effort. This project seeks to develop and validate complexity categories based on CST scores. METHODS Vizient member institutions in IDS assigned a CST complexity score and a perceived complexity category (low, medium, or high) for study initiation and maintenance. Receiver operating characteristic (ROC) curve analysis defined the best CST score cutoff points for each complexity category. Comparing the CST-assigned to the user-perceived complexity category determined whether the CST-assigned complexity category aligned with practitioner assignment. RESULTS A total of 322 responses were used to determine complexity score categories. The AUC values for study initiation and maintenance were 0.79 (P < 0.001) for the low/medium boundary and 0.80 (P < 0.001) for the medium/high boundary, suggesting the performance of the CST is good. The agreement between CST-assigned and user-perceived complexity categories was 60% for study initiation and 58% for maintenance. The Kendall rank correlation coefficient between the raters and ROC categories was strong, with a value of 0.48 for study initiation and 0.47 for maintenance. CONCLUSION Development of the CST allows IDS pharmacies to objectively measure the complexity of clinical trials, which is a significant step towards assessing workload and guiding resource allocation.
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Affiliation(s)
- Kangwon Song
- Augusta University Medical Center, Augusta, GA, USA
| | - Michelle Yu
- UW Health - University Hospital, Madison, WI, USA
| | | | | | | | - Victor Nguyen
- University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Michael Kraft
- University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
| | | | | | - Jennifer Roberts
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Saba L, Maindarkar M, Khanna NN, Johri AM, Mantella L, Laird JR, Paraskevas KI, Ruzsa Z, Kalra MK, Fernandes JFE, Chaturvedi S, Nicolaides A, Rathore V, Singh N, Fouda MM, Isenovic ER, Al-Maini M, Viswanathan V, Suri JS. A Pharmaceutical Paradigm for Cardiovascular Composite Risk Assessment Using Novel Radiogenomics Risk Predictors in Precision Explainable Artificial Intelligence Framework: Clinical Trial Tool. FRONT BIOSCI-LANDMRK 2023; 28:248. [PMID: 37919080 DOI: 10.31083/j.fbl2810248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/02/2023] [Accepted: 08/28/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is challenging to diagnose and treat since symptoms appear late during the progression of atherosclerosis. Conventional risk factors alone are not always sufficient to properly categorize at-risk patients, and clinical risk scores are inadequate in predicting cardiac events. Integrating genomic-based biomarkers (GBBM) found in plasma/serum samples with novel non-invasive radiomics-based biomarkers (RBBM) such as plaque area, plaque burden, and maximum plaque height can improve composite CVD risk prediction in the pharmaceutical paradigm. These biomarkers consider several pathways involved in the pathophysiology of atherosclerosis disease leading to CVD. OBJECTIVE This review proposes two hypotheses: (i) The composite biomarkers are strongly correlated and can be used to detect the severity of CVD/Stroke precisely, and (ii) an explainable artificial intelligence (XAI)-based composite risk CVD/Stroke model with survival analysis using deep learning (DL) can predict in preventive, precision, and personalized (aiP3) framework benefiting the pharmaceutical paradigm. METHOD The PRISMA search technique resulted in 214 studies assessing composite biomarkers using radiogenomics for CVD/Stroke. The study presents a XAI model using AtheroEdgeTM 4.0 to determine the risk of CVD/Stroke in the pharmaceutical framework using the radiogenomics biomarkers. CONCLUSIONS Our observations suggest that the composite CVD risk biomarkers using radiogenomics provide a new dimension to CVD/Stroke risk assessment. The proposed review suggests a unique, unbiased, and XAI model based on AtheroEdgeTM 4.0 that can predict the composite risk of CVD/Stroke using radiogenomics in the pharmaceutical paradigm.
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Affiliation(s)
- Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria, 40138 Cagliari, Italy
| | - Mahesh Maindarkar
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
- School of Bioengineering Research and Sciences, Maharashtra Institute of Technology's Art, Design and Technology University, 412021 Pune, India
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, 110001 New Delhi, India
| | - Amer M Johri
- Department of Medicine, Division of Cardiology, Queen's University, Kingston, ON K7L 1C2, Canada
| | - Laura Mantella
- Department of Medicine, Division of Cardiology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA 94574, USA
| | - Kosmas I Paraskevas
- Department of Vascular Surgery, Central Clinic of Athens, 11526 Athens, Greece
| | - Zoltan Ruzsa
- Invasive Cardiology Division, University of Szeged, 6725 Szeged, Hungary
| | - Manudeep K Kalra
- Department of Radiology, Harvard Medical School, Boston, MA 02118, USA
| | | | - Seemant Chaturvedi
- Department of Neurology & Stroke Program, University of Maryland, Baltimore, MD 21201, USA
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre and University of Nicosia Medical School, 2368 Agios Dometios, Cyprus
| | - Vijay Rathore
- Nephrology Department, Kaiser Permanente, Sacramento, CA 95823, USA
| | - Narpinder Singh
- Department of Food Science and Technology, Graphic Era Deemed to be University, Dehradun, 248002 Uttarakhand, India
| | - Mostafa M Fouda
- Department of Electrical and Computer Engineering, Idaho State University, Pocatello, ID 83209, USA
| | - Esma R Isenovic
- Department of Radiobiology and Molecular Genetics, National Institute of The Republic of Serbia, University of Belgrade, 11001 Belgrade, Serbia
| | - Mustafa Al-Maini
- Allergy, Clinical Immunology and Rheumatology Institute, Toronto, ON L4Z 4C4, Canada
| | | | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
- Department of Computer Engineering, Graphic Era Deemed to be University, 248002 Dehradun, India
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Hughes H, Leane M, Wray PS, Tobyn M. Non-contact Laser Interferometer Method to Characterize Tablet Punches: New Methodology to Assess Surface Roughness. AAPS PharmSciTech 2023; 24:209. [PMID: 37817056 DOI: 10.1208/s12249-023-02664-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/20/2023] [Indexed: 10/12/2023] Open
Abstract
Sticking to tablet punches is a major issue during drug product manufacturing. Research has shown that sticking involves the interrelationship of powder properties, compression force, length of manufacturing runs and punch quality. Here, we present a novel non-destructive methodology to study the surface metrology of punches to monitor them over their lifetime. This investigation used a non-contact laser interferometer to characterise roughness of commercial standard S7 steel punches coated with chrome that were originally used for commercial scale production that developed a sticking issue. During the development, this phenomenon had not been observed and was not considered a scale-up risk. The profilometer was used to examine the complete surface of these punches to investigate whether they met the acceptability criteria based on BS_ISO_18804 tooling standard. To improve data analysis during changeover, a 3D-printed holder was designed to enable analysis with minimal set-up requirements. Upon investigation, the punches were found to be of an unacceptable roughness and, particularly rough areas of the punch surface profiled, correlated well with areas of visually pronounced sticking. This non-destructive method can be used to produce a more detailed characterisation of punch roughness to ensure surfaces are of an acceptable quality after treatment with coatings.
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Affiliation(s)
- Helen Hughes
- Drug Product Development, Bristol Myers Squibb, Reeds Lane, Moreton, CH46 1QW, United Kingdom.
| | - Michael Leane
- Drug Product Development, Bristol Myers Squibb, Reeds Lane, Moreton, CH46 1QW, United Kingdom
| | - Patrick S Wray
- Drug Product Development, Bristol Myers Squibb, Reeds Lane, Moreton, CH46 1QW, United Kingdom
| | - Mike Tobyn
- Drug Product Development, Bristol Myers Squibb, Reeds Lane, Moreton, CH46 1QW, United Kingdom
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Briggs LG, Uppal N, Langbein B, Bhojani N, Kathrins M, Trinh QD. Venture capital investment in urology, 2011 to mid-2021. Can J Urol 2023; 30:11659-11667. [PMID: 37838992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
INTRODUCTION To characterize venture capital (VC) investments in urology in the past decade that represent promising innovations in early-stage companies. MATERIALS AND METHODS A retrospective analysis of deals made between VC investors and urologic companies from January 1, 2011, through June 28, 2021, was conducted by using a financial database (PitchBook Platform, PitchBook Data Inc). Data on urologic company and investor names; company information and funding categories (surgical device, therapeutic device, drug discovery/pharmaceutical, and health care technology companies); and deal sizes (in US dollars) and dates were abstracted and aggregated. Descriptive and linear regression analyses were conducted. RESULTS Urology-related VC funding fluctuated from 2011 through mid-2021, but no substantial change was observed in funding over time. In total, 191 distinct deals were made involving urologic companies, totaling $1.1 billion. The four largest funding categories together accounted for $848 million and comprised therapeutic devices ($373 million), surgical devices ($187 million), drug discovery/pharmaceuticals ($185 million), and health care technology ($102 million). At least $450 million (41% of total investments) was invested in companies developing minimally invasive surgical devices. CONCLUSIONS Urologic VC investments did not increase in the past decade and were allocated more toward devices than pharmaceuticals or health care technology. Given relative patterns within urology, VC investments may shift toward health care technology and away from pharmaceuticals but remain stable for devices. Further investments in promising technologies may help urologists more effectively manage urologic disease while optimizing outcomes.
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Affiliation(s)
- Logan G Briggs
- Department of Urology, Mayo Clinic, Phoenix, Arizona, USA
| | - Nishant Uppal
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Björn Langbein
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Naeem Bhojani
- Department of Surgery, University of Montreal, Montreal, Quebec, Canada
| | - Martin Kathrins
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Quoc-Dien Trinh
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Forster SP, Dippold E, Haser A, Emanuele D, Meier R. Integrated Continuous Wet Granulation and Drying: Process Evaluation and Comparison with Batch Processing. Pharmaceutics 2023; 15:2317. [PMID: 37765286 PMCID: PMC10537298 DOI: 10.3390/pharmaceutics15092317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The pharmaceutical industry is in the midst of a transition from traditional batch processes to continuous manufacturing. However, the challenges in making this transition vary depending on the selected manufacturing process. Compared with other oral solid dosage processes, wet granulation has been challenging to move towards continuous processing since traditional equipment has been predominantly strictly batch, instead of readily adapted to material flow such as dry granulation or tablet compression, and there have been few equipment options for continuous granule drying. Recently, pilot and commercial scale equipment combining a twin-screw wet granulator and a novel horizontal vibratory fluid-bed dryer have been developed. This study describes the process space of that equipment and compares the granules produced with batch high-shear and fluid-bed wet granulation processes. The results of this evaluation demonstrate that the equipment works across a range of formulations, effectively granulates and dries, and produces granules of similar or improved quality to batch wet granulation and drying.
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Affiliation(s)
| | | | - Abbe Haser
- Organon & Co., Inc., Jersey City, NJ 07302, USA
| | - Daniel Emanuele
- L.B. Bohle Maschinen und Verfahren GmbH, 59320 Ennigerloh, Germany
| | - Robin Meier
- L.B. Bohle Maschinen und Verfahren GmbH, 59320 Ennigerloh, Germany
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Abraham O, Nixon GA, Seitz LL. Parents' Perceptions of a Serious Game for Educating Families on Prescription Opioid Safety: Qualitative Pilot Study of MedSMARxT: Adventures in PharmaCity. JMIR Serious Games 2023; 11:e49382. [PMID: 37698899 PMCID: PMC10523225 DOI: 10.2196/49382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/25/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Opioid misuse is a pervasive, worsening problem that affects the health of people throughout the United States, including adolescents. There are few adolescent-focused interventions designed to educate them about opioid medication safety. The MedSMARxT: Adventures in PharmaCity, is a serious educational video game that teaches parents and their youths about safe opioid practices. OBJECTIVE This study aimed to elucidate parent's perceptions of MedSMARxT: Adventures in PharmaCity and its potential use by parents and their adolescents. METHODS Parents of adolescents aged 12 to 18 years who live in the United States were recruited from April to October 2021 via Qualtrics research panels, social media, email listserves, and snowball sampling. The study participants played MedSMARxT: Adventures in PharmaCity for 30 minutes and then participated in a 30-minute postgame interview via WebEx (Cisco). Questions were developed and piloted to examine adults' perceptions of the game. Participants were asked three sets of open-ended questions: (1) questions about the game and elements of the game, (2) what they learned from the game, and (3) questions about their experience with games. Audio recordings were transcribed verbatim. Interview transcripts were coded using content and thematic analysis by study team members to identify major themes and subthemes from the data. RESULTS Parent participants (N=67) played MedSMARxT: Adventures in PharmaCity and completed a postgame interview. Analysis extrapolated four primary themes from the data: (1) participant gaming experience, (2) perception of game features, (3) educational purpose of the game, and (4) future use of the game. Most participants (n=56, 84%), had at least some experience with video games. More than half of the participants (n=35, 52%) participants, had positive reactions to the game characters and scenes depicted in MedSMARxT: Adventures in PharmaCity and stated they were realistic for adolescents. Most participants (n=39, 58%), would recommend the game to others. Significant difficulties with gameplay navigation were reported by 38 (57%) participants, as well as a slow game pace. All participants were able to accurately identify the overarching goal of the game: opioid or medication safety. The game reinforced existing knowledge for participants, though many (n=15, 22%), reported a new awareness of the need to store opioid medications in a locked area and the availability of medication disposal drop boxes at pharmacies. Participants stated that they would recommend the game for future use by families and youths in various health care and non-health care settings. CONCLUSIONS The use of a tailored serious game is a novel, engaging tool to educate adolescents on opioid safety. MedSMARxT: Adventures in PharmaCity can be used as a tool for parents and adolescents to facilitate meaningful dialogue about safe and appropriate opioid use.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Grace Ann Nixon
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Laura Louise Seitz
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
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42
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Miljković N, Makridaki D, Kohl S. Access to medicines. Eur J Hosp Pharm 2023; 30:257-260. [PMID: 34949652 PMCID: PMC10447961 DOI: 10.1136/ejhpharm-2021-002974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Nenad Miljković
- Hospital Pharmacy, Institute of Orthopaedic Surgery "Banjica", Belgrade, Serbia
| | - Despina Makridaki
- Pharmacy Services, Sismanoglio-Amalia Fleming, General Hospital of Attica, Athens, Greece
| | - Stephanie Kohl
- Policy & Advocacy, European Association of Hospital Pharmacists, Brussels, Belgium
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43
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Traoré SC, Decoene A, Mazaud P. Medicine shortages in France: a 6-year retrospective study in a university medical centre. Eur J Hosp Pharm 2023; 30:297-301. [PMID: 34758973 PMCID: PMC10447959 DOI: 10.1136/ejhpharm-2021-002911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/25/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Medicine procurement disorders, commonly referred to as 'shortages', are a health-threatening phenomenon that have been reported by several stakeholders around the world. This study aimed to describe data from a mitigation tool, namely a shortages report implemented within one of the largest university hospitals in France over a 6-year period. METHODS For 6 years (from 1 June 2014 to 31 May 2020) the data used were collected from different sources: purchasing groups, distributors, manufacturers and the national health agency. The report included: medicine identification, disorder duration, starting and ending dates, available alternative products, the Anatomical Therapeutic and Chemical (ATC) classification. Different situations were described: medicine shortages, quotas, supply tensions and market withdrawals. RESULTS Over the 6-year period, 1780 disorders were registered comprising 0.67% market withdrawals, 16.97% quotas, 79.89% shortages and 2.47% supply tensions. The median duration of a disorder was 56 days and the most affected ATC classes were the nervous system (N), anti-infectives (J) and the cardiovascular system (C). A substitute medicine was registered for one-third of the disorders. In the N class, the most frequent level 4 classes were N01BB (local anaesthetic amids such as lidocaine, levobupivacaine and ropivacaine), N03AX (other antiepileptics) and N05AX (other antipsychotics). In the J class, the most frequent level 4 classes were J01CR (penicillin combinations), J01CA (extended-spectrum penicillins such as piperacillin and amoxicillin) and J01XX (other antibiotics for systematic use). CONCLUSIONS Procurement disorders are still spreading. The study results are similar to those of other research teams around the world. Common answers have to be found to deal with the phenomenon, that include standardisation and risk assessment methods.
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Affiliation(s)
- Serri Christophe Traoré
- Pharmacy Department - Purchases and supplying section, Lille University Hospital, Lille, France
| | - Anaelle Decoene
- Pharmacy Department - Purchases and supplying section, Lille University Hospital, Lille, France
| | - Patric Mazaud
- Pharmacy Department - Purchases and supplying section, Lille University Hospital, Lille, France
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Altan S, Faya P, Rauk AP, LeBlond D, Seaman JW, Banton D. Stability analysis using mixed models: A critique of tolerance interval methods and a probabilistic solution. Pharm Stat 2023; 22:784-796. [PMID: 37164770 DOI: 10.1002/pst.2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 05/12/2023]
Abstract
Recently, tolerance interval approaches to the calculation of a shelf life of a drug product have been proposed in the literature. These address the belief that shelf life should be related to control of a certain proportion of batches being out of specification. We question the appropriateness of the tolerance interval approach. Our concerns relate to the computational challenges and practical interpretations of the method. We provide an alternative Bayesian approach, which directly controls the desired proportion of batches falling out of specification assuming a controlled manufacturing process. The approach has an intuitive interpretation and posterior distributions are straightforward to compute. If prior information on the fixed and random parameters is available, a Bayesian approach can provide additional benefits both to the company and the consumer. It also avoids many of the computational challenges with the tolerance interval methodology.
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Affiliation(s)
- Stan Altan
- Statistics and Decision Sciences, Janssen R&D, Raritan, New Jersey, USA
| | - Paul Faya
- Statistics - Discovery and Development, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Adam P Rauk
- Statistics - Discovery and Development, Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | - John W Seaman
- Department of Statistical Science, Baylor University, Waco, Texas, USA
| | - Dwaine Banton
- Statistical Analysis and Research Center, LabCorp, Stockholm, Sweden
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Náfrádi M, Alapi T, Veres B, Farkas L, Bencsik G, Janáky C. Comparison of TiO 2 and ZnO for Heterogeneous Photocatalytic Activation of the Peroxydisulfate Ion in Trimethoprim Degradation. Materials (Basel) 2023; 16:5920. [PMID: 37687613 PMCID: PMC10489049 DOI: 10.3390/ma16175920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023]
Abstract
The persulfate-based advanced oxidation process is a promising method for degrading organic pollutants. Herein, TiO2 and ZnO photocatalysts were combined with the peroxydisulfate ion (PDS) to enhance the efficiency. ZnO was significantly more efficient in PDS conversion and SO4•- generation than TiO2. For ZnO, the PDS increased the transformation rate of the trimethoprim antibiotic from 1.58 × 10-7 M s-1 to 6.83 × 10-7 M s-1. However, in the case of TiO2, the moderated positive effect was manifested mainly in O2-free suspensions. The impact of dissolved O2 and trimethoprim on PDS transformation was also studied. The results reflected that the interaction of O2, PDS, and TRIM with the surface of the photocatalyst and their competition for photogenerated charges must be considered. The effect of radical scavengers confirmed that in addition to SO4•-, •OH plays an essential role even in O2-free suspensions, and the contribution of SO4•- to the transformation is much more significant for ZnO than for TiO2. The negative impact of biologically treated domestic wastewater as a matrix was manifested, most probably because of the radical scavenging capacity of Cl- and HCO3-. Nevertheless, in the case of ZnO, the positive effect of PDS successfully overcompensates that, due to the efficient SO4•- generation. Reusability tests were performed in Milli-Q water and biologically treated domestic wastewater, and only a slight decrease in the reactivity of ZnO photocatalysts was observed.
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Affiliation(s)
- Máté Náfrádi
- Department of Inorganic, Organic and Analytical Chemistry, University of Szeged, Dóm Square 7-8, H-6720 Szeged, Hungary; (M.N.); (B.V.); (L.F.)
| | - Tünde Alapi
- Department of Inorganic, Organic and Analytical Chemistry, University of Szeged, Dóm Square 7-8, H-6720 Szeged, Hungary; (M.N.); (B.V.); (L.F.)
| | - Bence Veres
- Department of Inorganic, Organic and Analytical Chemistry, University of Szeged, Dóm Square 7-8, H-6720 Szeged, Hungary; (M.N.); (B.V.); (L.F.)
| | - Luca Farkas
- Department of Inorganic, Organic and Analytical Chemistry, University of Szeged, Dóm Square 7-8, H-6720 Szeged, Hungary; (M.N.); (B.V.); (L.F.)
| | - Gábor Bencsik
- Department of Physical Chemistry and Materials Science, University of Szeged, Aradi Square 1, H-6720 Szeged, Hungary; (G.B.); (C.J.)
| | - Csaba Janáky
- Department of Physical Chemistry and Materials Science, University of Szeged, Aradi Square 1, H-6720 Szeged, Hungary; (G.B.); (C.J.)
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Kinch MS, Kraft Z, Schwartz T. 2022 in review: FDA approvals of new medicines. Drug Discov Today 2023; 28:103622. [PMID: 37201782 DOI: 10.1016/j.drudis.2023.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/20/2023]
Abstract
An accounting of all new entities approved by both the Center for Drug Evaluation and Research (CDER) and the Center for Biologics Evaluation and Research (CBER) identified the approval of 44 new entities in the year 2022. Oncology-based drugs continued to be the most popular indication for these medicines. Likewise, orphan indications encompassed more than half of new drug approvals. The number of new entities approved in 2022 declined from its peak after 5 years of more than 50 annual approvals. Likewise, the rate of consolidations slowed somewhat, among both new entries in the realm of clinical-stage developers and more established organizations.
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Affiliation(s)
- Michael S Kinch
- Center for Research Innovation in Biotechnology, Long Island University, 720 Northern Blvd, Greenvale, NY 11548, USA.
| | - Zachary Kraft
- Center for Research Innovation in Biotechnology, Long Island University, 720 Northern Blvd, Greenvale, NY 11548, USA
| | - Tyler Schwartz
- Center for Research Innovation in Biotechnology, Long Island University, 720 Northern Blvd, Greenvale, NY 11548, USA
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Parker MA, Valdez D, Rao VK, Eddens KS, Agley J. Results and Methodological Implications of the Digital Epidemiology of Prescription Drug References Among Twitter Users: Latent Dirichlet Allocation (LDA) Analyses. J Med Internet Res 2023; 25:e48405. [PMID: 37505795 PMCID: PMC10422173 DOI: 10.2196/48405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/01/2023] [Accepted: 06/15/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Social media is an important information source for a growing subset of the population and can likely be leveraged to provide insight into the evolving drug overdose epidemic. Twitter can provide valuable insight into trends, colloquial information available to potential users, and how networks and interactivity might influence what people are exposed to and how they engage in communication around drug use. OBJECTIVE This exploratory study was designed to investigate the ways in which unsupervised machine learning analyses using natural language processing could identify coherent themes for tweets containing substance names. METHODS This study involved harnessing data from Twitter, including large-scale collection of brand name (N=262,607) and street name (N=204,068) prescription drug-related tweets and use of unsupervised machine learning analyses (ie, natural language processing) of collected data with data visualization to identify pertinent tweet themes. Latent Dirichlet allocation (LDA) with coherence score calculations was performed to compare brand (eg, OxyContin) and street (eg, oxys) name tweets. RESULTS We found people discussed drug use differently depending on whether a brand name or street name was used. Brand name categories often contained political talking points (eg, border, crime, and political handling of ongoing drug mitigation strategies). In contrast, categories containing street names occasionally referenced drug misuse, though multiple social uses for a term (eg, Sonata) muddled topic clarity. CONCLUSIONS Content in the brand name corpus reflected discussion about the drug itself and less often reflected personal use. However, content in the street name corpus was notably more diverse and resisted simple LDA categorization. We speculate this may reflect effective use of slang terminology to clandestinely discuss drug-related activity. If so, straightforward analyses of digital drug-related communication may be more difficult than previously assumed. This work has the potential to be used for surveillance and detection of harmful drug use information. It also might be used for appropriate education and dissemination of information to persons engaged in drug use content on Twitter.
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Affiliation(s)
- Maria A Parker
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Danny Valdez
- Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Varun K Rao
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
- Department of Informatics, Luddy School of Informatics, Computing, and Engineering, Indiana University Bloomington, Bloomington, IN, United States
| | - Katherine S Eddens
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Jon Agley
- Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
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Shilpa VS, Shams R, Dash KK, Pandey VK, Dar AH, Ayaz Mukarram S, Harsányi E, Kovács B. Phytochemical Properties, Extraction, and Pharmacological Benefits of Naringin: A Review. Molecules 2023; 28:5623. [PMID: 37570594 PMCID: PMC10419872 DOI: 10.3390/molecules28155623] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
This review describes the various innovative approaches implemented for naringin extraction as well as the recent developments in the field. Naringin was assessed in terms of its structure, chemical composition, and potential food sources. How naringin works pharmacologically was discussed, including its potential as an anti-diabetic, anti-inflammatory, and hepatoprotective substance. Citrus flavonoids are crucial herbal additives that have a huge spectrum of organic activities. Naringin is a nutritional flavanone glycoside that has been shown to be effective in the treatment of a few chronic disorders associated with ageing. Citrus fruits contain a common flavone glycoside that has specific pharmacological and biological properties. Naringin, a flavone glycoside with a range of intriguing characteristics, is abundant in citrus fruits. Naringin has been shown to have a variety of biological, medicinal, and pharmacological effects. Naringin is hydrolyzed into rhamnose and prunin by the naringinase, which also possesses l-rhamnosidase activity. D-glucosidase subsequently catalyzes the hydrolysis of prunin into glucose and naringenin. Naringin is known for having anti-inflammatory, antioxidant, and tumor-fighting effects. Numerous test animals and cell lines have been used to correlate naringin exposure to asthma, hyperlipidemia, diabetes, cancer, hyperthyroidism, and osteoporosis. This study focused on the many documented actions of naringin in in-vitro and in-vivo experimental and preclinical investigations, as well as its prospective therapeutic advantages, utilizing the information that is presently accessible in the literature. In addition to its pharmacokinetic characteristics, naringin's structure, distribution, different extraction methods, and potential use in the cosmetic, food, pharmaceutical, and animal feed sectors were discussed.
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Affiliation(s)
- VS Shilpa
- Department of Food Technology & Nutrition, Lovely Professional University, Phagwara 144001, Punjab, India
| | - Rafeeya Shams
- Department of Food Technology & Nutrition, Lovely Professional University, Phagwara 144001, Punjab, India
| | - Kshirod Kumar Dash
- Department of Food Processing Technology, Ghani Khan Choudhury Institute of Engineering and Technology Malda, Malda 732141, West Bengal, India
| | - Vinay Kumar Pandey
- Department of Bioengineering, Integral University, Lucknow 226026, Uttar Pradesh, India
- Department of Biotechnology, Axis Institute of Higher Education, Kanpur 209402, Uttar Pradesh, India
| | - Aamir Hussain Dar
- Department of Food Technology, Islamic University of Science and Technology, Awantipora 192122, Kashmir, India
| | - Shaikh Ayaz Mukarram
- Faculty of Agriculture, Food Science and Environmental Management Institute of Food Science, University of Debrecen, 4032 Debrecen, Hungary
| | - Endre Harsányi
- Faculty of Agriculture, Food Science and Environmental Management, Institute of Land Utilization, Engineering and Precision Technology, University of Debrecen, 4032 Debrecen, Hungary
| | - Béla Kovács
- Faculty of Agriculture, Food Science and Environmental Management Institute of Food Science, University of Debrecen, 4032 Debrecen, Hungary
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Alav I, Buckner MMC. Non-antibiotic compounds associated with humans and the environment can promote horizontal transfer of antimicrobial resistance genes. Crit Rev Microbiol 2023:1-18. [PMID: 37462915 DOI: 10.1080/1040841x.2023.2233603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/23/2023] [Accepted: 06/30/2023] [Indexed: 02/15/2024]
Abstract
Horizontal gene transfer plays a key role in the global dissemination of antimicrobial resistance (AMR). AMR genes are often carried on self-transmissible plasmids, which are shared amongst bacteria primarily by conjugation. Antibiotic use has been a well-established driver of the emergence and spread of AMR. However, the impact of commonly used non-antibiotic compounds and environmental pollutants on AMR spread has been largely overlooked. Recent studies found common prescription and over-the-counter drugs, artificial sweeteners, food preservatives, and environmental pollutants, can increase the conjugative transfer of AMR plasmids. The potential mechanisms by which these compounds promote plasmid transmission include increased membrane permeability, upregulation of plasmid transfer genes, formation of reactive oxygen species, and SOS response gene induction. Many questions remain around the impact of most non-antibiotic compounds on AMR plasmid conjugation in clinical isolates and the long-term impact on AMR dissemination. By elucidating the role of routinely used pharmaceuticals, food additives, and pollutants in the dissemination of AMR, action can be taken to mitigate their impact by closely monitoring use and disposal. This review will discuss recent progress on understanding the influence of non-antibiotic compounds on plasmid transmission, the mechanisms by which they promote transfer, and the level of risk they pose.
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Affiliation(s)
- Ilyas Alav
- Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Michelle M C Buckner
- Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Schulz PJ, Crosignani F, Petrocchi S. Critical Test of the Beneficial Consequences of Lifting the Ban on Direct-to-Consumer Advertising for Prescription Drugs in Italy: Experimental Exposure and Questionnaire Study. J Med Internet Res 2023; 25:e40616. [PMID: 37459159 PMCID: PMC10390971 DOI: 10.2196/40616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/23/2022] [Accepted: 05/31/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND There are only two countries in the world (the United States and New Zealand) that allow the pharmaceutical branch to advertise prescription medication directly to consumers. There is pressure on governments to allow direct-to-consumer advertising (DTCA) for prescription drugs elsewhere too. One argument the industry uses frequently is the claim that exposure to DCTA, through various methods and occasions, is supposed to improve customers' knowledge of a disease and treatment. This argument has been part of the health care community's wider discussion of whether DTCA of prescription drugs benefits the population's general interest or is only an attempt to increase the sales of the pharmaceutical branch. Belief in true learning by DTCA is rooted in concepts of empowered consumers and their autonomous and empowered decision-making. OBJECTIVE In this study, we tested the hypotheses that contact with DTCA increases recipients' literacy/knowledge, especially regarding the side effects of treatment (hypothesis 1), and empowerment (hypothesis 2). We further hypothesized that DTCA exposure would not increase depression knowledge (ie, about treatments, symptoms, and prevalence) (hypothesis 3). METHODS A snowball sample of 180 participants was randomly split into three experimental groups receiving (1) a traditional information sheet, (2) a DTCA video clip for an antidepressant prescription drug, or (3) both. The video was original material from the United States translated into Italian for the experiment. Dependent variables were measures of depression knowledge (regarding treatments, symptoms and prevalence, and antidepressant side effects), depression literacy, and empowerment. RESULTS None of the experimental groups differed significantly from the others in the empowerment measure (hypothesis 2 not confirmed). Partial confirmation of hypothesis 1 was obtained. Lower values on the depression literacy scale were obtained when participants had been given the video compared to the sheet condition. However, the general depression knowledge and its subscale on side effects reached higher scores when participants were exposed to the DTCA, alone or in combination with the information sheet. Finally, participants showed lower scores on knowledge about treatment and symptoms or prevalence after watching the video compared to the sheet condition (hypothesis 3 confirmed). Symptoms and prevalence knowledge increased only when the video was presented in combination with the sheet. CONCLUSIONS There is no evidence for an increase in empowerment following DTCA exposure. An increase in knowledge of the side effects of the medication was observed in the group exposed to the DTCA video. This was the only result that confirmed the hypothesis of the beneficial effect of DTCA videos on knowledge. Written information proved to be the most suitable way to convey knowledge on treatments and symptoms prevalence. Our findings support the necessity of studying health literacy and patient empowerment together and the consequences of such an increase in knowledge in terms of help-seeking behavior.
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Affiliation(s)
- Peter Johannes Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Department of Communication & Media, Ewha Womans University, Seoul, Republic of Korea
- Wee Kim Wee School of Communication and Information & Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Francesca Crosignani
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
| | - Serena Petrocchi
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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