Search Results (36)

Antimicrobial resistance (AMR) is considered a global healthcare emergency in the 21st century. Although the evolution of microorganisms through Darwinian mechanisms and antibiotic misuse are established drivers, the structural socioeconomic factors of AMR remain insufficiently explored. This review takes on an analytical perspective, drawing upon a wide spectrum of evidence to examine the extent to which socioeconomic factors contribute to the global proliferation of AMR, with an emphasis on low- and middle-income countries (LMICs). The analytical review at hand was carried out through a search for relevant articles and reviews on PubMed, Google Scholar, the Centers for Disease Control and Prevention, and the World Health Organization database using combinations of the keywords “antimicrobial resistance,” “socioeconomic factors,” “low- and middle-income countries,” “surveillance,” “healthcare access,” and “agriculture.” Preference was given to systematic reviews, high-impact primary studies, and policy documents published in peer-reviewed journals or by reputable global health organizations. Our analysis identifies a complex interplay of systemic vulnerabilities that accelerate AMR in resource-limited settings. A lack of regulatory frameworks regarding non-prescription antibiotic use enables the proliferation of multi-drug-resistant microorganisms. Low sewer connectivity facilitates the environmental dissemination of resistance genes. Proper antibiotic selection is hindered by subpar healthcare systems and limited diagnostic capabilities to deliver appropriate treatment. Additionally, gender disparities, forced migration, and climate-driven zoonotic transmission compound the burden. During the COVID-19 pandemic, antimicrobial misuse surged, further amplifying resistance trends. AMR is not solely a biological phenomenon, but a manifestation of global inequity. Mitigation requires a transformation of policy directed toward a “One Health” strategy that incorporates socioeconomic, environmental, and health system reforms. Strengthening surveillance, investing in infrastructure, regulating pharmaceutical practices, and promoting health equity are essential to curb the rising tide of resistance. Full article

Hairy root cultures induced by Agrobacterium rhizogenes (Rhizobium rhizogenes) provide a sustainable approach to meet the growing demand for economically valuable plant-derived compounds in the face of depleting natural resources. These cultures exhibit rapid, hormone-independent growth and genetic stability, making them viable for producing bioactive compounds, plant-specialized metabolites, and recombinant proteins. However, challenges remain in optimizing large-scale production, improving bioreactor efficiency, and enhancing metabolite synthesis across different plant species. This review addresses these challenges by exploring the mechanisms behind the induction of hairy root cultures, their applications in genetic and metabolic engineering, and their potential in environmental remediation. The review further highlights recent advances in biotechnology and illustrates how the hairy root system can sustainably meet industrial, pharmaceutical, and agricultural needs. In addition, by pointing out essential research areas such as optimizing culture conditions, increasing metabolite yields, and scaling up production, this work strengthens the significance of hairy root cultures in meeting the demand for high-value products while ensuring sustainable resource utilization. In particular, the integration of hairy root systems with advanced genomic tools such as transcriptomics and CRISPR technology holds immense potential for accelerating pathway-specific metabolic engineering, enhancing biosynthetic flux, and expanding their applications in sustainable agriculture and pharmaceutical innovation. This convergence is expected to drive substantial economic value by optimizing the production of high-value bioactive compounds, improving crop resilience, and facilitating precision medicine. Future work involving systems and synthetic biology will be instrumental in unlocking novel functions and ensuring broader deployment of hairy root cultures across industrial biotechnological platforms. Full article

Background: This study evaluates one of the five regions of the state of Rio de Janeiro, Brazil, as part of a broader research project examining users’ perceptions of the Unified Health System (SUS), which has already generated publications in previous phases. The aim was to assess users’ perceptions of the SUS regarding access to and the quality of public health services, including pharmaceutical services, in the Metropolitan Region of Rio de Janeiro State. Method: A cross-sectional study was conducted between January and August 2024 with 200 participants, using a 66-item survey addressing access to and the quality of SUS services, appointment scheduling, medication acquisition, and the pharmacist’s role. Associations between variables were investigated using the Pearson Chi-Square Test in R software. Results: Frequent SUS users rated access as very good/good (p = 0.002) and overall quality as very good/good (p = 0.045). Reported challenges included the need for improved infrastructure (48.5%), better professional qualifications (30.6%), and easier access to medicines (16.8%). Higher ratings were given by those who used the SUS more frequently, and, in general, there was a tendency for participants with lower socioeconomic conditions to provide more favorable assessments of access to public health services (p = 0.024). Conclusions: A universal health system should cover diverse regions with unique needs. However, 49.4% of participants stated they never received information on how to store their medicines, and 42.3% reported never encountering a pharmacist in public pharmacies. Further ongoing studies assessing user perceptions are essential to ensure users play a central role in health decision-making, contributing to the system’s strengthening and improvement. Full article

Background and objectives: As part of Vision 2030, Saudi Arabia aims to strengthen its healthcare system by enhancing efficiency, reducing medical errors, and ensuring drug safety. Evidence on pharmacists’ experiences with adverse drug reactions (ADRs) in daily practice remains limited. Gaining insight into their perspectives is essential for improving patient safety and optimizing pharmaceutical care. Therefore, we aimed to assess pharmacists’ ability to identify ADRs in daily practice and the subsequent actions taken upon identification. Methods: Between July and August 2024, an email-based invitation was sent to randomly selected registered community and hospital pharmacists in Saudi Arabia to participate in the study, which employed a piloted questionnaire. Results: The study involved 305 pharmacists, including 169 hospital/clinical pharmacists (HCPs, 55.4%) and 136 community pharmacists (CPs, 44.6%). A majority (n = 251, 82.3%) indicated direct patient encounters, while 67.2% (n = 205) reported observing suspected ADRs in the preceding 12 months. Most respondents filed ADR reports to the Saudi Food and Drug Administration/National Pharmacovigilance Centre (HCP = 103, CP = 60) and hospital drug information centers (HCP = 89, CP = 64), with online forms being the favored mode (HCP = 122, CP = 96). Awareness of ADR reporting procedures was reported by 128 HCPs and 80 CPs. Conclusions: More than two-thirds of participants reported having participated in ADR reporting, with greater adherence observed in hospital settings. Pharmacists predominantly depend on the Saudi Food and Drug Administration/National Pharmacovigilance Centre and hospital drug information centers for reporting, with a preference for online submission methods. Targeted educational interventions addressing gaps in knowledge, reporting procedures, and form complexity could improve ADR reporting practices. These findings support the need for structured training and policy measures to strengthen pharmacovigilance system. Full article

Background: Yemen faces significant challenges related to drug smuggling and counterfeiting, exacerbated by socio-economic hardships and a fragile healthcare and regulatory system. These conditions create an environment conducive to illicit drug trafficking. This study aims to explore the perspectives of healthcare employees working in drug-related departments in the Capital Sana’a, Yemen, focusing on the factors contributing to drug smuggling and the broader challenges within Yemen’s pharmaceutical sector. Methods: A cross-sectional study was conducted among health employees in drug-related departments in the Capital Sana’a. Data were collected through a self-administered questionnaire and analyzed using SPSS version 22.0. Descriptive and inferential statistical analyses were performed to examine group differences, including t-tests and ANOVA. A significance level of p < 0.05 was considered statistically significant. Results: The t-test indicated significant disagreement among participants (50.3%) regarding the existence of a comprehensive pharmaceutical policy (p < 0.001). High levels of agreement were observed on commonly smuggled drugs (74.7%) and the underlying reasons for drug smuggling and counterfeiting (76%, p < 0.001). A significant gender difference emerged regarding perceptions of the Supreme Board of Drugs’ role, with males scoring lower (mean = 2.86, SD = 0.81) than females (mean = 3.43, SD = 0.42, p = 0.002). However, ANOVA results showed no significant differences within or between groups based on educational qualifications, professional roles, or years of service concerning pharmaceutical policy, the Supreme Board of Drugs, registration requirements, or drug smuggling and counterfeiting (p > 0.05). Conclusions: This study highlights critical challenges in Yemen’s pharmaceutical sector, including systemic weaknesses, policy gaps, and the prevalence of drug smuggling, while emphasizing the pivotal role of health employees in addressing these issues. Strengthening their capacity through targeted interventions—such as training, awareness campaigns, robust regulatory frameworks, equitable enforcement, and enhanced stakeholder engagement—is essential. Given the cross-border nature of drug smuggling, these findings underscore the urgent need for strengthened international cooperation, harmonized regulatory policies, and intelligence-sharing mechanisms to combat illicit pharmaceutical trade. Addressing these challenges at both national and international levels is vital for ensuring drug safety, protecting public health, and mitigating the global impact of counterfeit and smuggled medicines. Full article

Effective medical waste management is crucial for minimizing environmental contamination, protecting occupational health, and advancing sustainability goals in healthcare systems. However, microbiology laboratories remain underexplored in waste characterization studies, despite their potential to contribute to sustainable healthcare operations. This study assessed waste generation patterns, classification accuracy, and the impact of training on regulatory compliance in a university hospital microbiology laboratory. Over 45 days, waste from six specialized units was categorized and weighed daily. A survey of 304 healthcare professionals evaluated their knowledge of medical waste handling. Statistical analyses revealed that training frequency (R² = 0.72, p < 0.01) was the most significant predictor of compliance, while years of experience had no measurable impact. On average, the laboratory generated 22.78 kg/day of medical waste, 11.67 kg/day of liquid waste, and 5.61 kg/day of sharps waste, with the bacteriology unit being the largest contributor. Despite adequate general awareness, 15% of staff misclassified hazardous waste—particularly expired pharmaceuticals and cytotoxic vials—indicating critical gaps in practice. The findings support the need for recurring training programs, stricter monitoring systems, improved waste labeling, and the integration of digital tracking tools. These interventions can reduce environmental burdens, enhance healthcare sustainability, and support the development of more resilient waste management systems in medical institutions. Future research should explore how AI and automation can further strengthen sustainable healthcare waste strategies. Full article

The quality of the processed products in CNC machining centers is a critical factor in manufacturing equipment. The anomaly detection and predictive maintenance functions are essential for improving efficiency and reducing time and costs. This study aims to strengthen service competitiveness by reducing quality assurance costs and implementing AI-based predictive maintenance services, as well as establishing a predictive maintenance system for CNC manufacturing equipment. The proposed system integrates preventive maintenance, time-based maintenance, and condition-based maintenance strategies. Using continuous learning based on long short-term memory (LSTM), the system enables anomaly detection, failure prediction, cause analysis, root cause identification, remaining useful life (RUL) prediction, and optimal maintenance timing decisions. In addition, this study focuses on roller-cutting devices that are essential in packaging processes, such as food, pharmaceutical, and cosmetic production. When rolling pins are machining with CNC equipment, a sensor system is installed to collect acoustic data, analyze failure patterns, and apply RUL prediction algorithms. The AI-based predictive maintenance system developed ensures the reliability and operational efficiency of CNC equipment, while also laying the foundation for a smart factory monitoring platform, thus enhancing competitiveness in intelligent manufacturing environments. Full article

Gelatin, a water-soluble protein, shows unique gellification properties, which determine the active commercial availability of gelatin hydrogels in modern alimentary, cosmetic, and pharmaceutical applications. The traditional sources of gelatin for industrial technologies are pork and bovine skin and bones, which sometimes produce religious and some other restrictions. In recent years, there has been a significant increase in the production of gelatin from alternative sources, such as raw fish materials. Unfortunately, fish gelatin is characterized by weak gelling ability and a decrease in gelation and melting temperature, which are a consequence of the amino acid composition and structural features of fish gelatin. One of the ways to strengthen the natural gelling properties of fish gelatin is the structural modification of gelatin hydrogels by the introduction of polysaccharides of various natural origins. We have studied the association of our laboratory-made fish gelatin with three polysaccharides, namely, κ-carrageenan, alginate, and chitosan, which have distinct chemical structures and gelling capabilities. Structural features of the studied systems were analyzed by small-angle X-ray scattering (SAXS), powder X-ray diffraction (PXRD), and scanning electron microscopy (SEM). We applied computer modeling of molecular interactions between fish gelatin and polysaccharides by means of molecular docking and molecular dynamics approaches. The existence of a correlation between the structure of gelatin-polysaccharide systems and their physicochemical properties was demonstrated by wetting angles (flow angles) and dynamic light scattering (DLS) studies of hydrodynamic sizes and surface ζ-potential. Full article

Background: This study explored the readiness and strategic considerations of companies and key stakeholders for the implementation of the Joint Clinical Assessment (JCA) under the European Health Technology Assessment Regulation (HTAR). It examined the implications of the JCA process for jurisdictional submission strategies, and decision-making across Europe. The study aimed at identifying key measures for an efficient and effective JCA process to enable national rollout. Methods: A survey was conducted with international pharmaceutical companies, followed by a multi-stakeholder workshop that expanded on the findings. The survey and workshop focused on key areas such as time to market, submission strategies, and the role of JCA in national decision-making processes. Descriptive and qualitative analyses were performed to identify recommendations for measuring and improving the JCA process. Results: 13 companies responded to the survey, respondents were generally prepared for the JCA process (readiness rated 6–7/10), but concerns persist about timeline uncertainties and timely JCA report delivery. In the short term, success for the HTAR from the company perspective is measured by positive recommendations across EU jurisdictions. Long term, the focus shifts to aligning HTA methodologies and evidence requirements across the EU. Establishing metrics to assess the efficiency and effectiveness of the JCA is a key step in the HTAR’s ongoing learning journey. To enhance the efficiency of the JCA process, a list of metrics is recommended for continuous improvement, as well as establishing training programs to strengthen member states’ capabilities, fostering open dialog for sharing technology-specific insights, and creating open-source tools to support companies. Additionally, research should be conducted to understand agencies’ expectations of the JCA and how they will use its reports, grouping agencies by archetype to identify trends. A key recommendation is the development of a product-based scorecard to evaluate JCA submissions and reviews from various perspectives, ensuring the process meets stakeholders’ needs and can be effectively utilized in national decision-making. Conclusions: The JCA process offers a significant opportunity to streamline HTA decision-making across Europe. This study highlights several key measures and consideration for its successful rollout, including the need for clearer communication about the role of JCA in national decisions, measurement of rollout time components, and the development of quality evaluation frameworks. A collaborative, iterative approach, where stakeholders continually refine the system, will be essential for its effectiveness. Addressing these challenges will enable the JCA to enhance efficiency, consistency, and ultimately improve access to treatments for patients. Full article

Background: Pharmaceutical expenditures serve as key indicators of healthcare system efficiency, innovation, and sustainability. South Korea has implemented policies such as the economic evaluation exemption (EEE) and risk-sharing agreements (RSAs) to balance cost control and access to innovative therapies. However, discrepancies persist in the distribution of expenditures across therapeutic areas, raising concerns about alignment with public health needs. Methods: This retrospective observational study analyzed pharmaceutical expenditures in South Korea from 2007 to 2022, focusing on new chemical entities (NCEs). Data sources included the IQVIA MIDAS Global Database, the WHO Global Burden of Disease (GBD) database, and South Korea’s national health insurance records. Expenditure patterns were benchmarked against OECD and A8 countries using disability-adjusted life years (DALYs) and other healthcare metrics to assess the relationship between spending and disease burden. Results: By 2022, South Korea had introduced 276 NCEs, demonstrating progress, but still lagging the OECD average. NCE expenditure increased from 10.0% to 16.0% of total pharmaceutical spending between 2017 and 2022, whereas A8 countries’ share rose from 26.2% to 48.1%. While oncology expenditures were proportionate to disease burden, spending on chronic diseases such as musculoskeletal and cardiovascular conditions remained relatively low compared to their DALY contributions. Conclusions: Although South Korea has strengthened its investment in pharmaceutical innovation, disparities in expenditure distribution persist. Refining policies to enhance resource allocation for chronic diseases and expanding the RSA framework beyond oncology could improve equity and sustainability. Adopting international best practices—such as indication-based pricing and funding mechanisms for high-cost therapies—may further support optimal pharmaceutical expenditure management. Full article

Natural plant polysaccharides are renowned for their broad spectrum of biological activities, making them invaluable in both the pharmaceutical and food industries. Their safety, characterized by low toxicity and minimal side effects, coupled with their potential therapeutic properties, positions them as crucial elements in health-related applications. The functional effectiveness of these polysaccharides is deeply connected to their structural attributes, including molecular weight, monosaccharide components, and types of glycosidic bonds. These structural elements influence how polysaccharides interact with the gut microbiota, potentially alleviating various metabolic and inflammatory disorders such as inflammatory bowel disease, diabetes, liver-associated pathologies, obesity, and kidney diseases. The polysaccharides operate through a range of biological mechanisms. They enhance the formation of short-chain fatty acids, which are pivotal in keeping intestinal health and metabolic balance. Additionally, they strengthen the intestinal mucosal barrier, crucial for deterring the ingress of pathogens and toxins into the host system. By modulating the immune responses within the gut, they help in managing immune-mediated disorders, and their role in activating specific cellular signaling pathways further underscores their therapeutic potential. The review delves into the intricate structure–activity relationships of various natural polysaccharides and their interactions with the intestinal flora. By understanding these relationships, the scientific community can develop targeted strategies for the use of polysaccharides in therapeutics, potentially leading to innovative treatments for a range of diseases. Furthermore, the insights gained can drive the advancement of research in natural polysaccharide applications, providing direction for novel dietary supplements and functional foods designed to support gut health and overall well-being. Full article

Antibiotics, widely used pharmaceuticals, enter wastewater treatment systems and ultimately the aquatic environment through the discharge of wastewater from residential areas, hospitals, breeding farms, and pharmaceutical factories, posing potential ecological and health risks. Due to the misuse and discharge of antibiotics, the spread of antibiotic resistance genes (ARGs) in water bodies and significant changes in microbial community structure have direct toxic effects on aquatic ecosystems and human health. This paper summarizes the occurrence of antibiotics in wastewater treatment systems and their ecological and health risks, focusing on the impact of antibiotics on aquatic microorganisms, aquatic plants and animals, and human health. It points out that existing wastewater treatment processes have poor removal capabilities for antibiotics and even become an important pathway for the spread of some antibiotics. In terms of detection technology, the article discusses the application of immunoassays, instrumental analysis, and emerging sensor technologies in detecting antibiotics in sewage, each with its advantages and limitations. Future efforts should combine multiple technologies to improve detection accuracy. Regarding the removal methods of antibiotics, the paper categorizes physical, chemical, and biodegradation methods, introducing various advanced technologies including membrane separation, adsorption, electrochemical oxidation, photocatalytic oxidation, and membrane bioreactors. Although these methods have shown good removal effects in the laboratory, there are still many limitations in large-scale practical applications. This paper innovatively takes urban wastewater treatment systems as the entry point, systematically integrating the sources of antibiotics, environmental risks, detection technologies, and treatment methods, providing targeted and practical theoretical support and technical guidance, especially in the removal of antibiotics in wastewater treatment, on a scientific basis. Future efforts should strengthen the control of antibiotic sources, improve the efficiency of wastewater treatment, optimize detection technologies, and promote the formulation and implementation of relevant laws and standards to more effectively manage and control antibiotic pollution in the aquatic environment. Full article

Drug shortages are a significant global issue, particularly affecting healthcare systems in resource-limited countries such as Albania. Pharmacists play a critical role in managing these shortages, yet little is known about their experiences and perspectives. This study aims to explore pharmacists’ views on the current drug shortages in Albania, identifying the most affected drug classes, and suggesting potential strategies for mitigating these shortages. A cross-sectional survey was conducted with 93 pharmacists across Albania between December 2023 and May 2024. Data were collected using an online questionnaire that addressed the types of drugs experiencing shortages, the causes of these shortages, and pharmacists’ coping strategies. Cardiovascular and central nervous system medications were reported as the most frequently affected, with supply chain disruptions, regulatory hurdles, and low domestic production cited as key contributors. The findings suggest an urgent need for national policy reforms focusing on improving supply chain resilience and boosting the local pharmaceutical production. The pharmacists proposed mitigation strategies, including stricter regulatory oversight, improved communication channels, and increased local production to reduce dependence on imports. These recommendations underscore the study’s contribution to understanding how tailored, pharmacist-informed strategies could strengthen Albania’s healthcare system. Full article

Background: In recent years, the pharmaceutical industry in Germany has faced a significant decline in the number of clinical trials conducted. Methods: This study evaluates patient participation in clinical trials for oncology and chronic diseases in Germany, integrating quantitative and qualitative research. Data from the Institute for Applied Health Research Berlin (InGef (Institut für angewandte Gesundheitsforschung, Berlin, Germany)), covering about 88% of the German population, and expert interviews were used. Results: In 2022, 84.6% of 47,305 systemic lupus erythematosus patients (SLE) and 11.9% of 102,300 chronic lymphocytic leukemia patients (CLL) received guideline-based care based on study definitions. Eligibility for clinical trials between 2017 and 2022 was estimated for 8272 SLE and 886 CLL patients, with the actual enrolment of 21 of 2221 SLE patients and 86 of 340 CLL patients reflecting the respective potential. Conclusions: Findings indicate an unexploited potential to enroll patients with chronic diseases compared to the relatively higher enrolment rates observed for oncology diseases, such as CLL. Securing the continuation of clinical trials and utilizing the value of trial participation is of importance for strengthening Germany as an innovation hub and for ensuring that patients have timely access to medical innovations. Full article

Alternative innovation models have emerged to address failures of the traditional pharmaceutical system, particularly for diseases where market incentives do not attract sufficient research and development efforts. However, the feasibility of such models for diseases with significant markets is not well-established. This article analyses the development of a novel drug (ravidasvir) for the treatment of hepatitis C, a highly profitable market. Data from qualitative research methods, including literature reviews and semi-structured interviews, was analyzed using a novel conceptual framework focusing on actors, resources, organizational practices, and outcomes. Dissimilar to other projects, ravidasvir did not involve any major pharmaceutical companies. Rather, it leveraged the capacities of actors less traditionally involved in the development of novel medicines by constructing a collaborative network of private and public partners from low- and middle-income countries with a shared goal. The collaboration was successful in developing a highly effective, easy-to-use, and affordable medicine and contributed significantly to capacity-strengthening. However, the case also highlighted that strategic behavior by competing for-profit firms could pose significant challenges and that changing external conditions reduced the potential public health impact of the drug. Lessons from ravidasvir can inform future efforts to develop alternative innovation models for therapeutic areas with significant commercial interest. Full article