Search Results (47)

The current paper examines the sustainable possibility for recycling unused or expired Metoprolol (MET), a benzodiazepine derivative, as an effective corrosion inhibitor for carbon steel in saline solutions. Repurposing expired medicinal drugs aligns with green chemistry concepts and supports circular economy initiatives by reducing pharmaceutical waste and averting the production of new synthetic inhibitors. The technical benefit of recycling expired MET drugs pertains to the elimination of costs associated with organic inhibitor manufacturing and the decrease in disposal expenses for the expired medication. A combination of electrochemical techniques (potentiodynamic polarization and electrochemical impedance spectroscopy) and quantum chemical calculations was employed to evaluate the inhibitory mechanism and efficacy of MET. At a concentration of 10⁻³ M, MET reduced the corrosion current density from 19.38 to 5.97 μA cm⁻², achieving a maximum IE of 69.1%. Adsorption Gibbs free energy, determined using different adsorption isotherms, revealed that interactions between metal atoms and MET adsorbed molecules have a chemical character with a ∆G^o_ads value of −50.7 kJ·mol⁻¹. Furthermore, quantum chemistry calculations indicate that the investigated drug, owing to its molecular structure (E_HOMO = −9.12 eV, E_LUMO = 0.21 eV, µ = 3.95 D), possesses the capacity to establish an adsorption layer on the metal surface, thereby impeding the diffusion of molecules and ions involved in the overall corrosion process. The results obtained using the different techniques were in good agreement and highlighted the effectiveness of MET in the corrosion inhibition of carbon steel. Full article

(1) Background: Although Sri Lanka is a developing country and boasts of having a well-established healthcare system along with good healthcare indices, we are still lagging in certain aspects of healthcare. One such aspect is the deficiencies in guidelines and practices related to the handling of pharmaceutical waste. (2) Methods: This was a qualitative study performed using in-depth interviews with the help of a semi-structured questionnaire conducted among staff who are working at a ministry complex in Galle, Sri Lanka. Data analysis was performed using thematic analysis, (3) Results: There were 40 participants which included 29 (72.5%) females. Three main themes were identified, namely, (I) current knowledge, (II) perceptions, and (III) practices towards storage, disposal, and misuse of pharmaceutical waste. The death of the patient, forgetting, relieving symptoms, and adverse effects were some reasons for the accumulation of unused pharmaceuticals at home. Most of the participants did not believe that the reuse of unused medications can cause various health hazards. Moreover, all participants practiced unsafe methods such as flushing down toilets, pouring into a sink, burning, etc. (4) Conclusions: The incorrect practices and poor knowledge in the handling of pharmaceutical waste and less concern for the environment highlight the need for awareness programs to the general public and establishing proper medication waste management such drug take-back systems. Full article

This review focuses on the crucial role of aquatic ecosystems in preserving biodiversity and the biosphere, as well as the connection between antimicrobial resistance (AMR) and these ecosystems. It provides an in-depth analysis of the link between ecological well-being and public health, helping readers understand this complex subject. Aquatic ecosystems are essential for maintaining biodiversity and ecological balance. Additionally, they act as primary reservoirs and pathways for the spread of antimicrobial resistance (AMR). These ecosystems risk antibiotic contamination through various sources, such as the release of antibiotics from animal and human waste, improper disposal of unused medications, and pharmaceutical industry waste management practices. The presence of antibiotic residues in these environments significantly speeds up the development of bacterial resistance. The global prevalence of antimicrobial resistance (AMR) is evident in freshwater bodies, tributaries, sewage waters, and wastewater treatment facilities. Antimicrobial resistance (AMR) is now a significant public health threat, compromising the effectiveness of many previously successful treatments against various pathogens. One notable and alarming aspect of antimicrobial resistance (AMR) is its rapid development, often occurring within 5–10 years after introducing antimicrobial drugs to the market. This acceleration is closely tied to bacteria’s ability to thrive and adapt in the presence of antimicrobial agents and their residues in the environment. The implications of antimicrobial resistance (AMR) include treatment failures with long-term effects and a continuous increase in healthcare costs. This review comprehensively examines the intricate relationship between aquatic habitats, antibiotics, and the global challenge of antimicrobial resistance (AMR). It emphasizes the critical role of these ecosystems in preserving ecological diversity. It raises awareness about AMR’s urgent public health issue, laying a foundation for understanding its extensive consequences. Full article

Drug waste poses a real threat to human health and the environment. Therefore, recycling and sustainability scholars have recently sought practical solutions to the drug waste problem. Furthermore, several governments have made significant efforts to reduce the negative effects of waste, such as establishing programs to take back unwanted drugs (expired and unused) for recycling (i.e., drug reuse or drug redispersing). However, many of these programs have failed to achieve their goals. In this context, it is expected that creating green start-ups to collect unwanted drugs will contribute to solving this problem. Accordingly, this study aims to investigate the antecedents of intentions to create green start-ups for collecting unwanted drugs. To this end, the authors integrate start-up self-efficacy and drug waste collection-related knowledge constructs into the theory of planned behavior (TPB). Using a self-administered paper questionnaire and relying on a convenience sample, data were collected from 328 students in six Algerian universities. A hierarchical multiple regression was conducted to test the proposed study model. Theresults revealed that perceived behavioral control (PBC) (β = 0.187, p < 0.001), attitudes (β = 0.182, p = 0.002), start-up self-efficacy (β = 0.169, p = 0.001), drug waste collection-related knowledge (β = 0.161, p < 0.001), and subjective norms (β = 0.088, p < 0.05) have a positive significant effect on the intention to create a start-up to collect unwanted drugs. In conclusion, this paper contributes to reducing drug waste by investigating the drivers of intention to create green start-ups for collecting unwanted drugs. Therefore, our study is expected to provide valuable insights for hospitals, pharmacies, pharmaceutical manufacturers, environmental protection associations, and stakeholders interested in reverse logistics. Full article

Pedigree charts remain essential in oncological genetic counseling for identifying individuals with an increased risk of developing hereditary tumors. However, this valuable data source often remains confined to paper files, going unused. We propose a computer-aided detection/diagnosis system, based on machine learning and deep learning techniques, capable of the following: (1) assisting genetic oncologists in digitizing paper-based pedigree charts, and in generating new digital ones, and (2) automatically predicting the genetic predisposition risk directly from these digital pedigree charts. To the best of our knowledge, there are no similar studies in the current literature, and consequently, no utilization of software based on artificial intelligence on pedigree charts has been made public yet. By incorporating medical images and other data from omics sciences, there is also a fertile ground for training additional artificial intelligence systems, broadening the software predictive capabilities. We plan to bridge the gap between scientific advancements and practical implementation by modernizing and enhancing existing oncological genetic counseling services. This would mark the pioneering development of an AI-based application designed to enhance various aspects of genetic counseling, leading to improved patient care and advancements in the field of oncogenetics. Full article

Background: Wearable devices represent a new approach for monitoring key clinical parameters, such as ECG signals, for research and health purposes. These devices could outcompete medical devices in terms of affordability and use in out-clinic settings, allowing remote monitoring. The major limitation, especially when compared to implantable devices, is the presence of artifacts. Several authors reported a relevant percentage of recording time with poor/unusable traces for ECG, potentially hampering the use of these devices for this purpose. For this reason, it is of the utmost importance to develop a simple and inexpensive system enabling the user of the wearable devices to have immediate feedback on the quality of the acquired signal, allowing for real-time correction. Methods: A simple algorithm that can work in real time to verify the quality of the ECG signal (acceptable and unacceptable) was validated. Based on simple statistical parameters, the algorithm was blindly tested by comparison with ECG tracings previously classified by two expert cardiologists. Results: The classifications of 7200 10s-signal samples acquired on 20 patients with a commercial wearable ECG monitor were compared. The algorithm has an overall efficiency of approximately 95%, with a sensitivity of 94.7% and a specificity of 95.3%. Conclusions: The results demonstrate that even a simple algorithm can be used to classify signal coarseness, and this could allow real-time intervention by the subject or the technician. Full article

Background: There have been multiple reported pharmacy initiatives to reduce opioid misuse and accidental overdose to address our nation’s public health crisis. To date, there has not been a description in the literature of a community pharmacy follow-up initiative for dispensed opioids. Methods: A follow-up program was designed and implemented in community pharmacies as part of a previously developed opioid overdose and misuse prevention program (ONE Program). Five to twelve days after the dispensing of an opioid, pharmacy technicians called the patient to follow up on opioid safety topics. Pharmacy technicians used a questionnaire to inquire about medication disposal plans, if the patient was taking the medication more than prescribed, medication side effects, and if the patient needed a pharmacist consultation. The results from that questionnaire were documented. Results: During the first 18 months of the follow-up program, 1789 phone calls were completed. Of those contacted, 40% were still using their opioid medication, and over 10% were experiencing side effects which triggered a pharmacist consult. Patients were reminded of proper medication disposal methods, and most patients (78%) desired to dispose of unused medication at the pharmacy medication disposal box. Conclusions: Follow-up phone calls post-opioid medication dispensing were shown to add value to a previously established opioid misuse and accidental overdose prevention program and allowed for the fulfillment of the Pharmacist Patient Care Process. Full article

COVID-19 caused an increase in the demand for medications, which led to an increase in pharmaceutical waste and there is no doubt that this contributes to environmental pollution. Hence, it became necessary to search for how to protect and improve the environment by encouraging the behavior of medication waste reduction. Accordingly, this study aims to investigate the factors affecting intentions to reduce medication waste. Considering this, we develop an extended theory of planned behavior (TPB) framework by incorporating the constructs of moral obligation, environmental awareness, and medication waste risk perception. Using the convenience sampling method and based on a self-administered questionnaire, a total of 225 usable responses were collected in five Algerian cities. The results showed that positive attitudes (β = 0.316, p < 0.001), moral obligation (β = 0.291, p < 0.001), environmental awareness (β = 0.227, p < 0.001), perceived behavior control (PBC) (β = 0.151, p = 0.001), greater perceived risks (β = 0.127, p < 0.001), and subjective norm (β = 0.096, p < 0.05) significantly and positively influence the medication waste minimization intention. Furthermore, our analyses revealed that the extended TPB model explained 73.40% of the intention variance. In conclusion, we have explored the intentions, and there may be a gap between intent and actual behavior. Therefore, we recommend future studies to examine the factors affecting the actual behavior of medication waste reduction and to investigate environmental ethics and religious commitment as predictors of waste reduction intentions. Full article

Antibiotics are present in the environment, primarily due to their release through wastewater treatment plants, agricultural practices, and improper disposal of unused medications. In the environment, these drugs can be bioaccumulated by organisms and transferred along the food chain. This is a problem when considering the consumption of fish meat. In the United States, legislation stipulates that the maximum residue limit for sulfadiazine (SDZ) should not exceed 100 μg kg⁻¹. Lambari fishes have potential economic importance in aquaculture, as they are relatively easy to breed and can be raised in small-scale operations. Finally, studying the biology and ecology of lambari could provide valuable information about freshwater ecosystems and their inhabitants. The current work aimed to measure the bioaccumulation and depletion of the antibiotic SDZ ¹⁴C in lambari (Astyanax bimaculatus). For this purpose, the tests were divided into two stages; seven days of exposure and seven days of depletion, where one fish was randomly selected and sampled every day. In the exposure phase, the fish were fed the medicated feed three times a day at a concentration of 2.5 mg·g⁻¹. The control fish were fed uncontaminated feed. For the depletion phase, the remaining lambari were transferred to clean tanks and fed uncontaminated feed three times a day. The fish samples were burned in the Oxidizer and the reading of radioactivity was performed in a liquid scintillation spectrometer. It is worth noting that on day 7 and day 14, the water in the aquariums was filtered through filter paper to collect the metabolic excrement. SDZ concentrations increased over the days and accumulation occurred in the fish, with day seven presenting the maximum accumulation value of 91.7 ng·g⁻¹ due to feeding uptake. After the depletion phase on day 13, the value found was 0.83 ng·g⁻¹. The bioconcentration factor calculated was 20 L·kg⁻¹. After the bioaccumulation period, the concentrations of SDZ in the water and excreta were 4.5 µg·L⁻¹ and 363.5 ng·g⁻¹, respectively. In the depletion period, the concentrations in the water and excreta were 0.01 µg·L⁻¹ and 5.96 ng·g⁻¹, respectively. These results imply that there was little SDZ bioaccumulation in the fish, but that it was distributed in larger amounts in the water. This is due to the physicochemical properties of the molecule with the low Log P value. Regarding the maximum residue limit, the value was below the established value. This study contributes to understanding SDZ dynamics in an aquatic species native to Brazil. Full article

Nowadays, the contamination caused by emerging pollutants is a global concern due to the lack of scientific evidence to demonstrate the risk or toxicity to humans due to the presence of pharmaceutical residues in the environment. This study aimed to identify and describe the disposal practices of unused and unwanted medications, as well as to analyze and identify the most frequent drugs determined on water bodies adjacent to the biggest urban population in Mexico. A two-phase study with an epidemiological and an ecological assessment was performed. The epidemiological phase was carried out with a descriptive cross-sectional study among citizens from Mexico City and the metropolitan area using an electronic survey applied to 719 subjects aimed to assess practices in which pharmaceutical products are disposed. The ecological phase included a review of scientific reports. The results show that nearly 83.5% of those surveyed use inappropriate practices for disposal medicines, the main ones are through the municipal dump or directly in the drain. The ecological approach was carried out by a systematic literature review of original reports published between 2013 to 2023; information about the class of drugs, active substance, environmental compartments, location, and concentration was extracted and presented. Fifty-one different types of pharmaceutical residues were detected in wastewater in Mexico City in the last decade. The results of this study can contribute to the application of public policies for waste management authorities to mitigate the socio-environmental risks due to the inappropriate disposal of medicines. Full article

The reissuing, redispensing, redistributing, or even recycling of the returned unused stored medicines is referred to as medicine reuse. A few studies have examined people’s willingness to reuse unused stored medicines. This study aims primarily to explore the public’s willingness to reuse unused stored medicines in the future and the factors affecting their decisions, and to assess the pharmacological types and formulations of the unused stored medicines by the public. A cross-sectional study was conducted using a convenient sampling technique over three weeks (February–March 2022) among Jordanian populations. Data were collected from 681 participants who agreed to fill out a questionnaire, which was distributed online. Participants showed a positive perception of reusing any of the unused stored medicines in the future; of those, 79.6% (n = 400) believed that reusing “unused medicines” has economic benefits and 50% (n = 251) believe there are environmental benefits. Moreover, more than half of the participants believed that reusing “unused medicines” is safe (n = 256, 51%), but provided that a pharmacist or a doctor evaluates their quality or that the unused medicines are stored well. Results from this study show that the public positively endorses the idea of reusing unused stored medicines if the quality and safety are assured. However, future studies are needed to evaluate the Jordanian healthcare professionals’ perceptions towards medicine reuse and pharmaceutical companies’ willingness to be a part or facilitator of medicine reuse. Full article

The negative effect of the pharmaceuticals presence (persistence?) in various components of the environment is a global problem today. These compounds are released into the environment as a result of, inter alia, their use and improper disposal. Therefore, it is important to reduce excessive drug consumption and to develop a system for the collection of unused/expired pharmaceuticals. The effectiveness of actions in this area is inextricably linked with the need to educate society on how to deal properly with unwanted medications. The aim of the study was to show that the inappropriate handling of unused/expired drugs by society is an important problem in waste management systems, and it impacts the state of the environment. Forty-eight scientific articles published between 2012 and 2021 were taken into account that discussed the systems in various countries for the collection of unused/expired pharmaceuticals. This literature review shows that the main method of disposing of unused/expired medications, according to respondents from different countries, is either by disposing of them in household waste or flushing them into the sewage system. This is also the case in countries with systems or programs for the return of redundant drugs, which indicates that these systems are not sufficiently effective. This may be influenced by many factors, including the lack or ineffective education of the society. Full article

This descriptive cross-sectional study aimed to assess the knowledge and practices of pharmacy and nursing students at a medical college in Kosovo concerning unused and expired medications. A self-administered questionnaire was distributed to 500 randomly selected students of pharmacy (200 questionnaires) and nursing students (300 questionnaires). Overall, 336 returned the filled forms and the response rate was 67.2. SPSS version 26.0 was utilized for statistical analysis. The results showed that 89.2% of pharmacy students and 82.2% of nursing students check the expiration date of medications before purchasing them and a considerable number of students stated that they possess unused medicines at home (78.4% of pharmacy and 74% of nursing students). Regarding disposal practice, over 50% of both nursing and pharmacy students dispose of unused and expired medications in the trash. A small proportion of students returned unused or expired medicines to the pharmacy (11.4% of pharmacy students and 10.7% of nursing students return unused medications, whereas 14.4% of pharmacy respondents and 10.1% of nursing respondents reported returning expired medicines). There was a statistically significant difference in the ways pharmacy and nursing students purchase pharmaceuticals and in their opinions regarding institutions in charge of disposing of unused and expired medicines (p = 0.000). Students are aware of the detrimental effects improper disposal of unused and expired medicines has on the environment and public health, but lack information regarding the return of unused and expired medicines to the pharmacy. To change the existing practice the most appropriate method would be to add additional lectures on safe disposal practices into existing modules. It is recommended for involved stakeholders in Kosovo to organize training, seminars, and workshops for health professionals especially pharmacists and nurses, since they pass the information to patients/consumers as well as the government to make amendments to current legislation to ameliorate the returning procedures for patients/consumers in pharmacies. Full article

In this paper, we propose a new protocol called LoRaCog to introduce the concept of Cognitive Radio (CR) in the LoRa network. LoRaCog will enable access to a wider spectrum than that of LoRaWAN by using the unutilized spectrum and thus has better efficiency without impacting the end devices’ battery consumption. LoRa networks are managed by LoRaWAN protocol and operate on the unlicensed Industrial, Scientific and Medical (ISM) band. LoRaWAN is one of thriving protocols for Low-Power Wide-Area Networks (LPWAN) implemented for the Internet of Things (IoT). With the growing demand for IoT, the unlicensed spectrum is expected to be congested, unlike the licensed spectrum, which is not fully utilized. This can be fairly balanced by applying CR to the LoRa network, where the End Devices (EDs) may change the operating channel opportunistically over the free/available licensed spectrum. Spectrum sensing, channel selection and channel availability relevance become essential features to be respected by the proposed protocol. The main objective of adding CR to LoRaWAN is reducing the congestion and maintaining LoRaWAN’s suitability for battery-operated devices. This is achieved by modifying LoRaWAN components such as the ED receive window RX2 rearrangement, spectrum sensing functionality by gateway (GW) for identifying unused channels, and reaching a decision on the unused channels by network server (NS). These changes will create LoRaCog meeting spectrum efficiency and maintain the same level of battery consumption as in LoRaWAN. Numerical simulations show a significant decrease in the rejected packet rate (more than 50%) with LoRaCog when more EDs use cognitive channels. As the results prove, LoRaWAN can reach above 50% rejected packets for the simulated environment versus 24% rejection for LoRaCog using only one additional channel (means total two channels). This means that the system can eliminate rejected packets almost completely when operating over the possible many channels. As well, these results show the flexibility in the system to utilize the available frequencies in an efficient and fair way. The results also reveal that a lower number of GWs is needed for LoRaCog from LoRaWAN to cover the same area. Full article

The current work explores the potential for recycling unused or expired Midazolam (MID) drug, a benzodiazepine derivative, as an efficient corrosion inhibitor for copper in nitric acid solution. The technical advantage of recycling expired MID drug relates to the avoidance of organic inhibitor production costs and the reduction of disposal costs of the expired medication. A combination of electrochemical methods (potentiodynamic polarization and electrochemical impedance spectroscopy), weight loss, and quantum chemical calculation were used to assess the inhibition mechanism and efficiency of MID. It was found that inhibition efficiency increases with inhibitor concentration, reaching a highest value of 92.9% for a concentration of 10⁻⁴ M MID. MID was classified as a mixed-type inhibitor, showing a preferential cathodic suppression mechanism. The obtained values of −45.89 kJ mol⁻¹ for the standard free energy of adsorption indicate that the inhibition mechanism is based on chemisorption of MID molecules on the copper surface, which obeys the Langmuir isotherm. Surface analysis using scanning electronic microscopy revealed that MID offers high protection against corrosion during both immersion and polarization tests. Molecular modelling and quantum chemical calculations indicated chemical interactions between MID molecules and the copper surface, as well as electrostatic interactions. The results obtained using the different techniques were in good agreement and highlight the effectiveness of MID in the corrosion inhibition of copper. Full article