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Early industrialization and the development of cheap production processes for paper have led to an exponential accumulation of paper-based documents during the last two centuries. Archives and libraries harbor vast amounts of ancient and modern documents and have to undertake extensive endeavors to protect them from abiotic and biotic deterioration. While services for mechanical preservation such as ex post de-acidification of historic documents are already commercially available, the possibilities for long-term protection of paper-based documents against fungal attack (apart from temperature and humidity control) are very limited. Novel processes for mechanical enhancement of damaged cellulosic documents use Ionic Liquids (IL) as essential process components. With some of these ILs having azole-functionalities similar to well-known fungicides such as Clotrimazole, the possibility of antifungal activities of these ILs was proposed but has not yet been experimentally confirmed.We evaluated the potency of four ILs with potential application in paper restoration for suppression of fungal growth on five relevant paper-infesting molds. The results revealed a general antifungal activity of all ILs, which increased with the size of the non-polar group. Physiological experiments and ultimate elemental analysis allowed to determine the minimal inhibitory concentration of each IL as well as the residual IL concentration in process-treated paper. These results provide valuable guidelines for IL-applications in paper restoration processes with antifungal activity as an added benefit. With azoles remaining in the paper after the process, simultaneous repair and biotic protection in treated documents could be facilitated.

The entire world is struggling to control the spread of coronavirus (COVID‐19) as there are no proper drugs for treating the disease. Under clinical trials, some of the repurposed antiviral drugs have been applied to COVID‐19 patients and reported the efficacy of the drugs with the diverse inferences. Molecular topology has been developed in recent years as an influential approach for drug design and discovery in which molecules that are structurally related show similar pharmacological properties. It permits a purely mathematical description of the molecular structure so that in the development of identification of new drugs can be found through adequate topological indices. In this paper, we study the structural properties of the several antiviral drugs such as chloroquine, hydroxychloroquine, lopinavir, ritonavir, remdesivir, theaflavin, nafamostat, camostat, umifenovir and bevacizumab by considering the distance and bond measures of chemical compounds. Our quantitative values of the topological indices are extremely useful in the recent development of designing new drugs for COVID‐19., The primary results of the paper include distance‐based and bond additive topological descriptors of antiviral medications for the treatment of COVID‐19 like chloroquine, hydroxychloroquine, lopinavir, ritonavir, remdesivir, theaflavin, nafamostat, camostat, umifenovir, and bevacizumab by graph‐theoretic technique, in particular, strength‐weighted quotient graph.

Desorption atmospheric pressure photoionization (DAPPI) is an ambient mass spectrometry (MS) technique that allows the analysis of both polar and nonpolar compounds directly from the surfaces of various sample types. Here, DAPPI was used to study the chemical profiles in different parts of birch and alder tree barks. Four distinct fractions of Betula pendula (silver birch) bark were collected from three different developmental stages of the stem, after which the chemical profiles of the different tissue types were measured. Of special interest were triterpenoids, a class of important defensive substances, which are found in the bark of the silver birch. Additionally, the chemical profiles of lenticels and the surrounding surfaces in the phellem of B. pendula (silver birch), Alnus glutinosa (black alder), and Alnus incana (gray alder) were screened with DAPPI. Another ambient MS technique, laser ablation atmospheric pressure photoionization (LAAPPI), was further used for the mass spectrometry imaging of lenticels on the B. pendula phellem. All the studied birch bark fractions showed individual chemical profiles in DAPPI. The mass spectra from the young apical stem and the transition zone resembled each other more than the mature stem. Instead, the phellem was found to contain a high amount of triterpenoids in all the developmental stages of the stem. The most intense peaks in the DAPPI mass spectra of the birch bark fractions were those of betulin and lupeol. Betulinic and betulonic acid peaks were intense as well, and these compounds were detected especially in the lenticels of the tree samples.

Background Out-of-hospital cardiac arrests (OHCAs) are stressful, high-stake events that are associated with low survival rates. Acute stress experienced in this situation is associated with lower cardiopulmonary resuscitation performance in calculating drug dosages by emergency medical services. Children are particularly vulnerable to such errors. To date, no app has been validated to specifically support emergency drug preparation by paramedics through reducing the stress level of this procedure and medication errors. Objective This study aims to determine the effectiveness of an evidence-based mobile app compared with that of the conventional preparation methods in reducing acute stress in paramedics at the psychological and physiological levels while safely preparing emergency drugs during simulated pediatric OHCA scenarios. Methods In a parent, multicenter, randomized controlled trial of 14 emergency medical services, perceived and physiologic stress of advanced paramedics with drug preparation autonomy was assessed during a 20-minute, standardized, fully video-recorded, and highly realistic pediatric OHCA scenario in an 18-month-old child. The primary outcome was participants’ self-reported psychological stress perceived during sequential preparations of 4 intravenous emergency drugs (epinephrine, midazolam, 10% dextrose, and sodium bicarbonate) with the support of the PedAMINES (Pediatric Accurate Medication in Emergency Situations) app designed to help pediatric drug preparation (intervention) or conventional methods (control). The State-Trait Anxiety Inventory and Visual Analog Scale questionnaires were used to measure perceived stress. The secondary outcome was physiologic stress, measured by a single continuous measurement of the participants’ heart rate with optical photoplethysmography. Results From September 3, 2019, to January 21, 2020, 150 advanced paramedics underwent randomization. A total of 74 participants were assigned to the mobile app (intervention group), and 76 did not use the app (control group). A total of 600 drug doses were prepared. Higher State-Trait Anxiety Inventory–perceived stress increase from baseline was observed during the scenario using the conventional methods (mean 35.4, SD 8.2 to mean 49.8, SD 13.2; a 41.3%, 35.0 increase) than when using the app (mean 36.1, SD 8.1 to mean 39.0, SD 8.4; a 12.3%, 29.0 increase). This revealed a 30.1% (95% CI 20.5%-39.8%; P

Background As a computerized drug–drug interaction (DDI) alert system has not been widely implemented in China, health care providers are relying on mobile health (mHealth) apps as references for checking drug information, including DDIs. Objective The main objective of this study was to evaluate the quality and content of mHealth apps supporting DDI checking in Chinese app stores. Methods A systematic review was carried out in November 2020 to identify mHealth apps providing DDI checking in both Chinese iOS and Android platforms. We extracted the apps’ general information (including the developer, operating system, costs, release date, size, number of downloads, and average rating), scientific or clinical basis, and accountability, based on a multidimensional framework for evaluation of apps. The quality of mHealth apps was evaluated by using the Mobile App Rating Scale (MARS). Descriptive statistics, including numbers and percentages, were calculated to describe the characteristics of the apps. For each app selected for evaluation, the section-specific MARS scores were calculated by taking the arithmetic mean, while the overall MARS score was described as the arithmetic mean of the section scores. In addition, the Cohen kappa (κ) statistic was used to evaluate the interrater agreement. Results A total of 7 apps met the selection criteria, and only 3 included citations. The average rating score for Android apps was 3.5, with a minimum of 1.0 and a maximum of 4.9, while the average rating score for iOS apps was 4.7, with a minimum of 4.2 and a maximum of 4.9. The mean MARS score was 3.69 out of 5 (95% CI 3.34-4.04), with the lowest score of 1.96 for Medication Guidelines and the highest score of 4.27 for MCDEX mobile. The greatest variation was observed in the information section, which ranged from 1.41 to 4.60. The functionality section showed the highest mean score of 4.05 (95% CI 3.71-4.40), whereas the engagement section resulted in the lowest average score of 3.16 (95% CI 2.81-3.51). For the information quality section, which was the focus of this analysis, the average score was 3.42, with the MCDEX mobile app having the highest score of 4.6 and the Medication Guidelines app having the lowest score of 1.9. For the overall MARS score, the Cohen interrater κ was 0.354 (95% CI 0.236-0.473), the Fleiss κ was 0.353 (95% CI, 0.234-0.472), and the Krippendorff α was 0.356 (95% CI 0.237-0.475). Conclusions This study systematically reviewed the mHealth apps in China with a DDI check feature. The majority of investigated apps demonstrated high quality with accurate and comprehensive information on DDIs. However, a few of the apps that had a massive number of downloads in the Chinese market provided incorrect information. Given these apps might be used by health care providers for checking potential DDIs, this creates a substantial threat to patient safety.

Aminoacyl-tRNA synthetases (aaRSs) catalyze the aminoacylation of tRNAs to produce the aminoacyl-tRNAs (aa-tRNAs) required by ribosomes for translation of the genetic message into proteins. To ensure the accuracy of tRNA aminoacylation, and consequently the fidelity of protein synthesis, some aaRSs exhibit a proofreading (editing) site, distinct from the aa-tRNA synthetic site. The aaRS editing site hydrolyzes misacylated products formed when a non-cognate amino acid is used during tRNA charging. Because aaRSs play a central role in protein biosynthesis and cellular life, these proteins represent longstanding targets for therapeutic drug development to combat infectious diseases. Most existing aaRS inhibitors target the synthetic site, and it is only recently that drugs targeting the proofreading site have been considered. In the present study, we developed a robust assay for the high-throughput screening of libraries of inhibitors targeting both the synthetic and the proofreading sites of up to four aaRSs simultaneously. Thus, this assay allows for screening of eight distinct enzyme active sites in a single experiment. aaRSs from several prominent human pathogens (i.e., Mycobacterium tuberculosis, Plasmodium falciparum, and Escherichia coli) were used for development of this assay.

Background: Suicides by any method, plus ‘nonsuicide’ fatalities from drug self-intoxication (estimated from selected forensically undetermined and ‘accidental’ deaths), together represent self-injury mortality (SIM)—fatalities due to mental disorders or distress. SIM is especially important to examine given frequent undercounting of suicides amongst drug overdose deaths. We report suicide and SIM trends in the United States of America (US) during 1999–2018, portray interstate rate trends, and examine spatiotemporal (spacetime) diffusion or spread of the drug self-intoxication component of SIM, with attention to potential for differential suicide misclassification. Methods: For this state-based, cross-sectional, panel time series, we used de-identified manner and underlying cause-of-death data for the 50 states and District of Columbia (DC) from CDC's Wide-ranging Online Data for Epidemiologic Research. Procedures comprised joinpoint regression to describe national trends; Spearman's rank-order correlation coefficient to assess interstate SIM and suicide rate congruence; and spacetime hierarchical modelling of the ‘nonsuicide’ SIM component. Findings: The national annual average percentage change over the observation period in the SIM rate was 4.3% (95% CI: 3.3%, 5.4%; p6.0% increase (p

Clinical responses to bendamustine in chronic lymphocytic leukemia (CLL) are highly heterogeneous and no specific markers to predict sensitivity to this drug have been reported. In order to identify biomarkers of response, we analyzed the in vitro activity of bendamustine and the gene expression profile in primary CLL cells. We observed that mRNA expression of CD69 (CD69) and ITGAM (CD11b) constitute the most powerful predictor of response to bendamustine. When we interrogated the predictive value of the corresponding cell surface proteins, the expression of the activation marker CD69 was the most reliable predictor of sensitivity to bendamustine. Importantly, a multivariate analysis revealed that the predictive value of CD69 expression was independent from other clinico-biological CLL features. We also showed that when CLL cells were co-cultured with distinct subtypes of stromal cells, an upregulation of CD69 was accompanied by a reduced sensitivity to bendamustine. In agreement with this, tumor cells derived from lymphoid tumor niches harbored higher CD69 expression and were less sensitive to bendamustine than their peripheral blood counterparts. Furthermore, pretreatment of CD69 high CLL cases with the B-cell receptor (BCR) pathway inhibitors ibrutinib and idelalisib decreased CD69 levels and enhanced bendamustine cytotoxic effect. Collectively, our findings indicate that CD69 could be a predictor of bendamustine response in CLL patients and the combination of clinically-tested BCR signaling inhibitors with bendamustine may represent a promising strategy for bendamustine low responsive CLL cases.

In epidemiological surveys and surveillance the application of molecular tools is essential in detecting submicroscopic malaria. A genus-specific conventional cytochrome b (cytb) PCR has shown high sensitivity in field studies, detecting 70% submicroscopic malaria. The main objective of this study was to assess the conversion from conventional to real-time PCR testing both SYBR and probe protocols, and including quantitative (q) PCR. The protocols were assessed applying well-defined clinical patient material consisting of 33 positive and 80 negative samples. Sequencing of positive PCR products was performed. In addition, a sensitivity comparison of real-time PCR methods was done by including five relevant assays investigating the effect of amplification target and platform. Sensitivity was further examined using field material consisting of 111 P.falciparum positive samples from Tanzanian children (< 5 years), as well as using related patient data to assess the application of q-PCR with focus on low-level parasitaemia. Both the cytb SYBR and probe PCR protocols showed as high sensitivity and specificity as their conventional counterpart, except missing one P. malariae sample. The SYBR protocol was more sensitive and specific than using probe. Overall, choice of amplification target applied is relevant for achieving ultra-sensitivity, and using intercalating fluorescence dye rather than labelled hydrolysis probes is favourable. Application of q-PCR analysis in field projects is important for the awareness and understanding of low-level parasitaemia. For use in clinical diagnosis and epidemiological studies the highly sensitive and user-friendly cytb SYBR q-PCR method is a relevant tool. The genus-specific method has the advantage that species identification by sequencing can be performed as an alternative to species-specific PCR. publishedVersion

Background: Prospective memory is the ability to recall intended actions or events at the right time or in the right context. While cannabis is known to impair prospective memory, the acute effect of cocaine is unknown. In addition, it is not clear whether changes in prospective memory represent specific alterations in memory processing or result from more general effects on cognition that spread across multiple domains such as arousal and attention. Aims: The main objective of the study was, therefore, to determine whether drug-induced changes in prospective memory are memory specific or associated with more general drug-induced changes in attention and arousal. Methods: A placebo-controlled, three-way, cross-over study including 15 regular poly-drug users was set up to test the influence of oral cocaine (300 mg) and vaporised cannabis (300+150 ‘booster’ µg/kg bodyweight) on an event-based prospective memory task. Attentional performance was assessed using a divided attention task and subjective arousal was assessed with the Profile of Mood States questionnaire. Results: Results showed that cocaine enhanced prospective memory, attention and arousal. Mean performance of prospective memory and attention, as well as levels of arousal were lowest during treatment with cannabis as compared with placebo and cocaine as evinced by a significantly increased trend across treatment conditions. Prospective memory performance was only weakly positively associated to measures of attention and arousal. Conclusion: Together, these results indicate that cocaine enhancement of prospective memory performance cannot be fully explained by parallel changes in arousal and attention levels, and is likely to represent a direct change in the neural network underlying prospective memory.

Medications can cause many adverse reactions, both non-immunologic and immunologic ones. Allergies can take many forms, allergic reactions include all types of reactions according to Gell and Coombs. Typically, allergic reactions to drugs are manifested by skin lesions such as maculopapular rash or urticaria and life-threatening systemic reactions such as anaphylaxis. Allergy to drugs is diagnosed based on medical history and a number of specific tests: skin tests, blood tests. In diagnosing the causes of anaphylaxis, the basophil activation test is used to exclude false negative and false positive results of skin tests and specific IgE levels. Allergic reactions to medications usually resolve themselves after discontinuation of the drug. Sometimes in the treatment anti-allergic drugs are used to inhibit the development of skin lesions. After observing any signs of drug allergy it is important to accurately diagnose the cause, since the subsequent exposure to the drug may lead to a strong anaphylactic reaction and consequently death.

Cardiotoxicity is among the top drug safety concerns, and is of specific interest in tuberculosis, where this is a known or potential adverse event of current and emerging treatment regimens. As there is a need for a tool, beyond the QT interval, to quantify cardiotoxicity early in drug development, an empirical decision tree based classifier was developed to predict the risk of Torsades de pointes (TdP). The cardiac risk algorithm was developed using pseudo-electrocardiogram (ECG) outputs derived from cardiac myocyte electromechanical model simulations of increasing concentrations of 96 reference compounds which represented a range of clinical TdP risk. The algorithm correctly classified 89% of reference compounds with moderate sensitivity and high specificity (71 and 96%, respectively) as well as 10 out of 12 external validation compounds and the anti-TB drugs moxifloxacin and bedaquiline. The cardiac risk algorithm is suitable to help inform early drug development decisions in TB and will evolve with the addition of emerging data. Electronic supplementary material The online version of this article (10.1007/s10928-018-9580-2) contains supplementary material, which is available to authorized users.

Identification of new psychoactive substances (NPS) in biological and non-biological samples represents a hard challenge for forensic toxicologists. Their great chemical variety and the speed with which new NPS are synthesised and spread make stringent the need of advanced tools for their detection based on multidisciplinary approaches. For this reason, in August 2016, the “Unit of Research and Innovation in Forensic Toxicology and Neuroscience of Addiction” (U.R.I.To.N.) was founded by the Forensic Toxicology Division of the University of Florence. In this Research Unit, various professionals (i.e. forensic toxicologists, chemists, physicians) collaborate to study all the aspects of drugs of abuse, especially NPS. Herein, we describe the multidisciplinary approach comprising liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS), gas chromatography hyphenated to mass spectrometry (GC–MS) and solution nuclear magnetic resonance analysis that allowed the identification of three NPS such as 1-(benzofuran-5-yl)-N-methylpropan-2-amine, 2-amino-1-(4-bromo-2,5-dimethoxyphenyl)ethan-1-one (bk-2C-B), and 3-(2-aminopropyl)indole (α-methyltryptamine) in seized materials.

// Weibo Yu 1 , Xiaotian Qin 2 , Yusheng Jin 1 , Yawei Li 2 , Chintda Santiskulvong 3 , Victor Vu 1 , Gang Zeng 4, 5 , Zuofeng Zhang 6 , Michelle Chow 1 , Jianyu Rao 1, 5 1 Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA 2 Beijing Boyuantaihe Biological Technology Co., Ltd., Beijing, China 3 Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA, USA 4 Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA 5 Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, CA, USA 6 Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA Correspondence to: Jianyu Rao, email: jrao@mednet.ucla.edu Keywords: TSY-1, hematopoietic cells, Telomerase, TERT, methylation Received: September 08, 2016 Accepted: November 24, 2016 Published: December 15, 2016 ABSTRACT Telomere and Telomerase have recently been explored as anti-aging and anti-cancer drug targets with only limited success. Previously we showed that the Chinese herbal medicine Tianshengyuan-1 (TSY-1), an agent used to treat bone marrow deficiency, has a profound effect on stimulating Telomerase activity in hematopoietic cells. Here, the mechanism of TSY-1 on cellular Telomerase activity was further investigated using HL60, a promyelocytic leukemia cell line, normal peripheral blood mononuclear cells, and CD34+ hematopoietic stem cells derived from umbilical cord blood. TSY-1 increases Telomerase activity in normal peripheral blood mononuclear cells and CD34+ hematopoietic stem cells with innately low Telomerase activity but decreases Telomerase activity in HL60 cells with high intrinsic Telomerase activity, both in a dose-response manner. Gene profiling analysis identified Telomerase reverse transcriptase (TERT) as the potential target gene associated with the TSY-1 effect, which was verified by both RT-PCR and western blot analysis. The β-galactosidase reporter staining assay showed that the effect of TSY-1 on Telomerase activity correlates with cell senescence. TSY-1 induced hypomethylation within TERT core promoter in HL60 cells but induced hypermethylation within TERT core promoter in normal peripheral blood mononuclear cells and CD34+ hematopoietic stem cells. TSY-1 appears to affect the Telomerase activity in different cell lines differently and the effect is associated with TERT expression, possibly via the methylation of TERT promoter.

The effects of incorporating a biomarker-based (personalized or precision) selection strategy on drug development timelines for new oncology drugs merit investigation. Here we accessed documents from the Food and Drug Administration (FDA) database for anticancer agents approved between 09/1998 and 07/2014 to compare drugs developed with and without a personalized strategy. Sixty-three drugs were included (28 [44%] personalized and 35 [56%] non-personalized). No differences in access to FDA-expedited programs were observed between personalized and non-personalized drugs. A personalized approach for drug development was associated with faster clinical development (Investigational New Drug [IND] to New Drug Application [NDA] submission; median = 58.8 months [95% CI 53.8-81.8] vs. 93.5 months [95% CI 73.9-112.9], P =.001), but a similar approval time (NDA submission to approval; median=6.0 months [95% CI 5.5-8.4] vs. 6.1 months [95% CI 5.9-8.3], P = .756) compared to a non-personalized strategy. In the multivariate model, class of drug stratified by personalized status (targeted personalized vs. targeted non-personalized vs. cytotoxic) was the only independent factor associated with faster total time of clinical drug development (clinical plus approval phase, median = 64.6 vs 87.1 vs. 112.7 months [cytotoxic], P = .038). Response rates (RR) in early trials were positively correlated with RR in registration trials (r = 0.63, P =

Background Substance use is a major issue for adolescents and young adults, particularly college students. With the importance of peer influence and the ubiquitous use of social media among these age groups, it is important to assess what is discussed on various social media sites regarding substance use. One particular mobile app (Yik Yak) allowed users to post any message anonymously to nearby persons, often in areas with close proximity to major colleges and universities. Objective This study describes the content, including attitude toward substances, of social media discussions that occurred near college campuses and involved substances. Methods A total of 493 posts about drugs and alcohol on Yik Yak were reviewed and coded for their content, as well as the poster’s attitude toward the substance(s) mentioned. Results Alcohol (226/493, 45.8%), marijuana (206/493, 41.8%), and tobacco (67/493, 13%) were the most frequently mentioned substances. Posts about use (442/493) were generally positive toward the substance mentioned (262/442, 59.3%), unless the post was about abstinence from the substance. Additionally, posts that commented on the substance use of others tended to be less positive (18/92, 19.6% positive) compared to posts about one’s own use (132/202, 65.3% positive). Conclusions This study provides a description of anonymous discussions on or near college campuses about drugs and alcohol, which serves as an example of data that can be examined from social media sites for further research and prevention campaigns.

This study investigated 24 tablet crushing devices for drug loss using different methods to recover the crushed tablet. 24 devices were compared: 3 with disposable cups, 6 with disposable bags, 12 without separate vessels and 3 types of mortar and pestle. One paracetamol tablet was crushed and recovered by tapping the powder out. Where appropriate, depending on crusher size and manufacturer instructions, the powder was also recovered by mixing with water or food. Paracetamol recovery (quantity that can be delivered to a patient) and leftover (quantity remaining in the device) were measured using a validated UV method and the entire experiment was replicated 3 times. Drug recovery ranged from 86.7-98.1% when the crushed tablet was tapped out of the crushers (average loss 5.8%). Significant losses were measured for 18 crushers, particularly manually operated hand-twist crushers with a serrated crushing surface, and some devices with disposable bags or cups. Rinsing the crushed powder with water once resulted in an average of 24.2% drug loss, and this was reduced to 4.2% after a second rinse. If crushing is unavoidable, maximizing medication delivery to the patient is essential. Rinsing twice resulted in similar paracetamol recovery to tapping the powder out; however only water rinses have the potential for direct consumption by the patient, minimizing drug loss across the entire crushing and transfer process.

BackgroundPredicting the popularity of and harm caused by psychoactive agents is a serious problem that would be difficult to do by a single simple method. However, because of the growing number of drugs it is very important to provide a simple and fast tool for predicting some characteristics of these substances. We were inspired by the Google Flu Trends study on the activity of the influenza virus, which showed that influenza virus activity worldwide can be monitored based on queries entered into the Google search engine. ObjectiveOur aim was to propose a fast method for ranking the most popular and most harmful drugs based on easily available data gathered from the Internet. MethodsWe used the Google search engine to acquire data for the ranking lists. Subsequently, using the resulting list and the frequency of hits for the respective psychoactive drugs combined with the word “harm” or “harmful”, we estimated quickly how much harm is associated with each drug. ResultsWe ranked the most popular and harmful psychoactive drugs. As we conducted the research over a period of several months, we noted that the relative popularity indexes tended to change depending on when we obtained them. This suggests that the data may be useful in monitoring changes over time in the use of each of these psychoactive agents. ConclusionsOur data correlate well with the results from a multicriteria decision analysis of drug harms in the United Kingdom. We showed that Google search data can be a valuable source of information to assess the popularity of and harm caused by psychoactive agents and may help in monitoring drug use trends.

Introduction and objectives Atrial fibrillation is a common arrhythmia following coronary artery bypass graft surgery. Its incidence can range from 10 to 60% of patients undergoing coronary artery bypass graft. This rhythm can result in shorter or longer intervals between beats. Methods Medical records of 143 patients from the Queen’s Medical Center, Kuakini Medical Center, Saint Francis Medical Center, and Straub Hospital and Clinic, all of which are located in Honolulu, Hawaii were reviewed. An additional 39 records of patients who did not develop these complications were also reviewed as a control group. Patients were selected according to the ICD codes for atrial fibrillation/flutter and coronary artery bypass graft. Both anomalies can lead to increased health care costs, morbidity, and mortality. In this study, possible predisposing factors to these complications were investigated. The time of onset, weight gain, elapsed time, fluid status (in/out), hematocrit, and drug regimens were compared between the two groups. Results The differences in weight gain, fluid status, and hematocrit between the groups were not significant. There were a total of 17 different drugs prescribed to the group as a whole but not every patient received the same regimen. Conclusions Atrial fibrillation and flutter were found to be more common in males, particularly between the ages of 60 and 69 years. There were no other significant findings.

Summary Objective The objective of this article is to gain a deeper understanding of the attitudes and perceptions of adolescents in the United Arab Emirates regarding substance and to identify factors that, in their view, may influence the risk of substance use and suggest possible interventions. Design This was a qualitative study that used a focus group approach. Setting The study was carried out in Abu Dhabi, United Arab Emirates. Participants Male and female teenagers aged 13-18 years residing in the emirate of Abu Dhabi. Main outcome measures Adolescents’ awareness of substance use, patterns of use and associated harm; Adolescents' perceptions about the factors associated with substance use. Results Six focus groups were carried out, and a total of 41 adolescents (20 males and 21 females) participated. Data analysis identified three main themes: (1) adolescents’ awareness of substance use and associated harm; (2) gender role and image and (3) perceived factors affecting substance use among adolescents. Knowledge of substances and related consequences of use varied between groups but was compatible with participants’ age and school years. Factors that participants believed influenced substance use were classified into: (1) parent–adolescent relationship, (2) peer pressure, (3) substance accessibility, (4) religiosity and (5) others. Many factors were believed to increase the risk of substance use among adolescents such as peer pressure, inadequate knowledge of the harmful consequences of drug use, family-related factors (e.g. low monitoring and poor parent–adolescents relationship), affordability and availability of substances, boredom and affluence. On the other hand, religiosity was as a shield against substance use, especially alcohol. Other identified protective factors included carrying out schools- and communities-based educational campaigns, enhancing social workers’ ability to raise awareness and detect early signs of addiction and implementing CCTV systems in schools. Conclusions The study was successful in exploring adolescents’ awareness of substances and associated harm to health from their use. Also, it identifies a number of risk and protective factors based on the perceptions of a group of adolescents residing in the United Arab Emirates. Such factors can guide the planning, designing and implementing of prevention programmes that focus on raising awareness about the harms of substance use. The study findings would suggest that multifactorial prevention programmes that address social norms, gender role and image, and incorporate drug policy, religion, family and school would be more effective and may have better protective outcomes.

L’objectif de cet article est de revenir sur la place qu’occupe la Première Guerre mondiale dans l’émergence de la médicalisation de certaines émotions comme l’angoisse et, plus généralement, l’anxiété. L’article cherche à montrer que ces émotions, déjà repérées à la fin du XIXe siècle par des médecins issus de différentes spécialités, voient leur place consolidée dans le paysage médical et pharmaceutique, et ce bien avant l’émergence des anxiolytiques. L’article cherche aussi à faire porter le regard sur la société civile, moins souvent étudiée que la communauté des soldats pour tout ce qui touche aux traumatismes de guerre. The aim of this paper is to comment on the importance of World War One in the advent of the medicalization of certain emotions such as anguish and, more generally speaking, anxiety. They had already been identified by physicians coming from the fields of different medical specialties. The paper tries to show that these emotions had been well established in the medical and pharmaceutical landscapes well before the advent of antidepressants. The paper tries, in particular, to shift the viewpoint from the soldiers to the civilians. El objetivo de este artículo es repasar el papel que desempeñó la Primera Guerra Mundial en la aparición de la medicalización de ciertas emociones como la angustia y, más generalmente, la ansiedad. Identificadas ya a finales del siglo XIX por médicos de distintas especialidades, el artículo pretende demostrar que estas emociones vieron consolidado su lugar en el panorama médico y farmacéutico mucho antes de la aparición de los ansiolíticos. El artículo pretende, en particular, desplazar el foco de atención de los soldados a la sociedad civil.

Введение: В данной работе проводится анализ фармацевтического рынка лекарственных препаратов для лечения болезни Альцгеймера. Цель: является анализ пускового механизма возникновения болезни Альцгеймера и анализ лекарственных средств, предназначенных для лечения больных с данным заболеванием, с целью выявления необходимости создания новых лекарственных препаратов данной области. Материалы и методы: В работе использовались статистические методы, методы контент-анализа, а также анализ, имеющихся в литературе данных. Результаты: было показано, что механизмы развития болезни Альцгеймера являются причиной деменцией во всём мире. Её симптомы включают различные стадии, связанные с нарушением речи, с неспособностью выполнять двигательную активность. В настоящее время возникновение болезни объясняется двумя механизмами возникновения: амилоидным и клубочковым. В амилойдном механизме большая роль отводится β-амилоиду, клубочковой механизм предполагает продолжение внутри клетки с помощью особого Тау-белка. Обсуждения: расчётное количество людей с деменцией составила в 2020 году 29,23 млн в Азии, 12,71 млн. в Европе, 11.42 млн. в Северной Америке и 5.3 млн. в Африке. Согласно существующему и прогнозу случаи этого заболевания будут неуклонно возрастать. В данной работе проанализированы два типа препаратов: для лечения деменции и ингибиторы холинэстеразы. Показано, что в качестве лекарственных препаратов для лечения деменции используются преимущественно 3 международных непатентованных наименования (МНН) (Мемантин Донепезил + Мемантин, Галантамин), которым соответствует 25 торговых наименований, представленных в свою очередь 2 формами выпуска. Большую часть лекарственных препаратов данной группы производит Россия (67,6%). Второй по величине производства является Германия (8,1%). На третьем месте находится Польша (5,4%). Фармакологическая группа ингибиторов холинэстеразы представлена 6 МНН (Галантамин, Донепезил, Ипидакрин, Неостигмина метилсульфат, Пиридостигмина бромид, Ривастигмин), соответствует 15 торговых названий и 2 формы выпуска (раствор для внутривенного и подкожного введения и капсулы пролонгированного действия). Доля Российских препаратов в данной группе составляет 50%, что говорит о приоритете отечественных производителей в данной группе лекарственных препаратов. Заключение: было показано, что несмотря на то, что на фармацевтическом рынке существует приоритет отечественных производителей, тем не менее, ассортимент лекарственных форм является недостаточным, что приводит к необходимости создания новых лекарственных форм, в соответствии с современными инновационными технологиями., Introduction. This paper analyzes the pharmaceutical market for drugs for the treatment of Alzheimer's disease. The aim of the work is to analyze the trigger mechanism for the onset of Alzheimer's disease and the analysis of drugs intended for the treatment of patients with this disease in order to identify the need to create new drugs in this area. Materials and methods. The work used statistical methods, methods of content analysis, as well as analysis of data available in the literature. As a result of the study, it was shown that the mechanisms of development of Alzheimer's disease are the cause of dementia throughout the world. Its symptoms include various stages associated with impaired speech, with an inability to perform motor activities. Currently, the occurrence of the disease is explained by two mechanisms of occurrence: amyloid and glomerular. In the amyloid mechanism, a large role is assigned to β-amyloid, the glomerular mechanism involves continuation inside the cell with the help of a special Tau protein. Discussion: the estimated number of people with dementia in 2020 was 29.23 million in Asia, 12.71 million in Europe, 11.42 million in North America and 5.3 million in Africa. According to the existing and forecast cases of this disease will steadily increase. In this paper, we analyzed two types of drugs: for the treatment of dementia and cholinesterase inhibitors. It has been shown that mainly 3 international non-proprietary names (INN) (Memantine Donepezil + Memantine, Galantamine) are used as drugs for the treatment of dementia, which correspond to 25 trade names, represented in turn by 2 forms of release. Most of the drugs in this group are produced in Russia (67.6%). The second largest production is Germany (8.1%). In third place is Poland (5.4%). The pharmacological group of cholinesterase inhibitors is represented by 6 INNs (Galantamine, Donepezil, Ipidacrine, Neostigmine methyl sulfate, Pyridostigmine bromide, Rivastigmine), corresponding to 15 trade names and 2 forms of release (solution for intravenous and subcutaneous administration and prolonged-release capsules). The share of Russian drugs in this group is 50%, which indicates the priority of domestic manufacturers in this group of drugs. In conclusion, it was shown that despite the fact that there is a priority for domestic manufacturers in the pharmaceutical market, nevertheless, the range of dosage forms is insufficient, which leads to the need to create new dosage forms, in accordance with modern innovative technologies.

The number of people who are using prescribed medications is on the rise, largely due to an ageing population in the UK, but also because of early diagnosis and prompt medical management of a variety of conditions. Systemic medications may contribute to the development of oral side effects and translate into an increasing number of patients presenting in general dental practice settings. The aim of this paper is to provide an outline of oral side effects of systemic medications followed by a review of drug-associated oral ulcers (DAOUs). The paper also provides recommendations for early recognition and management of DAOUs in general dental practice settings, including referral to general medical practitioners and specialists in oral medicine.

We review the use of molecular dynamics (MD) simulation as a drug design tool in the context of the role that the lipid membrane can play in drug action, i.e., the interaction between candidate drug molecules and lipid membranes. In the standard “lock and key” paradigm, only the interaction between the drug and a specific active site of a specific protein is considered; the environment in which the drug acts is, from a biophysical perspective, far more complex than this. The possible mechanisms though which a drug can be designed to tinker with physiological processes are significantly broader than merely fitting to a single active site of a single protein. In this paper, we focus on the role of the lipid membrane, arguably the most important element outside the proteins themselves, as a case study. We discuss work that has been carried out, using MD simulation, concerning the transfection of drugs through membranes that act as biological barriers in the path of the drugs, the behavior of drug molecules within membranes, how their collective behavior can affect the structure and properties of the membrane and, finally, the role lipid membranes, to which the vast majority of drug target proteins are associated, can play in mediating the interaction between drug and target protein. This review paper is the second in a two-part series covering MD simulation as a tool in pharmaceutical research; both are designed as pedagogical review papers aimed at both pharmaceutical scientists interested in exploring how the tool of MD simulation can be applied to their research and computational scientists interested in exploring the possibility of a pharmaceutical context for their research.

Diabetes is increasing all around the world like an epidemic. It is creating an alarming situation and dragging countries into a threatening economic crisis in the world. The treatment and management of Diabetes Type 2 have remained challenging, even in this scientifically developed era, despite being known for a long period. At the current time, only half the patients can achieve recommended A1c hemoglobin target level. Variable therapeutic maneuvers have been discussed in this review paper that is under examination process in the management of diabetes. The production of new drugs like biguanides, thiazolidinediones, sulphonylureas, and alpha-glucosidase inhibitors has shown significant positive results in the control of hyperglycemia. A new category of therapeutics has been found with the latest approaches in drug discovery like Amylin analogs, Incretin mimetics, activated receptors of Peroxisome proliferator, GIP analogs, and dipeptidyl peptidase-4 inhibitors are used as recent progressive drugs for the management and treatment of diabetes. Similarly, recent advancements in the investigation, identification, and extraction of substances from plant sources have positively revolutionized the trends in diabetes management. This review paper, emphasizes the statistical prevalence, positive and negative impacts of commercial drugs, and multiple prospects of stem cell technology, nanotechnology, and statins for diabetes therapeutic management. Keywords: Diabetes, therapeutics, Drugs, Approach, Strategy, Insulin, treatment.

This paper selects and analyzes the key trends of current substance abuse that are most widespread in western European countries, the USA, Canada, and Russia, while also reviewing their differences and similarities. Foreign case studies, along with the results of analyzing the most prominent trends of substance abuse, must be accounted for when designing the optimal and most efficient measures for impacting the current drug abuse situation and eliminating its negative consequences. This paper examines the motivations and factors that encourage substance abuse; the phenomenon of substance abuse normalization; and the problems with identifying modern drug addicts that may arise as they try to adapt their behavior. The paper is based on a secondary analysis of several surveys among the working-age population (2013, 2016, 2017), as well as a college youth survey, entitled “The Student Lifestyle: Behavior Risks” (Ivanovo, Krasnodar, Moscow, Rybinsk, Chita, Yaroslavl). All of the above studies were conducted by the deviant behavior sociology sector of the RAS Federal Sociology Research Center. In addition, we considered surveys of college students in the USA and students in higher education in Canada.The analysis shows that: the age of first drug use is shifting upwards, which signifies that people are consciously deciding to consume addictive substances as mature individuals; there is an emerging trend of people aged 50 and over being introduced to addictive substances; the most popular motivation for consuming such substances is hedonism, i.e. the desire for pleasure; the attitude towards substance abuse is growing more and more tolerant, as introduction to recreational psychoactive drugs is becoming a fact of life and drug use is being integrated into society; modern substance abuse patterns still remain largely latent. We also consider foreign researchers’ insights, which warrant attention as we analyze the situation regarding substance abuse in Russian society and work on an effective anti-drug and addiction prevention policy.

Cell encapsulation—the process of coating cells with a semipermeable polymeric matrix—is of critical importance for many biomedical research applications including stem cell technologies, as the coating that encapsulates the cell is necessary to prevent immune rejection in cell transplantations. Using the layer-by-layer technique to encapsulate cells can provide several advantages to researchers, however, the current manual layer-by-layer process can be time-consuming and tedious, create difficulties in saving excess unbound material, and require cells to be kept out of an incubator for long periods of time during the encapsulation procedure. Therefore, a novel cell encapsulation device was designed to address these limitations. Through an iterative design process, an optimized prototype for this cell encapsulation device was developed specifically to aid stem cell researchers by providing improvements over the traditional layer-by-layer process. While lab closures due to the COVID-19 pandemic prevented complete assembly and testing of the final design iteration, it is expected that the outlined design validation process will prove the device capable of reducing the time necessary to complete the encapsulation procedure, reducing the amount of material lost during the procedure, as well as increasing the number of viable cells encapsulated during the layer-by-layer coating process. While the technical report included in this portfolio focuses on improving the process of cell encapsulation, the STS research paper takes a sociological look at the impacts of the War on Drugs. For decades, the federal government has criminalized certain substances through a movement called the War on Drugs in an effort to oppress marginalized communities. Drugs are a biomedical technology that quite literally have the potential to change one’s perception of the world, which can have huge implications on society. It makes sense that politicians may want to diminish the effect drugs have on people’s minds, but the way the legal system addresses drugs does not achieve this goal, but instead weaponizes the drugs in order to silence certain groups. This paper seeks to analyze the impact drugs have had on politics as well as society through the analytical framework of Co-Production, claiming that drugs and society both grow as a result of each other. This analysis will be done through case studies and personal interviews. Through this research, I expect to gain a deeper understanding of individuals due to a set of laws that in the twenty first century are generally seen as outdated. The drug technology and the analytical framework go hand in hand, because while the drugs themselves are simply chemicals that interact with the human mind a certain way, the widespread effects the War on Drugs has had are a result of STS concepts at play in the real world.

Recent research into the use of anabolic androgenic steroids (AAS) in fitness and strength training environments have revealed great variance in users’ approach to AAS use and more specifically their approach to health risks and desired objectives. However, there have only been few attempts to develop theoretical frameworks directed at conceptualising the variance in AAS use. In this paper, we propose a unified framework in the form of a typology, which concerns men’s general approach to AAS use. The typology is based on sociologist Max Weber’s method on the ideal typology. The work comes out of the authors’ own qualitative empirical research on male AAS users in fitness and strength training environments, but is also related to and draws on the international literature on the subject. The suggested typology consists of four ideal types: the Expert type, the Well-being type, the YOLO type, and the Athlete type. The four types are developed around two overarching categories, namely users’ approach to risk and effectiveness. The typology outlines distinct and characteristic approaches to AAS use and can, thus, be employed by researchers as well as health professionals as a heuristic tool for investigation and explanation. Recent research into the use of anabolic androgenic steroids (AAS) in fitness and strength training environments have revealed great variance in users’ approach to AAS use and more specifically their approach to health risks and desired objectives. However, there have only been few attempts to develop theoretical frameworks directed at conceptualising the variance in AAS use. In this paper, we propose a unified framework in the form of a typology, which concerns men’s general approach to AAS use. The typology is based on sociologist Max Weber’s method on the ideal typology. The work comes out of the authors’ own qualitative empirical research on male AAS users in fitness and strength training environments, but is also related to and draws on the international literature on the subject. The suggested typology consists of four ideal types: the Expert type, the Well-being type, the YOLO type and the Athlete type. The four types are developed around two overarching categories, namely users’ approach to risk and effectiveness. The typology outlines distinct and characteristic approaches to AAS use and can, thus, be employed by researchers as well as health professionals as a heuristic tool for investigation and explanation.

Background:Dual-targeting in cancer treatment by a single drug is an unconventional approach in relation to drug combinations. The rationale for the development of dualtargeting agents is to overcome incomplete efficacy and drug resistance frequently present when applying individual targeting agents. Consequently, -a more favorable outcome of cancer treatment is expected with dual-targeting strategies.Methods:We reviewed the literature, concentrating on the association between clinically relevant and/or novel dual inhibitors with the potential to modulate multidrug resistant phenotype of cancer cells, particularly the activity of P-glycoprotein. A balanced analysis of content was performed to emphasize the most important findings and optimize the structure of this review.Results:Two-hundred and forty-five papers were included in the review. The introductory part was interpreted by 9 papers. Tyrosine kinase inhibitors’ role in the inhibition of Pglycoprotein and chemosensitization was illustrated by 87 papers. The contribution of naturalbased compounds in overcoming multidrug resistance was reviewed using 92 papers, while specific dual inhibitors acting against microtubule assembling and/or topoisomerases were described with 55 papers. Eleven papers gave an insight into a novel and less explored approach with hybrid drugs. Their influence on P-glycoprotein and multidrug resistance was also evaluated.Conclusion:These findings bring into focus rational anticancer strategies with dual-targeting agents. Most evaluated synthetic and natural drugs showed a great potential in chemosensitization. Further steps in this direction are needed for the optimization of anticancer treatment.

Objective To identify the categories of problems with information technology (IT), which affect patient safety in general practice.Design General practitioners (GPs) reported incidents online or by telephone between May2012 and November 2013. Incidents were reviewed against an existing classification for problems associated with IT and the clinical process impacted.Participants and setting 87 GPs across Australia.Main outcome measure Types of problems,consequences and clinical processes.Results GPs reported 90 incidents involving IT which had an observable impact on the delivery of care, including actual patient harm as well as near miss events. Practice systems and medications were the most affected clinical processes. Problems with IT disrupted clinical workflow, wasted time and caused frustration.Issues with user interfaces, routine updates to software packages and drug databases, and the migration of records from one package to another generated clinical errors that were unique to IT; some could affect many patients at once. Human factors issues gave rise to some errors that have always existed with paper records but are more likely to occur and cause harm with IT. Such errors were linked to slips in concentration, multitasking, distractions and interruptions. Problems with patient identification and hybrid records generated errors that were in principle no different to paper records.Conclusions Problems associated with IT include perennial risks with paper records, but additional disruptions in workflow and hazards for patients unique to IT, occasionally affecting multiple patients. Surveillance for such hazards may have general utility, but particularly in the context of migrating historical records to new systems and software updates to existing systems. Refereed/Peer-reviewed

Background Antimicrobial resistance (AMR) has become an emerging issue in the developing countries as well as in Bangladesh. AMR is aggravated by irrational use of antimicrobials in a largely unregulated pluralistic health system. This review presents a ‘snap shot’ of the current situation including existing policies and practices to address AMR, and the challenges and barriers associated with their implementation. Methods A systematic approach was adopted for identifying, screening, and selecting relevant literature on AMR situation in Bangladesh. We used Google Scholar, Pubmed, and Biomed Central databases for searching peer-reviewed literature in human, animal and environment sectors during January 2010-August 2019, and Google for grey materials from the institutional and journal websites. Two members of the study team independently reviewed these documents for inclusion in the analysis. We used a ‘mixed studies review’ method for synthesizing evidences from different studies. Result Of the final 47 articles, 35 were primary research, nine laboratory-based research, two review papers and one situation analysis report. Nineteen articles on human health dealt with prescribing and/or use of antimicrobials, five on self-medication, two on non-compliance of dosage, and 10 on the sensitivity and resistance patterns of antibiotics. Four papers focused on the use of antimicrobials in food animals and seven on environmental contamination. Findings reveal widespread availability of antimicrobials without prescription in the country including rise in its irrational use across sectors and consequent contamination of environment and spread of resistance. The development and transmission of AMR is deep-rooted in various supply and demand side factors. Implementation of existing policies and strategies remains a challenge due to poor awareness, inadequate resources and absence of national surveillance. Conclusion AMR is a multi-dimensional problem involving different sectors, disciplines and stakeholders requiring a One Health comprehensive approach for containment.

Chronic obstructive pulmonary disease (COPD) is characterized by periodic episodes of worsening symptom (e.g., shortness of breath, irregular breathing, and worse coughing with increased phlegm production), also called pulmonary exacerbations. Inflammation is an important cause of reduced lung function as inflammation contributes to airflow obstruction in the small airways and lung parenchyma. Even in individuals with mild COPD, inflammation reduces lung function, accelerates decline in lung function overtime, and increases the risk for respiratory exacerbations. Agents that reduce systemic inflammation are hypothesized to decrease the inflammation in the lungs, resulting in improvements in lung function and a decrease in exacerbation frequency. We hypothesize that antidepressants have a beneficial effect on lung function. In addition to having anti-inflammatory properties, antidepressants act upon serotonin, which is integral in central breathing control. The combination of the anti-inflammatory and serotonergic effects may provide users of selective serotonin reuptake inhibitors with a lung function benefit while avoiding the side effects of steroids. This dissertation assesses whether selective serotonin reuptake inhibitors increase concurrent lung function and reduce the risk for respiratory exacerbations. It consists of three parts: a systematic literature review and two analytic papers using large prospective databases. The systematic review of the literature identified limitations concerning the effect of selective serotonin reuptake inhibitors on lung function. Overall, the analytic papers found no support for a beneficial association between selective serotonin reuptake inhibitors and spirometry, dyspnea or pulmonary exacerbations; indeed the association was in the opposite direction as hypothesized. In addition, there was no support for meaningful mediation by inflammatory markers. Further research is needed to determine if selective serotonin reuptake inhibitors have a harmful effect on lung function and pulmonary exacerbations.

IntroductionPrevious research has shown that statin adherence for the primary prevention of CVD is lower compared to secondary prevention populations. Therefore the aim of this systematic review was to review predictors of statin adherence for the primary prevention of CVD.MethodsA systematic search of papers published between Jan 1984 and May 2017 was conducted in PubMed, PsycINFO, EMbase and CINAHL databases. A study was eligible for inclusion if; 1) it was a study of the general population or of patients with familial hypercholesterolemia, hypertension, diabetes or arthritis; 2) statins were prescribed; 3) adherence was defined and measured as the extent to which patients followed their statin regimen during the period of prescription, and 4) it was an original trial or observational study (excluding case reports). A study was subsequently excluded if 1) results were not presented separately for primary prevention; 2) it was a trial of an intervention (for example patient education). Papers were reviewed by two researchers and consensus agreed with a third. A quality assessment (QA) tool was used to formally assess each included article. To evaluate the effect of predictors, data were quantitatively and qualitatively synthesised.ResultsIn total 19 studies met the inclusion criteria and nine were evaluated as high quality using the QA tool. The proportion of patients classed as "adherent" ranged from 17.8% to 79.2%. Potential predictors of statin adherence included traditional risk factors for CVD such as age, being male, diabetes and hypertension. Income associated with adherence more strongly in men than women, and highly educated men were more likely and highly educated women less likely to be adherent. Alcohol misuse and high BMI associated with non-adherence. There was no association between polypharmacy and statin adherence. The evidence base for the effect of other lifestyle factors and health beliefs on statin adherence was limited.ConclusionCurrent evidence suggests that patients with more traditional risk factors for CVD are more likely to be adherent to statins. The implications for future research are discussed.

In December 2019, the World Health Organization was informed of an outbreak of pneumonia of unknown etiology in Wuhan, Hubei Province, China. On January 7, 2020, a new type of coronavirus was isolated, with the WHO later officially calling it “COVID-19” and the International Committee on Taxonomy of Viruses naming the virus “SARS-CoV-2”. On January 30, 2020, the WHO declared the severe acute respiratory syndrome coronavirus 2 outbreak a public health emergency of international concern, making it an unprecedented global public health challenge. From a scientific and literary reference, it was established that the main drugs in the therapy with Covid-19 are Dexamethasone and Levofluoxetine. For this reason, we pay attention to the analysis of these two medicinal products. In the literature, we did not find an analysis of a combination of Dexamethasone and Levofloxacin. Development and validation of a highperformance liquid chromatographic analytical procedure for simultaneously determining Dexamethasone and Levofloxacin in a synthetic mixture is described in this paper. The separation was made with a LiChrosorb RP 18 (250 × 4.6 mm) column, at 25 °C temperature,with isocratic mode andmobile phase,containingt acetonitrile and woter (70-30v/v). Eluent was monitored at 254 nm and the flow rate was 1.0 ml/min. Dexamethasone and Levofluoxetine were effectively separated with retention time (tr) of 4.69 min and 14.51 min,respectively,with in the selected chromatographic conditions.The method was validated for analytical parameters: specificity, linearity, precision, accuracy,andlimits of detection and quantitation. The calibration curves were linear inthe concentration range of 12.5 to 100.0 μg/ml for Dexamethasone and Levofloxacin, and the regression coefficientswere more than 0.999. For Dexamethasone and Levofloxacin the recovery was 100.01% and 100.04%, respectively. This analytical procedure is applicable for the quality control of drug formulations.

ObjectiveIt has been demonstrated that alcohol continues to be the most prevalent reason causing traffic accidents. This study aimed to evaluate the alcohol levels in the traffic accident cases admitted to Ege University Hospital.MethodsBlood samples of the 4,266 cases were analyzed with the enzymatic immunoassay method between 2016 and 2017. The data was obtained from the hospital automation system and analyzed statistically.ResultsOf all cases (n = 20,058) admitted to the hospital department, the rate of traffic accidents was 21.3% (n = 4,266). The mean age was 32.38 +/- 12.4, and 70.4% of the cases were male. Ethyl alcohol was positive in 9.6% (n = 409) of the cases, and 33.1% (n = 136) of them were in the 25-34 age range. A significant increase was observed in 2017 compared to 2016 (p < 0.05). About 87.6% (n = 360) of the positive cases were above the legal limit of 0.50 g/L for drivers except for professional drivers. About 57.7% (n = 237) of the positive traffic accident cases were passengers, and 27.2% (n = 112) were motor vehicle and motorcycle drivers.ConclusionsThis paper presented an updated ethyl alcohol determination in the traffic accidents of the Izmir region in order to have an overall picture of Turkey. Continuous and systematic follow-up studies may help to monitor the alcohol use problem.

In Silico Trials methodologies will play a growing and fundamental role in the development and de-risking of new medical devices in the future. While the regulatory pathway for Digital Patient and Personal Health Forecasting solutions is clear, it is more complex for In Silico Trials solutions, and therefore deserves a deeper analysis. In this position paper, we investigate the current state of the art towards the regulatory system for in silico trials applied to medical devices while exploring the European regulatory system toward this topic. We suggest that the European regulatory system should start a process of innovation: in principle to limit distorted quality by different internal processes within notified bodies, hence avoiding that the more innovative and competitive companies focus their attention on the needs of other large markets, like the USA, where the use of such radical innovations is already rapidly developing. ispartof: IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS vol:26 issue:11 pages:5282-5286 ispartof: location:United States status: published

In recent years there has been increased attention to child neurodevelopment in studies on medication safety in pregnancy. Neurodevelopment is a multifactorial outcome that can be assessed by various assessors, using different measures. This has given rise to a debate on the validity of various measures of neurodevelopment. The aim of this review was twofold. Firstly we aimed to give an overview of studies on child neurodevelopment after prenatal exposure to central nervous system acting medications using psychotropics and analgesics as examples, giving special focus on the use and validity of outcome measures. Secondly, we aimed to give guidance on how to conduct and interpret medication safety studies with neurodevelopment outcomes. We conducted a systematic review in the MEDLINE, Embase, PsycINFO, Web of Science, Scopus, and Cochrane databases from inception to April 2019, including controlled studies on prenatal exposure to psychotropics or analgesics and child neurodevelopment, measured with standardised psychometric instruments or by diagnosis of neurodevelopmental disorder. The review management tool Covidence was used for data-extraction. Outcomes were grouped as motor skills, cognition, behaviour, emotionality, or “other”. We identified 110 eligible papers (psychotropics, 82 papers, analgesics, 29 papers). A variety of neurodevelopmental outcome measures were used, including 27 different psychometric instruments administered by health care professionals, 15 different instruments completed by parents, and 13 different diagnostic categories. In 23 papers, no comments were made on the validity of the outcome measure. In conclusion, establishing neurodevelopmental safety includes assessing a wide variety of outcomes important for the child’s daily functioning including motor skills, cognition, behaviour, and emotionality, with valid and reliable measures from infancy through to adolescence. Consensus is needed in the scientific community on how neurodevelopment should be assessed in medication safety in pregnancy studies. : © 2019 Hjorth et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Introduction Previous research has shown that statin adherence for the primary prevention of CVD is lower compared to secondary prevention populations. Therefore the aim of this systematic review was to review predictors of statin adherence for the primary prevention of CVD. Methods A systematic search of papers published between Jan 1984 and May 2017 was conducted in PubMed, PsycINFO, EMbase and CINAHL databases. A study was eligible for inclusion if; 1) it was a study of the general population or of patients with familial hypercholesterolemia, hypertension, diabetes or arthritis; 2) statins were prescribed; 3) adherence was defined and measured as the extent to which patients followed their statin regimen during the period of prescription, and 4) it was an original trial or observational study (excluding case reports). A study was subsequently excluded if 1) results were not presented separately for primary prevention; 2) it was a trial of an intervention (for example patient education). Papers were reviewed by two researchers and consensus agreed with a third. A quality assessment (QA) tool was used to formally assess each included article. To evaluate the effect of predictors, data were quantitatively and qualitatively synthesised. Results In total 19 studies met the inclusion criteria and nine were evaluated as high quality using the QA tool. The proportion of patients classed as “adherent” ranged from 17.8% to 79.2%. Potential predictors of statin adherence included traditional risk factors for CVD such as age, being male, diabetes and hypertension. Income associated with adherence more strongly in men than women, and highly educated men were more likely and highly educated women less likely to be adherent. Alcohol misuse and high BMI associated with non-adherence. There was no association between polypharmacy and statin adherence. The evidence base for the effect of other lifestyle factors and health beliefs on statin adherence was limited. Conclusion Current evidence suggests that patients with more traditional risk factors for CVD are more likely to be adherent to statins. The implications for future research are discussed.

It was already demonstrated by our research group that a direct catalytic methanol (or ethanol) fuel cell (DMFC) device can be used also for analytical purposes, such as the determination of ethanol content in beverages. In the present research we extended the application to the analysis of several ethanol-based pharmaceutical products, i.e., pharmaceutical tinctures (dyes) and disinfectants. In recent work we have also shown that the use of alcohol dehydrogenase enzyme as a component of the anodic section of a direct catalytic methanol (or ethanol) fuel cell significantly improves the performance of a simple DMFC device, making it more suitable to measure ethanol (or methanol) in real samples by this cell. At the same time, we have also shown that DMFC can respond to certain organic compounds that are more complex than methanol and ethanol and having R(R&rsquo, )CH-OH group in the molecule. Firstly, pharmaceutical dyes were analyzed for their ethanol content using the simple catalytic DMFC device, with good accuracy and precision. The results are illustrated in the present paper. Additionally, a detailed investigation carried out on commercial denatured alcoholic samples evidenced several interferences due to the contained additives. Secondly, we hypothesized that by using the enzymatic fuel cell it would be possible to improve the determination, for instance, of certain antibiotics, such as imipenem, or else carry out determinations of ethanol content in saliva and serum (simulating forensic tests, correlated to drivers &ldquo, breath test&rdquo, ), even if this has already been hypothesized in previous papers, the present study is the first to perform them experimentally, obtaining satisfactory results. In practice, all of the goals which we proposed were reached, confirming the remarkable opportunities of the enzymatic (or non-enzymatic) DMFC device.

The currently available anti-Toxoplasma agents have serious limitations. This systematic review was performed to evaluate drugs and new compounds used for the treatment of toxoplasmosis. Data was systematically collected from published papers on the efficacy of drugs/compounds used against Toxoplasma gondii (T. gondii) globally during 2006–2016. The searched databases were PubMed, Google Scholar, Science Direct, ISI Web of Science, EBSCO, and Scopus. One hundred and eighteen papers were eligible for inclusion in this systematic review, which were both in vitro and in vivo studies. Within this review, 80 clinically available drugs and a large number of new compounds with more than 39 mechanisms of action were evaluated. Interestingly, many of the drugs/compounds evaluated against T. gondii act on the apicoplast. Therefore, the apicoplast represents as a potential drug target for new chemotherapy. Based on the current findings, 49 drugs/compounds demonstrated in vitro half-maximal inhibitory concentration (IC50) values of below 1 μM, but most of them were not evaluated further for in vivo effectiveness. However, the derivatives of the ciprofloxacin, endochin-like quinolones and 1-[4-(4-nitrophenoxy) phenyl] propane-1-one (NPPP) were significantly active against T. gondii tachyzoites both in vitro and in vivo. Thus, these compounds are promising candidates for future studies. Also, compound 32 (T. gondii calcium-dependent protein kinase 1 inhibitor), endochin-like quinolones, miltefosine, rolipram abolish, and guanabenz can be repurposed into an effective anti-parasitic with a unique ability to reduce brain tissue cysts (88.7, 88, 78, 74, and 69%, respectively). Additionally, no promising drugs are available for congenital toxoplasmosis. In conclusion, as current chemotherapy against toxoplasmosis is still not satisfactory, development of well-tolerated and safe specific immunoprophylaxis in relaxing the need of dependence on chemotherapeutics is a highly valuable goal for global disease control. However, with the increasing number of high-risk individuals, and absence of a proper vaccine, continued efforts are necessary for the development of novel treatment options against T. gondii. Some of the novel compounds reviewed here may represent good starting points for the discovery of effective new drugs. In further, bioinformatic and in silico studies are needed in order to identify new potential toxoplasmicidal drugs.

Background: Zonal banning of disorderly and intoxicated young people has moved to centre stage in debates about nightlife governance. Whereas existing research has primarily focused on the use of zonal banning orders to address problems of alcohol-related harm and disorder, this article highlights how zonal banning is also used to target drug-using clubbers in Denmark.Methods and focus: Based on ethnographic observations and interviews with nightlife control agents in two Danish cities, the article aims to provide new insights into how the enforcement of national drug policies on drug-using clubbers, is shaped by plural nightlife policing complexes.Results: The paper demonstrates how the policing of drug-using clubbers is a growing priority for both police and private security agents. The article also demonstrates how the enforcement of zonal bans on drug-using clubbers involves complex collaborative relations between police, venue owners and private security agents.Conclusion: The paper argues that a third-party policing perspective combined with assemblage theory is useful for highlighting how the enforcement of national drug policies and nightlife banning systems is shaped by their embeddedness in local ‘drug policing assemblages’ characterized by inter-agency relation-building, the creative combination of public and private (legal) resources and internal power struggles. It also provides evidence of how drug policing assemblages give rise to many different, and often surprising, forms of jurisdiction involving divergent performances of spaces-, objects- and authorities of governance. Background: Zonal banning of disorderly and intoxicated young people has moved to centre stage in debates about nightlife governance. Whereas existing research has primarily focused on the use of zonal banning orders to address problems of alcohol-related harm and disorder, this article highlights howzonal banning is also used to target drug-using clubbers in Denmark.Methods: Based on ethnographic observations and interviews with nightlife control agents in two Danish cities, the article aims to provide new insights into how the enforcement of national drug policies on drug-using clubbers, is shaped by plural nightlife policing complexes.Results: The paper demonstrates how the policing of drug-using clubbers is a growing priority for both police and private security agents. The article also demonstrates how the enforcement of zonal bans on drug-using clubbers involves complex collaborative relations between police, venue owners and private security agents.Conclusion: The paper argues that a third-party policing perspective combined with assemblage theory is useful for highlighting how the enforcement of national drug policies and nightlife banning systems is shaped by their embeddedness in local ‘drug policing assemblages’ characterized by inter-agency relation-building, the creative combination of public and private (legal) resources and internal power struggles. It also provides evidence of how drug policing assemblages give rise to many different, and often surprising, forms of jurisdiction involving divergent performances of spaces-, objects- andauthorities of governance.

BACKGROUND: Inpatient medication errors are a significant concern. An approach not yet widely studied is to facilitate greater involvement of inpatients with their medication. At the same time, electronic prescribing is becoming increasingly prevalent in the hospital setting. In this study we aimed to explore hospital inpatients' involvement with medication safety-related behaviours, facilitators and barriers to this involvement, and the impact of electronic prescribing.METHODS: We conducted ethnographic observations and interviews in two UK hospital organisations, one with established electronic prescribing and one that changed from paper to electronic prescribing during our study. Researchers and lay volunteers observed nurses' medication administration rounds, pharmacists' ward rounds, doctor-led ward rounds and drug history taking. We also conducted interviews with healthcare professionals, patients and carers. Interviews were audio-recorded and transcribed. Observation notes and transcripts were coded thematically.RESULTS: Paper or electronic medication records were shown to patients in only 4 (2%) of 247 cases. However, where they were available during patient-healthcare professional interactions, healthcare professionals often viewed them in order to inform patients about their medicines and answer any questions. Interprofessional discussions about medicines seemed more likely to happen in front of the patient where paper or electronic drug charts were available near the bedside. Patients and carers had more access to paper-based drug charts than electronic equivalents. However, interviews and observations suggest there are potentially more significant factors that affect patient involvement with their inpatient medication. These include patient and healthcare professional beliefs concerning patient involvement, the way in which healthcare professionals operate as a team, and the underlying culture.CONCLUSION: Patients appear to have more access to paper-based records than electronic equivalents. However, to develop interventions to increase patient involvement with medication safety behaviours, a wider range of factors needs to be considered.

Resumo: Propõe-se uma leitura de três episódios da Odisseia, nos quais há o uso de um phármakon. São Helena, Circe e Hermes as personagens que administram as phármaka. Trata-se de leitura: 1) vinculada a um projeto: o levantamento e a interpretação de discursos que se distanciem e/ou questionem a perspectiva da “guerra às drogas”, algo como um projeto de extração de elementos textuais que possam servir como ferramentas teóricas, na construção de uma perspectiva menos mortífera em relação às substâncias; 2) guiada por três princípios, os quais podem ser ditos anticoloniais e antirracistas. Leitura centrada no phármakon, mas que o articula à comida floral dos lotófagos e à relação de xenía; dela, apresenta-se a proposta segundo a qual, no texto homérico, há a valorização de algo que pode ser chamado de multivalência. Abstract: The aim of this paper is to analyze three episodes of the Odyssey in which a pharmakon is used. Helen, Circe and Hermes are the characters that administer the pharmaka. This analysis is linked to a project - the survey of discourses that distance themselves and/or question the perspective of the “war on drugs”, a project that aims to extract textual elements that can serve as tools of thought in the construction of a less deadly path in relation to substances - and guided by three principles - which can be called anti-colonial and anti-racist. From this focus, centered on the pharmakon, also articulating it to the floral food of the lotophagi and the relationship of xenia, a thesis is put forward according to which, in the Homeric texts, one can find something that can be called multivalence.

Mental health issues can have significant impacts on individuals and communities and hence on social sustainability. There are several challenges facing mental health treatment, however, more important is to remove the root causes of mental illnesses because doing so can help prevent mental health problems from occurring or recurring. This requires a holistic approach to understanding mental health issues that are missing from the existing research. Mental health should be understood in the context of social and environmental factors. More research and awareness are needed, as well as interventions to address root causes. The effectiveness and risks of medications should also be studied. This paper proposes a big data and machine learning-based approach for the automatic discovery of parameters related to mental health from Twitter data. The parameters are discovered from three different perspectives, Drugs & Treatments, Causes & Effects, and Drug Abuse. We used Twitter to gather 1,048,575 tweets in Arabic about psychological health in Saudi Arabia. We built a big data machine learning software tool for this work. A total of 52 parameters were discovered for all three perspectives. We defined 6 macro-parameters (Diseases & Disorders, Individual Factors, Social & Economic Factors, Treatment Options, Treatment Limitations, and Drug Abuse) to aggregate related parameters. We provide a comprehensive account of mental health, causes, medicines and treatments, mental health and drug effects, and drug abuse, as seen on Twitter, discussed by the public and health professionals. Moreover, we identify their associations with different drugs. The work will open new directions for social media-based identification of drug use and abuse for mental health, as well as other micro and macro factors related to mental health. The methodology can be extended to other diseases and provides a potential for discovering evidence for forensics toxicology from social and digital media.

Background Daodi-herb is a part of Chinese culture, which has been naturally selected by traditional Chinese medicine clinical practice for many years. Sweet wormwood herb is a kind of Daodi-herb, and comes from Artemisia annua L. Artemisinin is a kind of effective antimalarial drug being extracted from A. annua. Because of artemisinin, Sweet wormwood herb earns a reputation. Based on the Pharmacopoeia of the People's Republic of China (PPRC), Sweet wormwood herb can be used to resolve summerheat-heat, and prevent malaria. Besides, it also has other medical efficacies. A. annua, a medicinal plant that is widely distributed in the world contains many kinds of chemical composition. Research has shown that compatibility of artemisinin, scopoletin, arteannuin B and arteannuic acid has antimalarial effect. Compatibility of scopoletin, arteannuin B and arteannuic acid is conducive to resolving summerheat-heat. Chemical constituents in A. annua vary significantly according to geographical locations. So, distribution of A. annua may play a key role in the characteristics of efficacy and chemical constituents of Sweet wormwood herb. It is of great significance to study this relationship. Objectives We mainly analyzed the relationship between the chemical constituents (arteannuin B, artemisinin, artemisinic acid, and scopoletin) with special efficacy in A. annua that come from different provinces in china, and analyzed the relationship between chemical constituents and spatial distribution, in order to find out the relationship between efficacy, chemical constituents and distribution. Methods A field survey was carried out to collect A. annua plant samples. A global positioning system (GPS) was used for obtaining geographical coordinates of sampling sites. Chemical constituents in A. annua were determined by liquid chromatography tandem an atmospheric pressure ionization-electrospray mass spectrometry. Relationship between chemical constituents including proportions, correlation analysis (CoA), principal component analysis (PCA) and cluster analysis (ClA) was displayed through Excel and R software version2.3.2(R), while the one between efficacy, chemical constituents and spatial distribution was presented through ArcGIS10.0, Excel and R software. Results According to the results of CoA, arteannuin B content presented a strong positive correlation with artemisinic acid content (p = 0), and a strong negative correlation with artemisinin content (p = 0). Scopoletin content presented a strong positive correlation with artemisinin content (p = 0), and a strong negative correlation with artemisinic acid content (p = 0). According to the results of PCA, the first two principal components accounted for 81.57% of the total accumulation contribution rate. The contribution of the first principal component is about 45.12%, manly including arteannuin B and artemisinic acid. The contribution of the second principal component is 36.45% of the total, manly including artemisinin and scopoletin. According to the ClA by using the principal component scores, 19 provinces could be divided into two groups. In terms of provinces in group one, the proportions of artemisinin are all higher than 80%. Based on the results of PCA, ClA, percentages and scatter plot analysis, chemical types are defined as "QHYS type", "INT type" and "QHS type." Conclusion As a conclusion, this paper shows the relationship between efficacy, chemical constituents and distribution. Sweet wormwood herb with high arteannuin B and artemisinic acid content, mainly distributes in northern China. Sweet wormwood herb with high artemisinin and scopoletin content has the medical function of preventing malaria, which mainly distributes in southern China. In this paper, it is proved that Sweet wormwood Daodi herb growing in particular geographic regions, has more significant therapeutical effect and higher chemical constituents compared with other same kind of CMM. And also, it has proved the old saying in China that Sweet wormwood Daodi herb which has been used to resolve summerheat-heat and prevent malaria, which distributed in central China. But in modern time, Daodi Sweet wormwood herb mainly has been used to extract artemisinin and prevent malaria, so the Daod-region has transferred to the southern China.

In this paper, an electrochemical sensor for levofloxacin detection was developed by electrochemical polymerization of pyrogallol red (PGR) on the glassy carbon electrode (GCE) surfaces. Surface morphology and electrical properties of the Poly(PGR)/GCE obtained was characterized by SEM and EIS techniques. Voltammetric behaviour of the levofloxacin was found pH dependent, and the best response was obtained at pH 6.0 PBS. By monitoring the peak current at around 0.9 V, a wide linear range of calibration graph: from 0.2 mu M- 15 mu M LEV and 15 mu M- 355 mu M for levofloxacin, and very low detection limit of 97 nM were achieved with amperometry. Selectivity of the method developed was proven in the presence of possible interfering substances and the method was successfully employed for levofloxacin detection in pharmaceutical tablet and synthetic urine sample.

Many different animal models are in use for drug development for leishmaniasis, but a universal model does not exist. There is a plethora of models, and this review assesses their design, quality, and limitations, including the attention paid to animal welfare in the study design and execution. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines of available literature after the year 2000 describing animal models for leishmaniasis. The risk of bias was determined using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) risk of bias assessment tool. A total of 10,980 records were initially identified after searching the databases PubMed, EMBASE, LILACS, and SciELO. Based on the application of predetermined exclusion and inclusion criteria, a total of 203 papers describing 216 animal experiments were available for full analysis. Major reasons for exclusion were a lack of essential study information or appropriate ethical review and approval. Mice (82.8%; an average of 35.9 animals per study) and hamsters (17.1%; an average of 7.4 animals per study) were the most frequently used animals, mostly commercially sourced, in the included studies. All studies lacked a formal sample size analysis. The promastigote stages of L. amazonensis or L. major were most frequently used to establish experimental infections (single inoculum). Animal welfare was poorly addressed in all included studies, as the definition of a human end-point or consideration of the 3Rs (Replacement, Reduction, Refinement) was hardly addressed. Most animals were euthanized at the termination of the experiment. The majority of the studies had an unknown or high risk of bias. Animal experiments for drug development for leishmaniasis mainly poorly designed and of low quality, lack appropriate ethical review, and are deficient in essential information needed to replicate and interpret the study. Importantly, aspects of animal welfare are hardly considered. This underpins the need to better consider and record the details of the study design and animal welfare.

Background How can we explain the uneven decline of syphilis around the world following the introduction of penicillin? In this paper we use antenatal syphilis prevalence (ASP) to investigate how syphilis prevalence varied worldwide in the past century, and what risk factors correlate with this variance. Methods 1) A systematic review using PubMed and Google Scholar was conducted to identify countries with published data relating to ASP estimates from before 1952 until the present. Eleven countries were identified (Canada, Denmark, Finland, India, Japan, Norway, Singapore, South Africa, United States of America (USA), United Kingdom (UK) and Zimbabwe). The ASP epidemic curve for each population was depicted graphically. In South Africa and the USA, results are reported separately for the black and white populations. 2) National antenatal syphilis prevalence estimates for 1990 to 1999 and 2008 were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low risk populations compiled for the Global Burden of Diseases study and from a recent review paper respectively. National ASPs were depicted graphically and regional median ASPs were calculated for both time periods. 3) Linear regression was used to test for an association between ASP in 1990–1999 and 2008 and four risk factors (efficacy of syphilis screening/treatment, health expenditure, GDP per capita and circumcision prevalence). WHO world regions were included as potential explanatory variables. Results In most populations, ASP dropped to under 1% before 1960. In Zimbabwe and black South Africans, ASP was high in the pre-penicillin period, dropped in the post-penicillin period, but then plateaued at around 6% until the end of the 20th century when ASP dropped to just above 1%. In black Americans, ASP declined in the post penicillin period, but plateaued at 3–5% thereafter. ASP was statistically significantly higher in sub-Saharan Africa in 1990–1999 and 2008 than in the other world regions (P < 0.001). On multivariate analysis in both time periods, ASP was only associated with residence in sub-Saharan Africa. Conclusions Further research is necessary to elucidate the reasons for the higher prevalence of syphilis in sub-Saharan Africa., Author Summary Syphilis rates have varied tremendously between different populations around the world. We conducted a systematic review of syphilis prevalence in pregnant women in 13 populations with available data for the last 100 years. Our findings were that in most populations syphilis prevalence dropped to under 1% before 1960. In the 2 populations from sub Saharan Africa, the syphilis prevalence remained around 6% until 50 years after the introduction of penicillin. Other systematic reviews were utilized to provide syphilis prevalence estimates for all countries with available data for the periods 1990–1999 and 2008. We assessed if there was a correlation between national syphilis prevalence in these periods and five explanatory factors. Only residence in sub-Saharan Africa was associated with syphilis prevalence in both time periods. These findings, considered in conjunction with other types of evidence we review, such as the strong correlations at population level between syphilis prevalence and those of Herpes Simplex Virus-2 prevalence and HIV prevalence, suggest that common risk factors may underpin the spread of all three of these sexually transmitted diseases. Establishing what these factors are is of great importance to improve the health of highly affected populations such as those in sub-Saharan Africa.

Researchers have observed differences in stress levels, and coping abilities and mechanisms based on the community being studied. This paper reports on the impact of extracurricular activities and student communities on stress and coping for youth in the Seattle area. Various self-reports, distributed through school health teachers, were used to gain information on students' stress levels, coping mechanisms, and coping ability. Results indicate that general categorizations of communities and activities (music, sports, etc.) did not demonstrate a significant correlation with students' stress or coping levels. Correlations between stress and coping were found, as were correlations between stress and coping and the number of communities/activities that students were involved in. Results provide insight into how students' activity loads impact their stress and coping levels more than the specific activities they are involved in and open the door to further research in the field.

In the article, we analyse discourse on drug abuse in contemporary Serbia. The ruling official discourse on drugs can be subsumed under the definition of moral panic, in creation of which, as well in dissemination, the media play an important role. Media uses specific vocabulary to send message warning of an impending social catastrophe. This tactic is effective: recipients of media content become anxious and frightened by the downfall of the society that awaits them in the near future. So logically they are converting into supporters of official discourses on the topic. In the end, this process has the power to briefly connect a shredded tissue of social cohesion, but also to produce a lack of freedom of citizens. In order to investigate whether drug-related moral panics in our country can have such implications, in this paper we analyzed the official discourse embodied in anti-drug policies, and the public discourse offered by media. Findings suggest that policymakers are calling on war against drugs, and name prevention and criminalization as the most successful strategies to fight it. The recipients of media content are agreeing with them. Furthermore, there is no doubt that such o discourse encourages the spread of moral panic about drugs, as well as social cohesion. Although abstractly defined, the enemy - drug, has the power to unite. However, it also causes a lack of freedom. Because of the narrative of the impending catastrophe, the citizens feel powerless and therefore demand from the higher state authorities to act in the name of the social future.