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Fungi are a diverse group of organisms that play an essential role in the biosphere. They have a unique ability to produce a vast array of secondary metabolites, including enzymes that have important applications in various industries. Fungal enzymes have been utilized in many fields, such as food processing, textile, paper, and pulp industries, to name a few. In recent years, there has been growing interest in the use of fungal enzymes in the synthesis of pharmaceutical compounds due to their scalability, high catalytic activity, relatively low cost, and ability to catalyze a wide range of chemical reactions under mild reaction conditions making the overall process greener and sustainable. Fungi produce a variety of enzymes such as oxidoreductases, transferases, and hydrolases which can be used in the synthesis of specific compounds with required chemo-, regio-, and stereoselectivity. This paper discusses the role of fungal enzymes in the synthesis of various drugs, active pharmaceutical ingredients (API), and drug intermediates and their applications in the pharmaceutical industry. [ABSTRACT FROM AUTHOR]

Effective and sustainable strategies are needed to address the burden of preventable deaths among children under-five in resource-constrained settings. The Tools for Integrated Management of Childhood Illness (TIMCI) project aims to support healthcare providers to identify and manage severe illness, whilst promoting resource stewardship, by introducing pulse oximetry and clinical decision support algorithms (CDSAs) to primary care facilities in India, Kenya, Senegal and Tanzania. Health impact is assessed through: a pragmatic parallel group, superiority cluster randomised controlled trial (RCT), with primary care facilities randomly allocated (1:1) in India to pulse oximetry or control, and (1:1:1) in Tanzania to pulse oximetry plus CDSA, pulse oximetry, or control; and through a quasi-experimental pre-post study in Kenya and Senegal. Devices are implemented with guidance and training, mentorship, and community engagement. Sociodemographic and clinical data are collected from caregivers and records of enrolled sick children aged 0-59 months at study facilities, with phone follow-up on Day 7 (and Day 28 in the RCT). The primary outcomes assessed for the RCT are severe complications (mortality and secondary hospitalisations) by Day 7 and primary hospitalisations (within 24 hours and with referral); and, for the pre-post study, referrals and antibiotic. Secondary outcomes on other aspects of health status, hypoxaemia, referral, follow-up and antimicrobial prescription are also evaluated. In all countries, embedded mixed-method studies further evaluate the effects of the intervention on care and care processes, implementation, cost and cost-effectiveness. Pilot and baseline studies started mid-2021, RCT and post-intervention mid-2022, with anticipated completion mid-2023 and first results late-2023. Study approval has been granted by all relevant institutional review boards, national and WHO ethical review committees. Findings will be shared with communities, healthcare providers, Ministries of Health and other local, national and international stakeholders to facilitate evidence-based decision-making on scale-up. Study registration : NCT04910750 and NCT05065320.