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The article is devoted to the study of the value conflict, which has a verbal embodiment, and in some cases it is impossible to distinguish it from a communicative (verbal, linguistic) conflict. The purpose of the article is to study the verbal embodiment of value conflict in the categories of linguoecology. Modern media abound with information about conflicts and serve as a platform for the struggle of some values with others. Common communicative benefit is that, when verbalizing conflict, the techniques of rhetorical argumentation prevail over dysphemization and invectives. All of the above determines the relevance of the article. Different linguistic units used in media discourse are considered as representatives of the conflict. For the first time, the article describes the means of representing axiological marked conflict in media space, taking into consideration the linguistic and pragmatic potential of units of different levels and its representation in media texts of different genres. Such a description contributes to the formation of skills for confident recognition of not only value problematics, but also the means of its representation in media texts, and as a result, the skills and abilities to create relevant professional media texts, diagnose media texts causing and reflecting axiologically marked, significant for linguistic culture conflicts. The novelty also lies in the study of standard and substandard units, neutral and expressive, nominative and tropeic ones, in common media text space, which can also contribute and determine the media education result, for example in creating impactful vivid media texts with an updated pragmatic effect. Media education and media literacy are mutually complementary. Predicting the language unit conflictogenicity in the media and skills to avoid it increase media literacy which is necessary for protection against cyberbullying, online fraud and other types of Internet threats. The empirical material is traditional media texts of topical issues related to different genres, posted on the official websites of media. Not only traditional linguistic descriptions and class stratification, but also elements of contextual and transformational analysis have been chosen as research methods. [ABSTRACT FROM AUTHOR]

Poor-quality medicines (substandard or counterfeit) can lead to treatment failure. There is a vast global imbalance in cancer treatment outcomes due to the difficulty of accessing quality chemotherapeutic products. Early diagnosis of cancer brings more hope for curative treatment of cancer and increases the demand for chemotherapeutic products. Consequently, it creates opportunities for unethical manufacturers and suppliers to develop substandard and/or counterfeit products. An ongoing review of cost-effective analytical methods is therefore paramount to tracking and tracing poor chemotherapeutic pharmaceutical products. Low- and middle-income country (LMIC) regulators lack safety equipment and standard operating procedures to handle chemotherapeutic products safely in the drug analysis laboratory and have limited capacity to perform post-marketing surveillance on these products. This review aimed to provide a compressive review of the Chemotherapeutic Paper Analytical Device (ChemoPAD). ChemoPAD is an important tool for quality screening of commonly used chemotherapeutic products in LMIC settings. It is an efficient, fast, simple, accessible, cost-effective, and transferable analytical method for verifying substandard and/or counterfeit chemotherapeutic products. Designed as a complete paper-based laboratory the size of a playing card, the ChemoPAD provides a promising solution for healthcare providers, patients, and other parties involved in post-marketing surveillance of chemotherapeutic products. Thus, in the near future, scientists could probably witness the use of the ChemoPAD technology platform to trace and track substandard and/or counterfeit chemotherapeutic products.

The article examines the linguistic and cultural characteristics of the substandard based on the material of artistic works of the second half of the XX – early XXI centuries. Substandard linguistic units, such as, for example, jargon and slang are an integral part of the artistic space when it comes to a realistic recreation of a certain period of time, describing the inner experiences of characters, verbalizing the worldview of the characters of the works. The use of a linguistic substandard allows you to recreate the linguistic and conceptual picture of the world not only of the characters of the work, the system of their norms and values, but also to rise to generalization and understanding of reality. The main functions of substandard units are ideological and emotional-evaluative, as well as cognitive, less often nominative.

Background: Substandard, falsified, unlicensed, and unregistered medicines pose significant risks to public health in developed and developing countries. This systematic review provides an overview of the prevalence of substandard, falsified, unlicensed, and unregistered medicine and its associated factors in Africa.Methods: Articles published from April 2014 to March 2024 were searched in Google Scholar, Science Direct, PubMed, MEDLINE, and Embase. The search strategy focused on open-access articles published in peer-reviewed scientific journals and studies exclusively conducted in African countries. The quality of the studies was assessed according to the Medicine Quality Assessment Reporting Guidelines (MEDQUARG). This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).Results: Of the 27 studies, 26 had good methodological quality after a quality assessment. Of the 7508 medicine samples, 1639 failed at least one quality test and were confirmed to be substandard/falsified medicines. The overall estimated prevalence of substandard/falsified medicines in Africa was 22.6% (1718/7592). The average prevalence of unregistered medicines was 34.6% (108/312). Antibiotics, antimalarial, and antihypertensive medicines accounted for 44.6% (712/1596), 15.6% (530/3530), 16.3% (249/1530), and 16.3% (249/1530), respectively. Approximately 60.7% (91/150) were antihelmintic and antiprotozoal medicines. Poor market regulatory permission, Free trade zones, poor registration, high demand, and poor importation standards contribute to the prevalence of these problems.Conclusion/Recommendations: Substandard, falsified, and unregistered medicines are highly prevalent in Africa, and attention has not been paid to the problem. Antibiotics, antimalarial, anthelmintic, and antiprotozoal are the most commonly reported substandard, falsified, and unregistered medicines. A consistent supply of high-quality products, enhancement of registration, market regulatory permission, and importation standards are essential to counter the problems in Africa. Preventing these problems is the primary duty of every responsible nation to save lives.

Shortly after Ukraine had declared its independence in December 1991, Joseph Brodsky, Nobel Prize Winner in Literature 1987, wrote the poem «На независимость Украины» [On the Independence of Ukraine], which sarcastically mourns the separation of Russia and Ukraine. In 2015, responding to the armed conflict in Ukraine, teacher and poet Aleksandr Byvshev issued a reply to this poem under the same title, taking the side of Ukraine. Both poems have been perceived as aggressive, insulting, and anti-Ukrainian or anti-Russian, respectively. This paper asks the question of whether – and in what sense – the two poems are aggressive by drawing on the linguistic features of the two texts. The investigation of the linguistic characteristics of the poems is supplemented by an analysis inspired by argumentation theory, since, as will be shown, both texts are essentially argumentative.

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Abstract Approximately 2 billion people globally have limited access to essential medicines, particularly those living in low‐ and middle‐income countries (LMICs). In addition, there is a higher prevalence of substandard and counterfeit medicines in LMICs, which may cause antimicrobial resistance and therapeutic failure. Good manufacturing practice (GMP) is key to ensuring access to high‐quality, safe and effective medicines, including active pharmaceutical ingredients and excipients used for manufacturing finished dosage forms. Compliance with GMP standards saves resources for both manufacturers (e.g. avoiding expensive product recalls) and governments (e.g. minimising compliance inspections). Concerted collaborations among different countries to harmonise GMP standards and procedures have occurred, and the World Health Organisation (WHO) GMP is commonly used in LMICs. However, barriers to GMP compliance remain apparent, particularly in LMICs. Pharmaceutical manufacturers in LMICs face several barriers such as inadequate resources and infrastructure, inefficient or weak regulation, a shortage of skilled people and limited training opportunities for manufacturing personnel. Although national regulatory authorities (NRAs) have been established in LMICs, most NRAs are not fully independent and are placed within the health department. NRAs in LMICs are not able to fully utilise international and regional reliance mechanisms and collaborations. Therefore, both NRAs and pharmaceutical manufacturers must be adequately supported through resources, infrastructure and capacity‐building opportunities. NRAs must be suitably empowered with assured functional independence. A comprehensive guideline for managing conflicts of interest among pharmaceutical manufacturers, procurement agencies and NRAs is needed. NRAs must liaise with other NRAs, participate in joint GMP inspections and leverage the expertise of regional or international collaborations. Pharmaceutical manufacturers in LMICs can leverage WHO GMP standards to improve GMP compliance and expand their market. However, as these solutions may have cost implications, prioritising key gaps for GMP compliance and optimisation of available resources are essential.

Assuring the quality of medical products manufactured, imported or distributed in francophone sub-Saharan Africa remains a challenge, despite positive signals like the growing engagement in the benchmarking of regulatory authorities and -particularly- in the establishment of the African Medicines Agency. In this short report, we describe the existing activities to prevent, detect and respond to substandard and falsified products (SF) in this region, either through African multilateral organizations and initiatives led by the World Health Organization, or through the contribution of other stakeholders, such as local universities and procurement agencies. We underline that these emerging local stakeholders may play a pivotal role to guide and inform the national regulatory authorities about the prevalence and patterns of SF medical products, complementing the market surveillance and control, and building awareness of the importance of pharmaceutical quality assurance for public health. [ABSTRACT FROM AUTHOR]

A moderate earthquake with a magnitude Mw of 6.8 hit the Elazig Province of Turkey on January 24th, 2020, causing fatalities and structural damage/failure. Following the earthquake, a field reconnaissance was conducted at the Administration and Operation Campus of Karakaya Dam, which is 19 km from the earthquake epicenter. The exhibited performances in two side-by-side nominally identical reinforced concrete (RC) buildings with the same material properties and soil conditions differed significantly. The main reason lies in the preventive action taken before the earthquake in one of the buildings. The building retrofitted with additional structural walls had a slight/no damage level. However, the non-retrofitted building suffered severe damage due to large cracks in numerous infill walls, some of which were exposed to partial collapse. That makes the non-retrofitted building unserviceable, requiring evacuation after the earthquake. The field-observed building damage was compared with the seismic performances acquired from their refined numerical models for the recorded ground motions. The photographic documentation exposing the entire performance and damage level in non-retrofitted and retrofitted buildings was quantified by static pushover and nonlinear response history analyses. The post-earthquake performance of nonstructural members in retrofitted and non-retrofitted buildings was simulated with reasonable accuracy. [ABSTRACT FROM AUTHOR]

IntroductionOver the years, counterfeit pharmaceuticals have posed immense concerns for global health and patient safety. This menace encompasses various classes of medications. Given the criticality of pharmacists’ interventions in drug distribution and supply, this study aimed at exploring their role in the prevention and control of counterfeit pharmaceutical products in Nigeria.MethodsA cross-sectional study was undertaken, using questionnaires to collect data from pharmacists across various sectors of pharmacy practice in Nigeria. Face and content validity was undertaken on the study tool prior to data collection. Ethical approval was obtained from the National Institute for Pharmaceutical Research and Development Health Research Ethics Committee, and confidentiality was strictly maintained during data collection process. Data were analyzed using Statistical Package for Social Sciences. Descriptive statistical analysis was undertaken and chi square was used to determine association between socio-demographic characteristics and variables.ResultsThe responses comprised 205 (52.6%) female and 185 (47.4%) male participants. Almost all the participants (98.4%) agreed that strict enforcement of drug laws can contribute to adequate control of counterfeit medicines in Nigeria, and majority of the study sample (64.7%) indicated that the poor implementation of these laws was a major factor influencing the preponderance of counterfeit medicines in the country. Two-thirds (63.5%) of the participants supported the need for pharmacists to provide adequate education to patients on strategies to identify counterfeit medicines, and a similar proportion (68.0%) were of the opinion that it was the responsibility of pharmacists to ensure that drugs are purchased from credible sources.ConclusionFindings from this study, in addition to confirming pharmacists’ instrumentality in the fight against counterfeit medicines, identified certain context specific factors that can strengthen the regulation, policy and the entire healthcare system. Government and relevant stakeholders can therefore begin to articulate strategic reforms for contextual policy intervention that address medicines’ counterfeiting, whilst prioritising pharmacists’ role in other critical areas in the healthcare system.

Abstract Objective Supraphysiologic doses of anabolic androgenic steroids (AAS) are widely used to improve body image and sport performance goals. These substances can easily be acquired over the internet, leading to a substantial black market. We reviewed literature that assessed the quality and quantity of AAS found on the black market. Methods We searched PubMed/Medline, Embase and Google Scholar for articles published before March 2022. Additional hand searches were conducted to obtain studies not found in the primary literature search. Studies were included if they report on qualitative and/or quantitative analytical findings of AAS from the black market. Primary outcomes were proportions of counterfeit or substandard AAS. Eligible articles were extracted; quality appraisal was done using the ToxRTool for in-vitro studies. We used random-effects models to calculate the overall mean estimates for outcomes. The review protocol has been published and registered in INPLASY. Results Overall, 19 studies, which in total comprised 5,413 anabolic samples, met the inclusion criteria, and passed the quality appraisal from two WHO world regions that reported findings, the Americas and Europe. Most studies were nonclinical laboratory studies (95%) and provided samples seized by authorities (74%). In 18 articles, proportions of counterfeit substances and in eight articles, proportions of substandard substances were presented. The overall mean estimate for counterfeit anabolic steroids found on the black market was 36% (95% CI = 29, 43). An additional 37% (95% CI = 17, 63) were of substandard quality. We also demonstrate that these drugs could contain no active ingredient, or in another amount than that labeled, a wrong active ingredient, as well as not all or more active ingredients than were labeled. High heterogeneity among all analyses and significant differences between geographical subgroups were found. Conclusion With this systematic review and meta-analysis, we demonstrate that substantial mean proportions of black-market AAS are counterfeit and of substandard quality. These products pose a considerable individual and public health threat, and the very wide range in proportions of fake black-market AAS puts the user in a situation of unpredictable uncertainty. There is a great need for future prevention and harm-reduction programs to protect users from these substances.

Abstract Background Veterinary medicines have been widely used for the prevention and treatment of animal diseases. Globally, the veterinary medicine industry is growing. However, there is a significant increase of concern on the quality of veterinary medicines in various developing countries’ legal markets. Poor-quality medicines are associated with treatment failure, development of drug resistance, increased healthcare cost, and death. These reasons warrant a need for monitoring the quality of the medicines circulating in the Tanzania Mainland. Methods This was a survey study and veterinary medicines samples were collected from 9 out of 26 regions of Tanzania mainland between 2014 and 2017. Veterinary medicines were sampled from wholesale pharmacies, retail pharmacies, veterinary clinics and Veterinary Accredited Drug Dispensing Outlets (ADDO-vet). All sampled medicines were subjected to product information review and full quality control testing at the Tanzania Medicines and Medical Devices Authority-World Health Organization prequalified laboratory. Results A total of 238 samples of veterinary medicines were collected. Out of these, 97.1% (231/238) were subjected to full quality control testing and product information review. All sampled veterinary medicines conformed to visual appearance, clarity, pH, solubility and sterility tests. Also, of the sampled veterinary medicines 97.8% (226/231) and 89.2% (206/231) passed identification and assay tests, respectively. As well as, the majority of the collected samples 92% (219/238) failed to comply with product information requirements. The most observed deficiencies on product information were inadequate information on the package insert 94.1% (224/238), inappropriate storage conditions 55.5% (132/238) and lack of Tanzania registration number 27% (64/238). Conclusion Veterinary medicines with poor quality were found circulating in the legal markets of Tanzania. This can potentiate treatment failure and the development of drug resistance in animals and humans. Post marketing surveillance program will continue to be implemented to ensure that only good quality, safe and efficacious medicines are circulating in the Tanzania Mainland market.

The circulation of substandard and counterfeit pharmaceutical products on the national and international markets has increased. Different studies revealed that there is limited information about pharmacy professionals' awareness of substandard and counterfeit pharmaceutical products. Therefore; the aim of the present study was to assess the pharmacy professionals' knowledge, attitude, and practice of substandard and counterfeit pharmaceutical products. A cross-sectional study was conducted to assess the knowledge, attitude, and practice of pharmacy professionals about substandard and counterfeited pharmaceutical products in Gondar City, North-West Ethiopia. Data were collected through a self-administered, structured questionnaire using the Kobo tool. SPSS version 27 was used for the analysis. To assess the association of factors with pharmacy professionals' practice towards substandard and counterfeit medicines, we conducted univariate and multivariate logistic regression analysis. A total of 170 respondents participated in the study. The highest numbers of participants (71.8%) were in the age group of 18–30 years. Only 10.6% of them reported purchasing medicines regularly. Of total, 31 (18.24%) of respondents had a good knowledge and more than one-third 60 (35.29%) of the respondents had a good level of practice. Multivariate logistic regression analysis results revealed that some socio-demography and attitude (AOR = 0.473 (0.225–0.995) were associated with the practice of pharmacy professionals towards substandard and counterfeit medicines. In general, less than one-quarters of the respondents had a good knowledge and more than one-thirds of the respondents had a good level of practice. However, half of the respondents had a positive attitude. [ABSTRACT FROM AUTHOR]

Elimination of lacunae is associated with the need to convey semantic content that has not found a single-word expression in the language. But elimination also turns out to be necessary for pragmatic reasons. It is precisely the pragmatic nuances that distinguish the primordial literary words and the borrowings or substandard units replacing them. Taking into account the entire palette of pragmatic meanings allows us to explain the emergence and consolidation of new units in the vocabulary and grammar of the modern Russian language.

Objective: Supraphysiologic doses of anabolic androgenic steroids (AAS) are widely used to improve body image and sport performance goals. These substances can easily be acquired over the internet, leading to a substantial black market. We reviewed literature that assessed the quality and quantity of AAS found on the black market. Methods: We searched PubMed/Medline, Embase and Google Scholar for articles published before March 2022. Additional hand searches were conducted to obtain studies not found in the primary literature search. Studies were included if they report on qualitative and/or quantitative analytical findings of AAS from the black market. Primary outcomes were proportions of counterfeit or substandard AAS. Eligible articles were extracted; quality appraisal was done using the ToxRTool for in-vitro studies. We used random-effects models to calculate the overall mean estimates for outcomes. The review protocol has been published and registered in INPLASY. Results: Overall, 19 studies, which in total comprised 5,413 anabolic samples, met the inclusion criteria, and passed the quality appraisal from two WHO world regions that reported findings, the Americas and Europe. Most studies were nonclinical laboratory studies (95%) and provided samples seized by authorities (74%). In 18 articles, proportions of counterfeit substances and in eight articles, proportions of substandard substances were presented. The overall mean estimate for counterfeit anabolic steroids found on the black market was 36% (95% CI = 29, 43). An additional 37% (95% CI = 17, 63) were of substandard quality. We also demonstrate that these drugs could contain no active ingredient, or in another amount than that labeled, a wrong active ingredient, as well as not all or more active ingredients than were labeled. High heterogeneity among all analyses and significant differences between geographical subgroups were found. Conclusion: With this systematic review and meta-analysis, we demonstrate that substantial mean proportions of black-market AAS are counterfeit and of substandard quality. These products pose a considerable individual and public health threat, and the very wide range in proportions of fake black-market AAS puts the user in a situation of unpredictable uncertainty. There is a great need for future prevention and harm-reduction programs to protect users from these substances. [ABSTRACT FROM AUTHOR]

Background: Veterinary medicines have been widely used for the prevention and treatment of animal diseases. Globally, the veterinary medicine industry is growing. However, there is a significant increase of concern on the quality of veterinary medicines in various developing countries' legal markets. Poor-quality medicines are associated with treatment failure, development of drug resistance, increased healthcare cost, and death. These reasons warrant a need for monitoring the quality of the medicines circulating in the Tanzania Mainland. Methods: This was a survey study and veterinary medicines samples were collected from 9 out of 26 regions of Tanzania mainland between 2014 and 2017. Veterinary medicines were sampled from wholesale pharmacies, retail pharmacies, veterinary clinics and Veterinary Accredited Drug Dispensing Outlets (ADDO-vet). All sampled medicines were subjected to product information review and full quality control testing at the Tanzania Medicines and Medical Devices Authority-World Health Organization prequalified laboratory. Results: A total of 238 samples of veterinary medicines were collected. Out of these, 97.1% (231/238) were subjected to full quality control testing and product information review. All sampled veterinary medicines conformed to visual appearance, clarity, pH, solubility and sterility tests. Also, of the sampled veterinary medicines 97.8% (226/231) and 89.2% (206/231) passed identification and assay tests, respectively. As well as, the majority of the collected samples 92% (219/238) failed to comply with product information requirements. The most observed deficiencies on product information were inadequate information on the package insert 94.1% (224/238), inappropriate storage conditions 55.5% (132/238) and lack of Tanzania registration number 27% (64/238). Conclusion: Veterinary medicines with poor quality were found circulating in the legal markets of Tanzania. This can potentiate treatment failure and the development of drug resistance in animals and humans. Post marketing surveillance program will continue to be implemented to ensure that only good quality, safe and efficacious medicines are circulating in the Tanzania Mainland market. [ABSTRACT FROM AUTHOR]

Abstract Background Antiretroviral drugs (ARVs) have significantly reduced morbidity, mortality and improved the quality of life of people living with HIV infection. Poor quality ARVs may result in harmful consequences such as adverse drug reactions, treatment failure and development of drug resistant strains and sometimes death, which in turn may undermine the healthcare delivery system. To ensure optimal treatment outcomes, medicines quality control must be undertaken regularly. This study was aimed at evaluating the quality of ARVs circulating on the Tanzania Mainland market. Methods This was a survey study. ARVs samples were collected in 20 regions of Tanzania Mainland, between 2012 and 2018. All sampled ARVs were subjected to screening testing using the Global Pharma Health Fund® Mini-Lab kits. Sampled ARV’s that failed screening test or yielded doubtful results and 10 % (10 %) of all that complied with the screening test requirements were selected for full quality control testing. Quality control testing was conducted at the Tanzania Medicines and Medical Devices Authority (TMDA) laboratory a World Health Organisation prequalified. Samples collected from the medicine distribution outlets were also, subjected to product information review. Results A total of 2,630 samples were collected, of which 83.7 % (2200/2630) were from port of entry (POEs). All sampled ARVs were screened and conformed to the specifications, except of the fixed dose combination (FDC) lopinavir/ritonavir 0.27 % (7/2630) and lamivudine/zidovudine/nevirapine 0.27 % (7/2630) that failed the disintegration test. Out of the 100 samples selected for full quality control testing, 3 % of them failed to comply with the specifications, of which FDC stavudine/lamivudine/nevirapine failed disintegration and assay tests 2 % (2/100) and 1 % (1/100), respectively. Samples failing the assay test had low content of stavudine (86.6 %) versus specification limits (90 -110 %). Out of the 430 samples which were subjected to product information review, 25.6 % (110/430) failed to comply with the TMDA packaging and labelling requirements. Conclusions The quality of majority of ARVs circulating on the Tanzania Mainland market was good, even so, significant deficiencies on labelling and packaging were observed. These results call for continuous monitoring of quality of medicines circulating on the Tanzania Mainland market.

The article is devoted to LOL-trasianka – a network variety of mixed Belarus-Russian speech, which is actively used in Belarus Internet communities as a source of comic and a trigger for laughing communicative situations. It was found that laughter discourse in LOL-trasianka is characterized by deliberate distortion of the norms of both Russian and Belarus languages, hypertrophied interference, violation of ethical and etiquette rules of communication, demonstrative marginalization of the speech flow, general intention of irony and sarcasm. Sociolinguistic and communicative-discursive factors that determined the status of LOL-trasianka as the main code resource of Internet communities with an ironic-grotesque discourse of a socially critical orientation are a) stereotypes of marking the state Russian and Belarus languages and their variants; b) strengthening the symbolic function of the Belarus language; c) disdainful attitude towards mixed Belarus-Russian speech; d) expanding the scope of use of trasianka. It was found that in the communicative interaction of participants in the analyzed communities, LOL-trasianka performs a number of functions: creative (is a means of self-expression of participants), emotional expressive (allows the writer to convey a palette of emotions), integrative (unites members of the online community), identification (provides adequate perception and understanding each other’s intentions), interpretive (forms an alternative laughing reality), dissociative (expresses the protest of community members, dissatisfaction with the surrounding reality).

Artykuł dotyczy zagadnień podstandardowej leksykografii, a w szczególności żargonu. Przedstawiliśmy główne problemy, jakie napotyka autor słownika przy znalezieniu odpowiednika do jednostki żargonowej. W pierwszej części przedstawiono główne metody przekładu neologizmów frazeologicznych na inny język. Druga część artykułu zawiera informacje o historii leksykografii żargonu. Część trzecia zawiera niewielką część zebranego materiału do słownika tłumaczeniowego.

While great effort is being placed on reducing disease burdens in Africa, the circulation of falsified and substandard medicines in the continent are reversing the hard-won gains. This commentary provides insights on the high (and increasing) burden, impact and threat that falsified and substandard medicines pose to the region's development. The proposed recommendations, such as a coherent multi-sectorial and government-led strategy, call for a fundamental rethink of approaches towards strong regulations, policies, legislations, community-based approaches, collaborations and investments, which all must be scaled up before this the situation gets out of control. These recommendations are of paramount importance and have the potential to ensure access to genuine medicines and also to avert therapeutic failure and intoxication from dangerous substances. In addition, there will be added benefits to the economic, social, health and well-being of the region. Concerted efforts towards medicine regulations have enormous potential to contribute towards averting many preventable deaths and reducing disease burden in the region. A paradigm shift is necessary to ensure quality medicines reach patients at community and healthcare facilities to prevent this silent epidemic in Africa.

Abstract Background Poor quality medicines have serious implications for public health. The aim of this study was to explore the quality of the antidiabetic pioglitazone, using samples collected in China and Myanmar, and samples purchased online. Methods In this cross-sectional study, we examined samples (n = 163) collected from hospitals in Shanghai, China in 2012 (n = 44), products purchased via the internet and imported into Japan in 2013 (n = 59), and samples purchased in shops in Yangon, Myanmar in 2015 (n = 60). Collected samples were subjected to visual inspection, authenticity investigation and quality testing (potency, content uniformity and dissolution test) by high-performance liquid chromatography. Samples were rated as compliant or non-compliant based on the relevant pharmacopoeial acceptance criteria. Results Visual inspection of all samples revealed compliant products. However, responses from manufacturers during authenticity investigation were poor. Among the n = 44 samples from China, one was non-compliant in the potency test. Among the n = 59 samples personally imported into Japan, 38% of generic samples were found to be non-compliant. In Myanmar, 13.3% of samples were non-compliant. Non-compliant samples predominantly failed in the dissolution test. All non-compliant samples were generic. Conclusions Despite the apparent satisfactory outcome on the samples from China, pioglitazone samples collected in Myanmar and purchased online for personal import into Japan included many substandard products, which failed quality assessment predominantly because of poor dissolution. Internet providers did not comply with Japanese regulations in various respects.

Substandard and falsified medicines are a global health concern negatively affecting individuals, the public, the pharmaceutical industry and governments all over the world. This review aims to examine the global prevalence of substandard and falsified medicines, its impact on health and the health system, including socio-economic impacts and strategies for curbing this menace. A literature review of published articles between January 2000 and May 2020 was done with keywords "substandard", "counterfeit", and "falsified medicines". Articles were sourced from PubMed, World Health Organization (WHO) databases and Google Scholar. There are reports of substandard and falsified medicines from all WHO Regions with noticeable prevalence in the African Region. These medicines have been reported to cause death, antimicrobial resistance, increase prevalence of diseases, and loss of confidence in the health system. Increased patients spending, loss of productivity, strain of limited health systems resources, and loss of government revenue are major socio-economic implications of substandard and falsified medicines. An increase in criminal sanctions, global harmonization of drug regulatory authorities, and appropriate education of healthcare professionals and patients on how to prevent, detect, and respond to reported cases of substandard and falsified medicines are strategies that can be implemented to curb the menace of these medicines. Registered pharmacists and pharmacy students play critical roles in addressing this global health issue. [ABSTRACT FROM AUTHOR]

Copyright of Językoznawstwo is the property of Akademii Humanistyczno-Ekonomicznej and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The Department of Health and Human Services and the Food and Drug Administration released the Safe Importation Action Plan in July 2020 detailing methods to import medicines from Canada to combat increasing drug costs. In November 2020, Florida became the first state in the United States to create and propose an importation plan from Canada. This study examines the proposal submitted by Florida, Florida pharmacists' perceptions of the program on patient safety, and Florida pharmacists' thoughts on the pharmacy operational impact. Methods: This was a cross-sectional study utilizing an electronic questionnaire sent to pharmacist members of the Florida Pharmacy Association. The survey incorporated closed-ended and open-ended questions. The results from the study were reported and analyzed through descriptive statistics, qualitative and quantitative data. Results: Two-hundred and forty-four pharmacists responded to the survey. Of those respondents, 25% stated they had no knowledge about Florida's drug importation plan. Less than 12% of respondents stated they would trust the safety and quality of imported medicines. Seventy percent of pharmacists expressed concerns regarding the changes required in pharmacy operations to increase medicine safety. About half of the respondents questioned whether this plan would promote cost-savings as intended. Conclusion: Florida pharmacists believe the drug importation plan does not address all aspects of patient and medicine safety and expressed concerns regarding logistical operations of a pharmacy. This article highlights those concerns and acts as a summons to action. [ABSTRACT FROM AUTHOR]

Brittle failure of lightly reinforced concrete columns is one of the primary reasons for partial or total collapse of substandard existing buildings subjected to earthquake loading. This study presents collapse performance of a full-scale building that was performed to gain insight into the seismic behavior and the collapse mechanisms of nonductile buildings with lightly reinforced concrete columns. The three-story building was tested under displacement-controlled quasi-static reversed cyclic loading followed by a lateral pushover loading up to realization of the total collapse. In addition to the poor reinforcement details, columns had high axial load–to–axial capacity ratios as also observed in many existing substandard buildings. During the test, severe structural damage was observed at 0.9% first-story drift ratio in the cyclic part of the lateral loading and the brittle total collapse of the building took place during the pushover loading at 1.45% first-story drift ratio. In this paper, after the introduction of the test campaign, the formation of structural damage and collapse mechanisms are discussed. In addition, an attempt to predict the behavior and performance of the test building is made by using a column model that considers flexural, slip, and shear deformations. Finally, the obtained analytical results are compared with the experimental observations and results. [ABSTRACT FROM AUTHOR]

Abstract Background A new incidence of a substandard medicinal product is discovered weekly as stated by the World Health Organization (WHO) around the world. After discovering an incidence of a substandard medicinal product, a drug recall announced to remove the affected medicinal product from the market. Drug recalls in SaudiArabia (SA) are made by the Saudi Food and Drug Authority (SFDA) or the distributors of the drug when certain criteria are met. A retrospective study of drug recalls in SA was carried out. Data were collected through a website search of the SFDA for drug recalls since January 2010–January 2019. Results SFDA recalled 84 substandard medicinal products which related to 47 alert letters and 52 drugs. The number of drug recall reported by SFDA increased six-folds in 2018 than in 2010. The major frequent therapeutic class of drug recall was the antihypertensive drugs followed by the antibiotic drugs (27.7% and 10.8%, respectively). The majority of the recalls were tablets followed by parenteral dosage forms (58% and 25%, respectively). The major reasons for the drug recalls were due to contamination (32.14%) followed by non-compliance with manufacturer’s specifications (20.48%). Two manufacturers were accounted for 34.52% of all recalled drugs. Conclusion Substandard medicinal products are considered as a serious problem in SA. Contamination was the main cause of drug recalls, which requires root investigation of causes and for strict protective tools to be applied by drug manufacturers.

Abstract Background Many countries are striving to become malaria-free, but global reduction in case estimates has stagnated in recent years. Substandard and falsified medicines may contribute to this lack of progress. Zambia aims to eliminate their annual burden of 1.2 million pediatric malaria cases and 2500 child deaths due to malaria. We examined the health and economic impact of poor-quality antimalarials in Zambia. Methods An agent-based model, Substandard and Falsified Antimalarial Research Impact (SAFARI), was modified and applied to Zambia. The model was developed to simulate population characteristics, malaria incidence, patient care-seeking, disease progression, treatment outcomes, and associated costs of malaria for children under age five. Zambia-specific demographic, epidemiological, and cost inputs were extracted from the literature. Simulations were run to estimate the health and economic impact of poor-quality antimalarials, the effect of potential artemisinin resistance, and six additional malaria focused policy interventions. Results We simulated annual malaria cases among Zambian children under five. At baseline, we found 2610 deaths resulting in $141.5 million in annual economic burden of malaria. We estimated that elimination of substandard and falsified antimalarials would result in an 8.1% (n = 213) reduction in under-five deaths, prevent 937 hospitalizations, and realize $8.5 million in economic savings, annually. Potential artemisinin resistance could further increase deaths by 6.3% (n = 166) and cost an additional $9.7 million every year. Conclusions Eliminating substandard and falsified antimalarials is an important step towards a malaria-free Zambia. Beyond the dissemination of insecticide-treated bed nets, indoor residual spraying, and other malaria control measures, attention must also be paid to assure the quality of antimalarial treatments.

Abstract Background In developing countries, brand-generic substitution is not based on validated scientific evidence that confirm the therapeutic equivalence of the generic to the originator. Rather, decisions are made based on the availability of generic medications. Substitution by inappropriate preparations applies to antibiotics, which may increase the risk of resistance in case of underdosing. This analytical study aims to dose and assess for the accuracy of labeling three oral antibiotic preparations, namely ciprofloxacin hydrochloride, amoxicillin trihydrate and amoxicillin trihydrate-clavulanate potassium, the active pharmaceutical ingredients (APIs) found in brand and generic tablets available on the Lebanese market. Methods One brand and 4 generics of ciprofloxacin tablets, 3 generic amoxicillin tablets, and 1 brand and 4 generics of amoxicillin-clavulanic acid medications, were quantified, taking 2 batches of each. According to the United States Pharmacopeia (USP) guidelines, ultra-high pressure liquid chromatography was used to measure the APIs content within tablets. The USP required assay limit of the API was taken as the main comparison criteria. Results Out of the 5 ciprofloxacin medications tested, all 5 were out of the 2% required range, thus being substandard. For amoxicillin, all 3 medications were within the 20% range. As for amoxicillin-clavulanic acid medications, 4 out of 5 medications met the 30% required range of clavulanic acid and one exceeded the claimed amount of clavulanic acid, while all 5 met the assay limit for amoxicillin. Conclusion These findings raise safety and efficacy concerns, providing solid grounds for potential correlations of antibiotic resistance/substandard antibiotics.

Background The Department of Health and Human Services and the Food and Drug Administration released the Safe Importation Action Plan in July 2020 detailing methods to import medicines from Canada to combat increasing drug costs. In November 2020, Florida became the first state in the United States to create and propose an importation plan from Canada. This study examines the proposal submitted by Florida, Florida pharmacists’ perceptions of the program on patient safety, and Florida pharmacists’ thoughts on the pharmacy operational impact. Methods This was a cross-sectional study utilizing an electronic questionnaire sent to pharmacist members of the Florida Pharmacy Association. The survey incorporated closed-ended and open-ended questions. The results from the study were reported and analyzed through descriptive statistics, qualitative and quantitative data. Results Two-hundred and forty-four pharmacists responded to the survey. Of those respondents, 25% stated they had no knowledge about Florida’s drug importation plan. Less than 12% of respondents stated they would trust the safety and quality of imported medicines. Seventy percent of pharmacists expressed concerns regarding the changes required in pharmacy operations to increase medicine safety. About half of the respondents questioned whether this plan would promote cost-savings as intended. Conclusion Florida pharmacists believe the drug importation plan does not address all aspects of patient and medicine safety and expressed concerns regarding logistical operations of a pharmacy. This article highlights those concerns and acts as a summons to action.

Background: There is growing concern in sub-Saharan Africa that poor-quality antimicrobial medicines may negate management of infectious diseases of public health importance should they fail to meet the set criteria of quality, safety and efficacy., Objectives: The objective was to ascertain the quality of antiretroviral, antimalarial and antituberculosis medicines supplied and available in the public health sector in Zambia., Design: A descriptive cross-sectional study was conducted involving the analysis of data from the continuous routine in-country post-marketing surveillance programme in Zambia that assessed the quality of antiretroviral, antimalarial and antituberculosis medicines supplied to public healthcare facilities between January 2018 and June 2023., Methods: Data were extracted from laboratory quality analysis results from samples collected as part of routine post-marketing surveillance by the Zambia Medicines Regulatory Authority between January 2018 and June 2023. The samples were collected from various levels of the pharmaceutical supply chain across Zambia. Samples were analysed according to their respective pharmacopoeia standards at the Medicines Control Authority of Zimbabwe Quality Control Laboratory, a World Health Organization prequalified laboratory. Data were extracted using a structured Excel database and analysed using Microsoft Excel, and GraphPad Prism Software was used for visualizations., Results: Of the 198 samples, 86 (43.43%) were antiretrovirals, 54 (27.27%) antimalarials and 58 (29.29%) antituberculosis medicines. Of these 198 samples, 171 (86.36%) originated from Asia, 19 (9.60%) Africa and 8 (4.04%) Europe. All sampled medicines met their respective quality specifications with respect to tests, which included appearance, identification, assay, uniformity of mass, weight variation, disintegration, dissolution, pH and specific gravity, giving a compliance rate of 100%., Conclusion: Antiretrovirals, antimalarials and antituberculosis medicines obtained from public healthcare facilities in Zambia through routine post-marketing surveillance met their quality standards. This might positively impact treatment outcomes for HIV/AIDS, malaria and tuberculosis. There is a need for large-scale continuous monitoring of the quality of medicines in order to ensure quality is maintained and substandard products removed from the pharmaceutical supply chain., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: The first and sixth authors are Pharmacists currently working under Zambia Medicines Regulatory Authority, Department of Medicines Control and are involved in post-marketing surveillance activities. Zambia Medicines Regulatory Authority had no role in the design of this study and collection, analysis and interpretation of data. Any views and opinions expressed are personal and belong solely to the individuals and do not represent any individual institutions, or organizations that the individuals are associated with in a personal or professional capacity. The remaining authors declare that they have no conflict of interest., (© The Author(s) 2024.)

Background: Substandard, falsified, unlicensed, and unregistered medicines pose significant risks to public health in developed and developing countries. This systematic review provides an overview of the prevalence of substandard, falsified, unlicensed, and unregistered medicine and its associated factors in Africa., Methods: Articles published from April 2014 to March 2024 were searched in Google Scholar, Science Direct, PubMed, MEDLINE, and Embase. The search strategy focused on open-access articles published in peer-reviewed scientific journals and studies exclusively conducted in African countries. The quality of the studies was assessed according to the Medicine Quality Assessment Reporting Guidelines (MEDQUARG). This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)., Results: Of the 27 studies, 26 had good methodological quality after a quality assessment. Of the 7508 medicine samples, 1639 failed at least one quality test and were confirmed to be substandard/falsified medicines. The overall estimated prevalence of substandard/falsified medicines in Africa was 22.6% (1718/7592). The average prevalence of unregistered medicines was 34.6% (108/312). Antibiotics, antimalarial, and antihypertensive medicines accounted for 44.6% (712/1596), 15.6% (530/3530), 16.3% (249/1530), and 16.3% (249/1530), respectively. Approximately 60.7% (91/150) were antihelmintic and antiprotozoal medicines. Poor market regulatory permission, Free trade zones, poor registration, high demand, and poor importation standards contribute to the prevalence of these problems., Conclusion/recommendations: Substandard, falsified, and unregistered medicines are highly prevalent in Africa, and attention has not been paid to the problem. Antibiotics, antimalarial, anthelmintic, and antiprotozoal are the most commonly reported substandard, falsified, and unregistered medicines. A consistent supply of high-quality products, enhancement of registration, market regulatory permission, and importation standards are essential to counter the problems in Africa. Preventing these problems is the primary duty of every responsible nation to save lives., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Post-earthquake observations have outlined the poor seismic performance of substandard reinforced concrete (RC) beam-column joints in existing buildings. They often exhibit significant cracking even under moderate intensity earthquakes, compromising the seismic performance of the entire building. This makes the quantification of their residual capacity and the definition of reliable repairability thresholds critical. Different approaches are available in the literature to establish the repairability of RC joints. However, a simple crack width-based criterion is required for practitioners during in-situ inspections. This study deals with the definition of crack width-based fragility curves relying on numerical analyses. Those are carried out by using the validated finite element (FE) models, being capable of reproducing the initiation and development of cracks in RC joints. To this end, the uncertainties in material properties, influencing the seismic performance of structural components, are accounted for different joints. In particular, experimentally validated FE models are evolved to stochastic level by generating random variables of material properties with the stratified sampling scheme. Fragility curves representing a certain level of probability of exceeding the defined crack width at the joint back, joint core, and beam-to-joint interface are developed. An application of the proposed methodology for in-situ inspections is also presented, and the results of in-situ measurements of residual crack width from real buildings damaged by recent earthquakes are used for the validation. [ABSTRACT FROM AUTHOR]

Background: Antiretroviral drugs (ARVs) have significantly reduced morbidity, mortality and improved the quality of life of people living with HIV infection. Poor quality ARVs may result in harmful consequences such as adverse drug reactions, treatment failure and development of drug resistant strains and sometimes death, which in turn may undermine the healthcare delivery system. To ensure optimal treatment outcomes, medicines quality control must be undertaken regularly. This study was aimed at evaluating the quality of ARVs circulating on the Tanzania Mainland market. Methods: This was a survey study. ARVs samples were collected in 20 regions of Tanzania Mainland, between 2012 and 2018. All sampled ARVs were subjected to screening testing using the Global Pharma Health Fund® Mini-Lab kits. Sampled ARV's that failed screening test or yielded doubtful results and 10 % (10 %) of all that complied with the screening test requirements were selected for full quality control testing. Quality control testing was conducted at the Tanzania Medicines and Medical Devices Authority (TMDA) laboratory a World Health Organisation prequalified. Samples collected from the medicine distribution outlets were also, subjected to product information review. Results: A total of 2,630 samples were collected, of which 83.7 % (2200/2630) were from port of entry (POEs). All sampled ARVs were screened and conformed to the specifications, except of the fixed dose combination (FDC) lopinavir/ritonavir 0.27 % (7/2630) and lamivudine/zidovudine/nevirapine 0.27 % (7/2630) that failed the disintegration test. Out of the 100 samples selected for full quality control testing, 3 % of them failed to comply with the specifications, of which FDC stavudine/lamivudine/nevirapine failed disintegration and assay tests 2 % (2/100) and 1 % (1/100), respectively. Samples failing the assay test had low content of stavudine (86.6 %) versus specification limits (90 -110 %). Out of the 430 samples which were subjected to product information review, 25.6 % (110/430) failed to comply with the TMDA packaging and labelling requirements. Conclusions: The quality of majority of ARVs circulating on the Tanzania Mainland market was good, even so, significant deficiencies on labelling and packaging were observed. These results call for continuous monitoring of quality of medicines circulating on the Tanzania Mainland market. [ABSTRACT FROM AUTHOR]

Cyclic response of substandard reinforced concrete (RC) columns and structural repair of pre-damaged columns by carbon-fiber-reinforced polymers (CFRPs) were investigated through combination of experimental and advanced numerical modeling methods. The specimens, representing typical RC columns in substandard buildings, were constructed from low-strength concrete, plain round bars, and nonconforming reinforcement details. The key parameters under investigation included the lap-splice, hook detail in the longitudinal reinforcement, and axial load ratio. First, the RC columns were subjected to cyclic loading until the attainment of their heavy damage state. The failure mode was dominated by the flexural response alongside significant reinforcement slip and axial damage, involving concrete crushing and reinforcement buckling. Subsequently, the severe cracks and concrete damage were repaired by the externally wrapped CFRP sheets. The former load-carrying capacities of the repaired RC columns were recovered. The damage formation in the concrete and reinforcement was transferred to CFRP sheets. The final failure mode was characterized by local deformations in the CFRP, with minimal damage observed in the concrete and reinforcement bars. Furthermore, the numerical solution effectively reproduced the nonlinear behavior of the as-built specimens. The crack patterns and capacities observed in the numerical solutions align with the responses observed in the experimental tests. • Cyclic response of substandard RC columns and subsequent structural repair using CFRPs. • Critical parameters such as lap-splice, hook detail, and axial load ratio. • Flexural response alongside significant reinforcement slip, and severe axial damage. • A feasible method for repairing and restoring structural integrity. • Reproduced the nonlinear response matching experimental observations. [ABSTRACT FROM AUTHOR]

Nawaf Abu-Khalaf,1 Abdel Naser Zaid,2 Nidal Jaradat,2 Alaaldin M Alkilany,3 Samer R Abulateefeh,3 Rowa Al Ramahi,2 Mashhour Ghanem4 1Department of Agricultural Biotechnology, College of Agricultural Sciences and Technology, Palestine Technical University-Kadoorie (PTUK), Tulkarm, Palestine; 2Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; 3Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, the University of Jordan, Amman 11942, Jordan; 4Department of Regulatory, Pharmacare PLC, Ramallah, PalestineCorrespondence: Abdel Naser ZaidDepartment of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, B.O. Box 7, Nablus, PalestineEmail anzaid@najah.eduBackground: Electronic tongue (ET) is a well-established technology that is used to detect the taste of a food or a medicinal product and to differentiate between different products based on their tastes. In addition, it can be used to monitor environmental parameters and biochemical and biological processes.Purpose: This study aims to assess any correlation between the results of pharmacopeial quality control (ie, assay, impurities, and dissolution, etc) and ET analysis for reconstituted cefdinir (CR) suspension over 10 days (ie, shelf-life).Methods: The reconstituted CR suspension was tested for several quality attributes such as dissolution behavior, pH, assay, related substances, and microbial contamination. An HPLC analytical method was verified and then used for chemical analysis. The taste of CR reconstituted suspension was followed over 10 days and was then compared with the quality control results. Moreover, Pearson’s correlation test was used to find a correlation between chemical analysis results and ET results.Results: Pearson’s test of correlation showed a significant correlation (p-value

Abstract It is the right of all humans to have access to safe, quality and effective medicines. This article seeks to expound on the problems of drug manufacturing and challenges of accessing medicines in West Africa, and evaluate the strategies being adopted by international developmental partners and the governments to address them. West Africa is uniquely diverse in culture (having English, French and Portuguese speaking people) but generally affected by the same diseases (e.g., malaria, HIV/AIDS, and Tuberculosis). In this developmentally beleaguered region, drug development and manufacturing are still stuck in their embryonic stages where medicine distribution is chaotic and insufficiently regulated. An enduring question is why investment in research and development in medicines for neglected tropical diseases and manufacturing is still very low in Africa and in particular West Africa. In this article, we look at how these vulnerabilities are exploited by unscrupulous merchants, leading to massive influx of fake and substandard medicines to the supply chain, making it difficult for the rural, voiceless poor to access quality safe medication. Through an examination of current research and published works by the World Health Organization (WHO), the United States Pharmacopeia (USP) and other international development partners in Africa, first hand interactions with manufacturers, medicine regulators, regulatory consultants, and the patients, as well as from personal observations, the article crystallizes the major issues and challenges to drug manufacturing and access to quality, safe, and effective essential medicines in West Africa. This article also examines the strategies and policies being implemented to salvage the situation. It is irrevocably clear that solving the challenges of providing safe medication to West Africa is a collective responsibility - the government (through legislation, strategic regulations and policies), medicines manufacturers (adoption of Good Manufacturing Practices and ethics), regulators (through persuasion and enforcement of rules), regulatory consultants, the patients (empowered, informed about their rights and courage and willingness to report drug reactions and discernible counterfeiting), the international development partners and all other stake holders in the health care sector have roles to play in ensuring that the public has access to quality safe and efficacious medicines.

Malaria, a parasitic infectious disease causes approximately >1 million deaths annually worldwide. Treatment with effective antimalarials is one of the major strategies to combat malaria-related mortalities. However, there is a continuous threat of counterfeit antimalarials in the community. Counterfeit antimalarial drugs not only result in an economic loss but also decrease the efficacy of treatment resulting in the loss of faith in the health system and increases the the chances of drug resistance in the parasites. Counterfeit drugs hamper the intellectual property-based innovation paradigms as well. Awareness about these counterfeit drugs not only helps in avoiding drug resistance but may also enhance the drug therapeutic value. This review discusses the prevalence of counterfeit drugs in different geographic areas across the globe, the methods deployed for its detection and possible anticounterfeiting strategies. Literature search was conducted through PubMed, Google and International Pharmaceutical Abstracts using the terms ‘counterfeit antimalarials’, ‘substandard’, ‘falsified’, and ‘drug resistance’. Free searches in other search engines included the terms ‘antimalarial counterfeit drugs’ and ‘drug resistance’. Analysis of the literature survey indicated that majority of such studies were conducted in Southeast Asia and Africa region. The prevalence of substandard antimalarials was reported as high as 88.4% in Africa region and 53 % in Southeast Asia region. There is a need to follow a multifaceted approach to prevent the entry of falsified drugs with pre- and post-marketing surveillance. The samples need to be examined by regulatory bodies and strict legislation should be envisaged in order to maintain the quality of medicines.

Background: E-commerce of medicines has been extensively spread worldwide. Many reasons influence consumers to purchase their medical needs through the Internet, including low cost, availability, accessibility, and time saving. However, most of these medicines are substandard and counterfeit. Aim: To assess the perception of people in the UAE about purchasing medicines from online sources and to evaluate the quality of furosemide tablets from two different sources including illegal online source. Materials and Methods: A cross-sectional study was conducted on 528 participants in the UAE. The questionnaire included three parts to assess the public perception and experience toward purchasing medicines from online sources. Furosemide tablets, purchased from the UAE market and an illegal online source, were physically and chemically studied to assess their quality according to the British Pharmacopoeia (2018). Results: The survey results revealed that less than 10% of participants have purchased their medicines from online sources and mostly they were nonprescription products (78%). Most common motives for online purchasing were either unavailability in the local pharmacies (43%) or lower cost compared to that in local market (43%). The opinion of participants toward purchasing of online medicines was negative. On the other hand, the experimental analysis showed that online furosemide had failed to pass the chemical assay test (91.0% ± 0.8), which makes it a substandard product. Conclusion: This study showed that few consumers had considered purchasing pharmaceutical products from online sources as a feasible way to save money and time. However, most of them were in doubt about their quality, which encourages health-care providers to guide patients to government-supported websites if required. The study also showed that the quality of online medicines is questionable, indicating that these products are not equally effective as the medicines purchased from a local pharmacy.

Abstract Background Global efforts to address the burden of malaria have stagnated in recent years with malaria cases beginning to rise. Substandard and falsified anti-malarial treatments contribute to this stagnation. Poor quality anti-malarials directly affect health outcomes by increasing malaria morbidity and mortality, as well as threaten the effectiveness of treatment by contributing to artemisinin resistance. Research to assess the scope and impact of poor quality anti-malarials is essential to raise awareness and allocate resources to improve the quality of treatment. A probabilistic agent-based model was developed to provide country-specific estimates of the health and economic impact of poor quality anti-malarials on paediatric malaria. This paper presents the methodology and case study of the Substandard and Falsified Antimalarial Research Impact (SAFARI) model developed and applied to Uganda. Results The total annual economic impact of malaria in Ugandan children under age five was estimated at US$614 million. Among children who sought medical care, the total economic impact was estimated at $403 million, including $57.7 million in direct costs. Substandard and falsified anti-malarials were a significant contributor to this annual burden, accounting for $31 million (8% of care-seeking children) in total economic impact involving $5.2 million in direct costs. Further, 9% of malaria deaths relating to cases seeking treatment were attributable to poor quality anti-malarials. In the event of widespread artemisinin resistance in Uganda, we simulated a 12% yearly increase in costs associated with paediatric malaria cases that sought care, inflicting $48.5 million in additional economic impact annually. Conclusions Improving the quality of treatment is essential to combat the burden of malaria and prevent the development of drug resistance. The SAFARI model provides country-specific estimates of the health and economic impact of substandard and falsified anti-malarials to inform governments, policy makers, donors and the malaria community about the threat posed by poor quality medicines. The model findings are useful to illustrate the significance of the issue and inform policy and interventions to improve medicinal quality.

Background: Poor quality medicines have serious implications for public health. The aim of this study was to explore the quality of the antidiabetic pioglitazone, using samples collected in China and Myanmar, and samples purchased online. Methods: In this cross-sectional study, we examined samples (n = 163) collected from hospitals in Shanghai, China in 2012 (n = 44), products purchased via the internet and imported into Japan in 2013 (n = 59), and samples purchased in shops in Yangon, Myanmar in 2015 (n = 60). Collected samples were subjected to visual inspection, authenticity investigation and quality testing (potency, content uniformity and dissolution test) by high-performance liquid chromatography. Samples were rated as compliant or non-compliant based on the relevant pharmacopoeial acceptance criteria. Results: Visual inspection of all samples revealed compliant products. However, responses from manufacturers during authenticity investigation were poor. Among the n = 44 samples from China, one was non-compliant in the potency test. Among the n = 59 samples personally imported into Japan, 38% of generic samples were found to be non-compliant. In Myanmar, 13.3% of samples were non-compliant. Non-compliant samples predominantly failed in the dissolution test. All non-compliant samples were generic. Conclusions: Despite the apparent satisfactory outcome on the samples from China, pioglitazone samples collected in Myanmar and purchased online for personal import into Japan included many substandard products, which failed quality assessment predominantly because of poor dissolution. Internet providers did not comply with Japanese regulations in various respects. [ABSTRACT FROM AUTHOR]

Although health professionals, communities, governments and global institutions work closely to halt the spread of COVID-19 and mitigate its societal impact, COVID-19 remains a challenge to many countries around the world. In addition to its direct health, economic and social consequences, the pandemic has also resulted in unforeseen consequences in Africa especially in East African countries. COVID-19 might increase the demand and consumption of Substandard and Falsified (SF) medical products in three major ways. The first way is due to the inability of vulnerable segment of the population to access healthcare services as they used to do before. The second way people get exposed to SF medical products is due to fear of being quarantined, isolated and traced. Yet another way is related to import permits for medical products. Concerned regulatory bodies shall intervene aggressively in ensuring the safety, quality and effectiveness of medical products before we face a parallel pandemic from SF medical products.

Background Universal Health Coverage (UHC) is challenged by the prevalence of poor-quality medicines, those that either do not meet required specifications (substandard) or are outrightly fraudulent (falsified), especially in Low- and Middle-Income Countries, LMICs. Whereas poor-quality medicines are a significant burden in these countries, medicine quality still remains a neglected component of UHC programs. This article describes key barriers to quality medicines and presents five select approaches leveraging the scale-up of UHC for medicine quality assurance. Main body Barriers to medicine quality assurance, while numerous, are described in five key inter-related domains as: low political priority, weak regulatory systems capacity, poor access to accredited facilities and licensed outlets, medicine manufacturing and other supply-chain challenges, and lack of public awareness. Five select approaches for leveraging the scale-up of UHC for medicine quality assurance in LMICs are (1): political commitment (2) strengthening the capacity of regulatory authorities and investment in detection technologies as part of national security (3); licensing of medicines outlets and expanding pharmacovigilance (4); strengthening the supply-chain; and (5) public awareness and participation. Conclusions Unchecked, poor-quality medicines can jeopardize UHC. National governments in LMICs need to prioritize medicine quality assurance through enforcing policies, regulatory strengthening and investments in technologies. Healthcare facilities and insurance schemes under UHC also play critical roles through incorporating medicine quality assurance into procurement practices and by promoting awareness among beneficiaries. Tackling medicine quality with a committed systems approach will enhance progress towards UHC implementation.

Background Substandard and falsified medicines, mainly prevalent in low and middle-income countries (LMICs), cause avoidable morbidity and mortality, and put at stake the performance of health systems. They may be prevented by an adequate implementation of pharmaceutical Quality Assurance (QA) guidelines, but unfortunately, most guidelines address upstream stakeholders and specialized staff in the supply chain. A multi-layered approach is needed, in order to empower the health workers at the point-of-care to proactively contribute to the fight against poor-quality medicines. Visual inspection is a simple technique, suitable for field screening. The findings of a survey conducted in the Democratic Republic of the Congo (DRC) suggested that it might be a fairly good (yet partial) predictor of poor-quality, when compared to full laboratory tests. Methods and results Starting from the 68-questions checklist originally used in the survey in the DRC, we developed a simplified checklist, specifically designed to guide health workers at the point of care to rapidly identify suspect poor-quality medicines. We selected those medicines’ attributes the assessment of which does not require technical expertise, or access to regulatory information. Attributes were categorized according to a 3-level risk scale, to guide decision-making on suspect poor-quality medicines, based on an informed risk assessment. The simplified checklist contains 26 binary questions (YES/NO), grouped into four themes: packaging, identification, traceability, and physical appearance. Each non-conformity corresponds to a level of risk for patients. The user is guided towards three possible actions: A) reasonably safe for dispensing; B) dispense with explanation; C) quarantine and make a risk-benefit evaluation before dispensing. Conclusion The simplified checklist should now be implemented in real-life setting in LMICs. If proven useful in guiding health workers at the point-of-care to take rapid, transparent, patient-centred actions when facing a suspect poor-quality medicine, it could be further extended to address specific formulations. Digitalization for linkage with pharmacovigilance programs could also be considered.

Infill walls are mostly considered as distributed load only on the beams in the design and assessment of RC buildings. However, it has been emphasized by many researchers that the infill walls have a considerable impact on the seismic behavior of reinforced concrete frames. The infill walls can cause brittle shear damages at the ends of the boundary columns during the earthquake. The column shear damage can even lead to total collapse of reinforced concrete buildings. Therefore, considering the infill walls in analytical models is essential for achieving realistic structural design and assessment. Hence the infill wall modeling method should satisfactorily reproduce the internal forces that are developed in the frame columns. In this study, the experimental results of an infilled RC frame were used to investigate the effectiveness of infill wall modeling techniques by comparing with the analytically obtained cyclic response of the tested frame. Analytical modelling of infill walls was made by considering four different force-displacement relations and six different geometric modelling techniques. The most appropriate modelling technique is sought through the investigated ones that has the closest results with the cyclic response of the tested frame. Moreover, a parallel two-strut model was proposed as an original infill wall modelling technique. [ABSTRACT FROM AUTHOR]

Generating the nonlinear behavior of substandard beam‐column joints is challenging. Difficulties arise even more in reproducing the contribution of different nonlinear mechanisms (and their mutual effects) on the global cyclic response. This paper deals with the advanced numerical modeling of substandard reinforced concrete (RC) beam‐column joints designed with structural details and material properties non‐conforming to current seismic codes. Refined numerical models developed in VecTor2 and ATENA Science finite element (FE) software are investigated in detail to identify the factors affecting the global and local joint response. Two different modeling strategies are closely compared with experimental results of joint subassemblies with different failure modes in terms of hysteric response, crack pattern and its development, and local deformations at the joint panel and framing members. The advantages‐disadvantages, difficulties in implementing the numerical model and their capability to reproduce the experimental behavior are discussed in detail. The comparison against experimental results in terms of local and global response is useful to assess the accuracy of the proposed models and it provides details on their applicability. [ABSTRACT FROM AUTHOR]

The modern stage of language development is characterized not only by the expansion of the usual sphere of substandard existence, reflecting the corresponding subculture, but also by its expansion into written (codified) forms of communication. Widespread narcotism makes the reality of the drug subculture, which is heterogeneous itself, involves different strata. Drug addiction gradually ceases to be perceived in society as a condemned dependence, goes into the category of habits when there is a special «drugs-lifestyle», and drugs are assigned a special «stylistic» role in it. The aestheticization of the drug addicts lifestyle is carried out through the nominations with a positive emotional-expressive connotation. Since the advertising of drugs is prohibited by law, there is a hidden advertising. Often, the fight against drug addiction itself is essentially transformed into drug advertising, for example, all the discussions about the distinction between «light» and «heavy» drugs. In the last ten years, these nominations – «heavy» and «light» drugs – are extremely popular in media. The very nomination – «easy» – in the consciousness of teenagers is associated with the features, such as ‘harmless, innocent, resolved’, i.e. the nomination itself gives veiled permission on use. Meanwhile, Russian legislation prohibits this distinction, because all the drugs are certainly harmful and dangerous.

Background Quality issues in pharmaceuticals are identified as a huge global and public health problem, especially with reference to low- and middle-income countries like Pakistan. The 2011 “Fake Drug Crisis” acted as a driving force to reform the regulatory structures of the country and for establishing the autonomous “Drug Regulatory Authority of Pakistan”. Despite the fact that Pakistan possesses a huge pharmaceutical industry, there is a severe dearth of published literature and scientific evidence for the country regarding medicine quality and the prevalence of counterfeit and low-quality products, respectively. Aims and objectives This narrative review covers relevant features of the regulatory framework for pharmaceuticals in Pakistan, its national pharmaceutical industry, as well as a compilation and analysis of published literature for documentation of the country’s situation regarding the overall quality of medicines. Methods Available data including scientific publications on the quality of pharmaceuticals in peer reviewed journals, research reports, notifications, and alerts issued by the World Health Organization and other agencies were accessed and compiled. Post graduate dissertations were used to represent unpublished research data and drug safety alerts issued from the local Pakistan authority were analysed to assess the type and number of quality failures reported for pharmaceuticals. Results It could be clearly shown that there is negligible scientific data available on the issue of medicine quality in Pakistan. The anticipated number of 40—50% of poor-quality drugs in Pakistan cannot be defended by data available from the literature. Accessible technologies and strategies used in recent years at global level, especially in developing countries, were also reviewed and recommendations are devised for Pakistan to combat the fight against poor-quality medicines. Conclusion The case reports, investigations, and general data listed for Pakistan suggest the need of strengthening regulatory systems for premises and GMP inspections, analytical laboratories, as well as an overall capacity building in the field of unravelling and controlling substandard and falsified medicines. It is proposed that well-planned and properly funded studies need to be carried out for collecting critical statistics regarding the prevalence of substandard and falsified medicines in Pakistan.