Research Publications and Outputs

Pharmaceutical industry payments to Australian patient groups: January 2013 to December 2022

2026-04-09T00:59:55Z

Pharmaceutical industry payments to Australian patient groups: January 2013 to December 2022 Hooimeyer, Ashleigh; Fabbri, Alice; Swandari, Swestika; Phan, Melanie; Mohammad, Annim; Chiu, Kellia; Mintzes, Barbara This dataset includes data from transparency reports from the pharmaceutical industry from 2013-2022 of payments to patient groups. Since 2013, companies which are members of Medicines Australia (the peak body for the prescription pharmaceutical industry in Australia) have been required by the Medicines Australia Code of Conduct to disclose any financial and significant non-financial support provided to patient groups. These reports are published on the Medicines Australia website for a period of three years and include information on the recipient patient group, a brief description of the support provided, and the monetary value of the sponsorship.

New chemical and biological entities approved by the Therapeutic Goods Administration, January 1, 2005 to July 25, 2025

2025-10-13T23:54:31Z

New chemical and biological entities approved by the Therapeutic Goods Administration, January 1, 2005 to July 25, 2025 Lexchin, Joel; Hooimeyer, Ashleigh This dataset includes information on drug approvals by the Australian Therapeutic Goods Administration (TGA) from 2005 to July 2025. Generic, brand name, indication, approval pathway (when applicable), and date of approval are included. In addition, therapeutic ratings from the Patented Medicines Prices Review Board (PMPRB, Canada), Prescrire, Haute Autorité de Santé (HAS, France), and the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG, Germany), and Pharmaceutical Benefits Schedule (PBS) listing status have been included.

Literature Review and Environmental Scan: Review and update the Guiding principles to achieve continuity in medication management

2025-07-18T03:55:53Z

Literature Review and Environmental Scan: Review and update the Guiding principles to achieve continuity in medication management Chen, Timothy; Schneider, Carl; Gnjidic, Danijela; Baysari, Melissa; Sawan, Mouna; Jordan, Margaret; Mullan, Judy; van Dort, Bethany; Kouladjian-O’Donnell, Lisa; Langford, Aili; Luetsch, Karen; Hilmer, Sarah A report prepared for the Australian Commission on Safety and Quality in Health Care

Australian Poisoning Surveillance Initiative (APSI) Databank

2024-12-19T04:45:35Z

Australian Poisoning Surveillance Initiative (APSI) Databank Cairns, Rose; Buckley, Nicholas; Dzidowska, Monika; Benger, Lauren; Roberts, Darren; Wright, Nicole; Wylie, Carol; Elliott, Rohan; Greene, Shaun; Dean, Danielle; Heiner, Madeline; Armstrong, Jason; Isoardi, Katherine; Chiew, Angela; Brown, Jared; Dawson, Andrew; Merwood, Nick; Soderstrom, Jessamine The APSI Databank is a de-identified dataset derived from calls logged by poisons specialists working at Australian Poisons Information Centres (PICs) during routine clinical operations. This includes data on calls from the public and healthcare professionals in all Australian states and territories. PICs are called about exposures and queries regarding medicines, chemicals, plants, bites/stings. Exposures include accidental poisonings, dosing errors, self-harm, recreational substance use, and occupational exposures. Variables include basic demographics (age, sex), exposure details (substance, dose, time, intent), details of clinical features and advice provided (including handling/disposition). PIC data are particularly valuable due to: (i) the ability to capture instances of poisoning that are not in other data sources (e.g. those not requiring hospital admission), (ii) detailed nature of substance coding, including substance-level information of specific agents in the exposure event (much more detailed than ICD-10 coding which is used for hospital data), and (iii) timely data: data are coded in real-time at the time of the call to PIC. Limitations of the dataset include the fact that PICs don't routinely capture outcome data, and the fact that not all poisoning exposures result in a call to a PIC. Initially, data from the New South Wales Poisons Information Centre (NSWPIC) will be available. NSWPIC takes approximately 50% of the nation's poisoning calls, including a sample of calls from all Australian states and territories. Incorporation of other PIC's data into APSI is anticipated in 2025.

The intestinal microbiota and improving the efficacy of COVID-19 vaccinations

2022-08-24T05:18:39Z

The intestinal microbiota and improving the efficacy of COVID-19 vaccinations Chen, Jiezhong; Vitetta, Luis; Henson, Jeremy D; Hall, Sean Most COVID-19 cases are mild or asymptomatic and recover well, suggesting that effective immune responses ensue, which successfully eliminate SARS-CoV-2 viruses. However, a small proportion of patients develop severe COVID-19 with pathological immune responses. This indicates that a strong immune system balanced with anti-inflammatory mechanisms is critical for the recovery from SARS-CoV-2 infections. Many vaccines against SARS-CoV-2 have now been developed for eliciting effective immune responses to protect from SARS-CoV-2 infections or reduce the severity of the disease if infected. Although uncommon, serious morbidity and mortality have resulted from both COVID-19 vaccine adverse reactions and lack of efficacy, and further improvement of efficacy and prevention of adverse effects are urgently warranted. Many factors could affect efficacy of these vaccines to achieve optimal immune responses. Dysregulation of the gut microbiota (gut dysbiosis) could be an important risk factor as the gut microbiota is associated with the development and maintenance of an effective immune system response. In this narrative review, we discuss the immune responses to SARS-CoV-2, how COVID-19 vaccines elicit protective immune responses, gut dysbiosis involvement in inefficacy and adverse effects of COVID-19 vaccines and the modulation of the gut microbiota by functional foods to improve COVID-19 vaccine immunisations.

Enhancing Endocannabinoid Control of Stress with Cannabidiol.

2022-08-24T05:10:31Z

Enhancing Endocannabinoid Control of Stress with Cannabidiol. Henson, Jeremy D; Vitetta, Luis; Quezada, Michelle; Hall, Sean The stress response is a well-defined physiological function activated frequently by life events. However, sometimes the stress response can be inappropriate, excessive, or prolonged; in which case, it can hinder rather than help in coping with the stressor, impair normal functioning, and increase the risk of somatic and mental health disorders. There is a need for a more effective and safe pharmacological treatment that can dampen maladaptive stress responses. The endocannabinoid system is one of the main regulators of the stress response. A basal endocannabinoid tone inhibits the stress response, modulation of this tone permits/curtails an active stress response, and chronic deficiency in the endocannabinoid tone is associated with the pathological complications of chronic stress. Cannabidiol is a safe exogenous cannabinoid enhancer of the endocannabinoid system that could be a useful treatment for stress. There have been seven double-blind placebo controlled clinical trials of CBD for stress on a combined total of 232 participants and one partially controlled study on 120 participants. All showed that CBD was effective in significantly reducing the stress response and was non-inferior to pharmaceutical comparators, when included. The clinical trial results are supported by the established mechanisms of action of CBD (including increased N-arachidonylethanolamine levels) and extensive real-world and preclinical evidence of the effectiveness of CBD for treating stress.

Intestinal Dysbiosis, the Tryptophan Pathway and Nonalcoholic Steatohepatitis.

2022-08-24T05:01:23Z

Intestinal Dysbiosis, the Tryptophan Pathway and Nonalcoholic Steatohepatitis. Chen, Jiezhong; Vitetta, Luis; Henson, Jeremy D; Hall, Sean Non-alcoholic fatty liver disease (NAFLD) progresses from simple steatosis to steatohepatitis (NASH), which may then progress to the development of cirrhosis and hepatocarcinoma. NASH is characterized by both steatosis and inflammation. Control of inflammation in NASH is a key step for the prevention of disease progression to severe sequalae. Intestinal dysbiosis has been recognized to be an important causal factor in the pathogenesis of NASH, involving both the accumulation of lipids and aggravation of inflammation. The effects of gut dysbiosis are mediated by adverse shifts of various intestinal commensal bacterial genera and their associated metabolites such as butyrate, tryptophan, and bile acids. In this review, we focus on the roles of tryptophan and its metabolites in NASH in association with intestinal dysbiosis and discuss possible therapeutic implications.

Comment on: Cannabis use among Danish patients with cancer: a cross‑sectional survey of sociodemographic traits, quality of life, and patient experiences.

2026-03-04T04:09:50Z

Comment on: Cannabis use among Danish patients with cancer: a cross‑sectional survey of sociodemographic traits, quality of life, and patient experiences. Vitetta, Luis; Sikali, Jason F; Fletcher, Courtney; Henson, Jeremy D The recent article by Nielsen and colleagues [1] presents an interesting cross-sectional investigation on a subgroup of cancer patients that self-prescribed cannabinoids. The authors present a study with a high response rate (83%) among the 326 patients (13% of the total cohort) that had used a cannabis-based medicine. Notwithstanding the small sample size, it still constitutes an evaluable response rate, given that the use of cannabis for medicinal purposes in Denmark is permitted.

Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions

2022-08-24T04:37:38Z

Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions Henson, Jeremy D.; Vitetta, Luis; Hall, Sean Combination tetrahydrocannabinol (THC)/cannabidiol (CBD) medicines or CBD-only medicines are prospective treatments for chronic pain, stress, anxiety, depression, and insomnia. THC and CBD increase signaling from cannabinoid receptors, which reduces synaptic transmission in parts of the central and peripheral nervous systems and reduces the secretion of inflammatory factors from immune and glial cells. The overall effect of adding CBD to THC medicines is to enhance the analgesic effect but counteract some of the adverse effects. There is substantial evidence for the effectiveness of THC/CBD combination medicines for chronic pain, especially neuropathic and nociplastic pain or pain with an inflammatory component. For CBD-only medication, there is substantial evidence for stress, moderate evidence for anxiety and insomnia, and minimal evidence for depression and pain. THC/CBD combination medicines have a good tolerability and safety profile relative to opioid analgesics and have negligible dependence and abuse potential; however, should be avoided in patients predisposed to depression, psychosis and suicide as these conditions appear to be exacerbated. Non-serious adverse events are usually dose-proportional, subject to tachyphylaxis and are rarely dose limiting when patients are commenced on a low dose with gradual up-titration. THC and CBD inhibit several Phase I and II metabolism enzymes, which increases the exposure to a wide range of drugs and appropriate care needs to be taken. Low-dose CBD that appears effective for chronic pain and mental health has good tolerability and safety, with few adverse effects and is appropriate as an initial treatment.

Can krill oil from small crustaceans be a panacea that alleviates symptoms of knee osteoarthritis?

2022-08-25T01:41:20Z

Can krill oil from small crustaceans be a panacea that alleviates symptoms of knee osteoarthritis? Vitetta, Luis For decades fish oils have been promoted as important for health, and currently it is well known that the long-chain omega-3 (n–3) fatty acids, EPA and DHA, are fats with essential considerations for health (1, 2). A wide range of health advantages have been attributed to PUFAs, such as strong anti-inflammatory and antiarthritic properties with the potential to provide beneficial effects for metabolic diseases (3).

A Narrative Review of COVID-19 Vaccines

2026-04-29T05:42:03Z

A Narrative Review of COVID-19 Vaccines Eroglu, B.; Nuwarda, R.F.; Ramzan, I.; Kayser, V. The COVID-19 pandemic has shaken the world since early 2020 and its health, social, economic, and societal negative impacts at the global scale have been catastrophic. Since the early days of the pandemic, development of safe and effective vaccines was judged to be the best possible tool to minimize the effects of this pandemic. Drastic public health measures were put into place to stop the spread of the virus, with the hope that vaccines would be available soon. Thanks to the extraordinary commitments of many organizations and individuals from around the globe and the collaborative effort of many international scientists, vaccines against COVID-19 received regulatory approval for emergency human use in many jurisdictions in less than a year after the identification of the viral sequence. Several of these vaccines have been in use for some time; however, the pandemic is still ongoing and likely to persist for the foreseeable future. This is due to many reasons including reduced compliance with public health restrictions, limited vaccine manufacturing/distribution capacity, high rates of vaccine hesitancy, and the emergence of new variants with the capacity to spread more easily and to evade current vaccines. Here we discuss the discovery and availability of COVID-19 vaccines and evolving issues around mass vaccination programs.

Country-specific lockdown measures in response to the COVID-19 pandemic and its impact on tuberculosis control: a global study

2026-04-29T05:42:01Z

Country-specific lockdown measures in response to the COVID-19 pandemic and its impact on tuberculosis control: a global study Migliori, G.B.; Thong, P.M.; Alffenaar, J.-W.; Denholm, J.; Tadolini, M.; Alyaquobi, F.; Al-Abri, S.; Blanc, F.-X.; Buonsenso, D.; Chakaya, J.; Cho, J.-G.; Codecasa, L.R.; Danila, E.; Duarte, R.; Dukpa, R.; García-García, J.-M.; Gualano, G.; Kurhasani, X.; Manika, K.; Mello, F.C.Q.; Pahl, K.; Rendon, A.; Sotgiu, G.; Souleymane, M.B.; Thomas, T.A.; Tiberi, S.; Kunst, H.; Udwadia, Z.F.; Goletti, D.; Centis, R.; D'Ambrosio, L.; Silva, D.R. The objective of this study was to describe country-specific lockdown measures and tuberculosis indicators collected during the first year of the COVID-19 pandemic. Data on lockdown/social restrictions (compulsory face masks and hand hygiene; international and local travel restrictions; restrictions to family visits, and school closures) were collected from 24 countries spanning five continents. The majority of the countries implemented multiple lockdowns with partial or full reopening. There was an overall decrease in active tuberculosis, drug-resistant tuberculosis, and latent tuberculosis cases. Although national lockdowns were effective in containing COVID-19 cases, several indicators of tuberculosis were affected during the pandemic.

Biologics and Vaccines for Nasal and Pulmonary Drug Delivery

2026-04-29T05:42:05Z

Biologics and Vaccines for Nasal and Pulmonary Drug Delivery Komalla, Varsha; Haghi, Mehra; Kayser, Veysel Biologics are a rapidly emerging class of therapeutics that have succeeded clinically and commercially due to their specificity and efficacy against various diseases including cancer, inflammatory, and autoimmune diseases. Even though most biologics are administered parenterally, nasal and pulmonary delivery would be beneficial due to numerous advantages such as being patient-friendly, noninvasive, cost-effective, and less toxic. While there are currently a few nasal and inhaled biologics on the market, for example, Suprefact®, Minirin®, Miacalcin®, most of them are designed to treat ailments related to prostate carcinoma, diabetes, osteoporosis but not for respiratory diseases. Moreover, there are some marketed nasally delivered vaccines such as Flumist® and Nasovac-S® against influenza virus, inhaled vaccines that did not make it to market. Given the rise of respiratory infections such as MERS, SARS, and SARS-CoV-2, a great deal of interest exists in developing nasal and pulmonary-delivered biologics and vaccines for respiratory diseases. The objective of this chapter is to describe the potential for pulmonary and nasal delivery of biologics. Each section delves into introducing biologics and vaccines, followed by a portrayal of recent updates on nasal and pulmonary delivery of biologics and vaccines. The most promising formulation strategies for enhancing the stability and therapeutic efficacy of biologics as a part of research and development will be discussed.

The tension between national consistency and jurisdictional professional expansion: The case of pharmacist-administered vaccinations

2026-04-29T05:42:07Z

The tension between national consistency and jurisdictional professional expansion: The case of pharmacist-administered vaccinations Chiu, Kellia; Thow, Anne Marie; Bero, Lisa BACKGROUND: The COVID-19 pandemic has highlighted the importance of coordinating policies on vaccinations at the national level. In Australia, the regulation and management of pharmacist-administered vaccination programs are the responsibility of each of the eight jurisdictions (six states and two territories), and have been developed independently of each other, leading to substantial variation. Consequently, there are variations regarding which vaccines pharmacists can administer, the minimum age, and whether these vaccines are publicly funded. OBJECTIVE(S): To identify opportunities for a nationally consistent approach to pharmacist-administered vaccinations in Australia. METHODS: This policy analysis used the Multiple Streams Framework to identify barriers and enablers within the three "streams" of problem, policy, and politics, and how they affected the development of a national approach. Data were drawn from semi-structured interviews with 13 key policy actors and documents (pre-budget submissions and parliamentary inquiry reports). Themes were generated around actor interests, current and proposed pharmacist vaccination programs, and policymaking processes. RESULTS: From the pharmacy sector, there was little clarity around the need for a nationally consistent approach. This issue was linked to their ultimate goal of expanding pharmacist vaccination programs; it was seen as a means for states/territories with smaller programs to 'catch up' to other jurisdictions. There was also no unified policy approach from this sector; additionally, decision-makers within jurisdictional health departments faced different service delivery models, policy priorities, agendas, and policy actor relationships. Lastly, there was no federal body that had the capacity to coordinate a national approach. Possible enablers include refining the problem definition and re-framing it to a patient-centric model. CONCLUSIONS: Coordination of vaccination policies is an ongoing policy issue with implications for pharmacist vaccination programs and other health policy areas in which a national approach is being considered. This analysis provides insight into how this may be developed in the future.

Physiologically Based Pharmacokinetic Modeling Approaches for Patients With SARS‐CoV‐2 Infection: A Case Study With Imatinib

2026-04-29T05:42:01Z

Physiologically Based Pharmacokinetic Modeling Approaches for Patients With SARS‐CoV‐2 Infection: A Case Study With Imatinib Adiwidjaja, Jeffry; Adattini, Josephine A.; Boddy, Alan V.; McLachlan, Andrew J. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which causes coronavirus disease 2019 (COVID-19), manifests as mild respiratory symptoms to severe respiratory failure and is associated with inflammation and other physiological changes. Of note, substantial increases in plasma concentrations of α1 -acid-glycoprotein and interleukin-6 have been observed among patients admitted to the hospital with advanced SARS-CoV-2 infection. A physiologically based pharmacokinetic (PBPK) approach is a useful tool to evaluate and predict disease-related changes on drug pharmacokinetics. A PBPK model of imatinib has previously been developed and verified in healthy people and patients with cancer. In this study, the PBPK model of imatinib was successfully extrapolated to patients with SARS-CoV-2 infection by accounting for disease-related changes in plasma α1 -acid-glycoprotein concentrations and the potential drug interaction between imatinib and dexamethasone. The model demonstrated a good predictive performance in describing total and unbound imatinib concentrations in patients with SARS-CoV-2 infection. PBPK simulations highlight that an equivalent dose of imatinib may lead to substantially higher total drug concentrations in patients with SARS-CoV-2 infection compared to that in patients with cancer, while the unbound concentrations remain comparable between the 2 patient populations. This supports the notion that unbound trough concentration is a better exposure metric for dose adjustment of imatinib in patients with SARS-CoV-2 infection, compared to the corresponding total drug concentration. Potential strategies for refinement and generalization of the PBPK modeling approach in the patient population with SARS-CoV-2 are also provided in this article, which could be used to guide study design and inform dose adjustment in the future.

Ciprofloxacin nanocrystals liposomal powders for controlled drug release via inhalation

2022-06-07T23:42:30Z

Ciprofloxacin nanocrystals liposomal powders for controlled drug release via inhalation Khatib, Isra; Khanal, Dipesh; Ruan, Juanfang; Cipolla, David; Dayton, Francis; Blanchard, James; Chan, Hak-Kim This study was conducted to evaluate the feasibility of developing inhalable dry powders of liposomal encapsulated ciprofloxacin nanocrystals (LECN) for controlled drug release. Dry powders of LECN were produced by freeze-thaw followed by spray drying. The formulations contained sucrose as a lyoprotectant in different weight ratios (0.75:1, 1:1 and 2:1 sucrose to lipids), along with 2 % magnesium stearate and 5 % isoleucine as aerosolization enhancers. The powder physical properties (particle size, morphology, crystallinity, moisture content), in vitro aerosolization performance, drug encapsulation efficiency and in vitro drug release were investigated. The spray dried powders were comprised of spherical particles with a median diameter of ~ 1 μm, partially crystalline, with a low water content (~2 % mass) and did not undergo recrystallization at high relative humidity. When dispersed by an Osmohaler® inhaler at 100 L/min, the powders showed a high aerosol performance with a fine particle fraction (% wt. < 5 μm) of 66-70 %. After reconstitution of the powders in saline, ciprofloxacin nanocrystals were confirmed by cryoelectron microscopy. The drug encapsulation efficiency of the reconstituted liposomes was 71-79 % compared with the stock liquid formulation. Of the three formulations, the one containing a sucrose to lipids wt. ratio of 2:1 demonstrated a prolonged release of ciprofloxacin from the liposomes. In conclusion, ciprofloxacin nanocrystal liposomal powders were prepared that were suitable for inhalation aerosol delivery and controlled drug release.

Storage stability of inhalable, controlled-release powder formulations of ciprofloxacin nanocrystal-containing liposomes

2022-06-07T23:42:17Z

Storage stability of inhalable, controlled-release powder formulations of ciprofloxacin nanocrystal-containing liposomes Khatib, Isra; Ke, Wei-Ren; Cipolla, David; Chan, Hak-Kim Novel inhalable and controlled release powder formulations of ciprofloxacin nanocrystals inside liposomes (CNL) were recently developed. In the present study, the storage stability of CNL powders consisting of lyoprotectant (i.e. sucrose or lactose), lipids, ciprofloxacin ( CIP ), and magnesium stearate or isoleucine was investigated. These powders were produced by spray drying, collected in a dry box at < 15% relative humidity (RH), then stored at room temperature and either 4 or 20 %RH. Liposomal integrity, CIP encapsulation efficiency (EE), in vitro drug release (IVR), aerosol performance, and solid-state properties were examined over six months. Sucrose CNL powder exhibited consistent liposomal integrity, aerosol performance, and controlled release of CIP over six months of storage at 4 %RH. However, storage of the powder at 20 %RH for the same period caused sucrose crystallization and consequently a significant drop in EE and aerosol performance (p-values <0.05), along with the IVR of CIP becoming similar to that of the non-crystalline CIP liposomal dispersions (f2 > 50). Lactose CNL maintained superior aerosol performance over the six months irrespective of the storage RH. However, liposomal instability occurred at both RHs within the first month of storage with a significant drop in EE and an increase in liposome size (p-values <0.05). Moreover, the IVR assay of CIP from lactose CNL showed a less controlled release and a substantial difference (f2 < 50) from its initial value after six months regardless of the storage RHs. In conclusion, dry powder inhalers of CNL were physiochemically stable in sucrose lyoprotectant when stored below 4 %RH at room temperature for six months.

Modeling of a spray drying method to produce ciprofloxacin nanocrystals inside the liposomes utilizing a response surface methodology: Box-Behnken experimental design

2022-06-07T23:42:08Z

Modeling of a spray drying method to produce ciprofloxacin nanocrystals inside the liposomes utilizing a response surface methodology: Box-Behnken experimental design Khatib, Isra; Chow, Michael YT; Ruan, Juanfang; Cipolla, David; Chan, Hak-Kim Spray drying was previously used to modify the physical form of the encapsulated ciprofloxacin drug to produce ciprofloxacin nanocrystals inside the liposomes (CNL). The purpose of the present study was to optimize CNL powder production by evaluating the response surface via design of experiments (DoE). Using the Box–Behnken (BB) design, the study independent variables were the protectant type (sucrose, trehalose or lactose), protectant amount, drying temperature, and spray gas flow. Individual spray drying experiments were performed at various set points for each variable followed by characterization of the produced powders. Liposomal particle size, drug encapsulation efficiency (EE%), liposomal surface zeta potential, and nanocrystal dimensions were the design dependant variables. By applying the least square regression method on the experimental data, mathematical models were developed using the mathematical software package MATLAB R2018b. Model reliability and the significance of the model’s factors were estimated using analysis of variance (ANOVA). The generated CNL powders showed spherical to elliptical liposomal vesicles with particle sizes ranging from 98 to 159 nm. The EE (%) ranged from 30 to 95% w/w while the zeta potential varied between -3.5 and -10.5 mV. The encapsulated ciprofloxacin nanocrystals were elongated cylindrical structures with an aspect ratio of 4.0 - 7.8. Coefficients of determination ( R 2 > 0.9) revealed a good agreement between the predicted and experimental values for all responses except for the nanocrystal dimensions. Sucrose and lactose were superior to trehalose in protecting the liposomes during spray drying. The amount of sugar significantly affected the characteristics of the CNL powders ( p -value < 0.05). In conclusion, the DoE approach using BB design has efficiently modelled the generation of CNL by spray drying. The optimum processing conditions which produced high drug encapsulation (90%) after formation of nanocrystals and a vesicle size of ~125 nm utilized 57% (w/w) sucrose, an 80°C inlet temperature, and an atomization rate of 742 L/hr.

Formation of ciprofloxacin nanocrystals within liposomes by spray drying for controlled release via inhalation

2022-06-07T23:41:55Z

Formation of ciprofloxacin nanocrystals within liposomes by spray drying for controlled release via inhalation Khatib, Isra; Tang, Patricia; Ruan, Juanfang; Cipolla, David; Dayton, Francis; Blanchard, James; Chan, Hak-Kim The present study was conducted to harness spray drying technology as a novel method of producing Ciprofloxacin nanocrystals inside liposomes (CNL) for inhalation delivery. Liposomal ciprofloxacin dispersions were spray dried with sucrose as a lyoprotectant in different mass ratios (0.5:1, 1:1 and 2:1 sucrose to lipids), along with 2% w/w magnesium stearate and 5% w/w isoleucine as aerosolization enhancers. Spray drying conditions were: inlet air temperature 50 °C, outlet air temperature 33-35 °C, atomizer rate 742 L/h and aspirator 35 m3/h. After spray drying, the formation of ciprofloxacin nanocrystals inside the liposomes was confirmed by cryo- transmission electron microscopy. The physiochemical characteristics of the spray dried powder (particle size, morphology, crystallinity, moisture content, drug encapsulation efficiency (EE), in vitro aerosolization performance and drug release) were determined. The EE of the liposomes was found to vary between 44 and 87% w/w as the sucrose content was increased from 25 to 57% w/w. The powders contained partially crystalline particles with a volume median diameter of ~ 1 μm. The powders had low water content (~2 % wt.) and were stable at high relative humidity. Aerosol delivery using the Osmohaler® inhaler at a flow rate of 100 L/min produced an aerosol fine particle fraction (% wt. < 5 μm) of 58 - 64%. The formulation with the highest sucrose content (2:1 w/w sucrose to lipid) demonstrated extended ciprofloxacin release from liposomes (80% released within 7 hours) in comparison to the original liquid formulation (80% released within 2 hours). In conclusion, a stable and inhalable CNL powder with controlled drug release was successfully prepared by spray drying.

Nanoscale probing of liposome encapsulating drug nanocrystal using Atomic Force Microscopy-Infrared Spectroscopy

2026-05-07T02:24:13Z

Nanoscale probing of liposome encapsulating drug nanocrystal using Atomic Force Microscopy-Infrared Spectroscopy Khanal, Dipesh; Khatib, Isra; Ruan, Juanfang; Cipolla, David; Dayton, Francis; Blanchard, James; Chan, Hak-Kim; Chrzanowski, Wojciech Use of liposomes encapsulating drug nanocrystals for the treatment of diseases like cancer and pulmonary infections is gaining attention. The potential therapeutic benefit of these engineered formulations relies on maintaining the physical integrity of the liposomes and the stability of the encapsulated drug. With the significant advancement in the microscopic and analytical techniques, analysis of the size and size distribution of these nanosized vesicles is possible. However, due to the limited spatial resolution of conventional vibrational spectroscopy techniques, the chemical composition of individual nanosized liposome cannot be resolved. To address this limitation, we applied atomic force microscopy infrared spectroscopy (AFM-IR) to assess the chemical composition of individual liposomes encapsulating ciprofloxacin in dissolved and nanocrystalline form. Spatially resolved AFMIR spectra acquired from individual liposomes confirmed the presence of peaks related to N-H bending vibration, C-N stretching and symmetric and asymmetric vibration of the carboxyl group present in the ciprofloxacin. Our results further demonstrated the effectiveness of AFM-IR in differentiating the liposome containing ciprofloxacin in dissolved or nano-crystalline form. Spectra acquired from dissolved ciprofloxacin had peaks related to the ionised carboxyl group, i.e. at 1576 cm-1 and 1392 cm-1, which were either absent or far weaker in intensity in the spectra of liposomal sample containing ciprofloxacin nanocrystals. These findings are highly significant for pharmaceutical scientists to ascertain the stability and physicochemical composition of individual liposomes and will facilitate the design and development of liposomes with greater therapeutic benefits.

Healthcare Workers' Knowledge and Perception of the SARS-CoV-2 Omicron Variant: A Multinational Cross-Sectional Study

2026-04-29T05:42:06Z

Healthcare Workers' Knowledge and Perception of the SARS-CoV-2 Omicron Variant: A Multinational Cross-Sectional Study Bhagavathula, Akshaya Srikanth; Mahabadi, Mohammadjavad Ashrafi; Tesfaye, Wubshet; Nayar, Kesavan Rajasekharan; Chattu, Vijay Kumar In late November 2021, a new SARS-CoV-2 Variant of Concern (VOC) named Omicron (initially named B.1.1.529) was first detected in South Africa. The rapid spread of the SARS-CoV-2 Omicron variant became globally dominant, and the currently available COVID-19 vaccines showed less protection against this variant. This study aimed to investigate healthcare workers’ (HCWs) knowledge and perceptions about the novel SARS-CoV-2 Omicron variant. A cross-sectional anonymous electronic survey concerning the SARS-CoV-2 Omicron variant was conducted among HCWs during the second week of January 2022. The survey instrument was distributed through social media among HCWs to explore awareness (2 items), knowledge (10 items), source of information (1 item), and perceptions (10 items). Respondents who answered ≥80% of the items correctly were considered as having good knowledge and perception. A total of 940 of the 1054 HCW participants completed the survey (response rate: 89.1%); they had a mean age of 31.2 ± 11.2 years, most were doctors (45.7%), and most were from Asia (64.3%). All the participants were aware of the SARS-CoV-2 Omicron variant (100%). Only 36.3% attended lectures/discussions about Omicron and used news media to obtain information. Only a quarter of the HCWs demonstrated good knowledge (24.3%, n = 228) and perception (20.6%) about Omicron. However, while significant differences were observed in the knowledge and perception among HCWs, only a small proportion of doctors exhibited good knowledge (13%) and perception (10%) about the Omicron variant. HCWs who had participated in training/discussion related to the Omicron variant were more likely to have higher knowledge and perception scores (odds ratio: 1.80; 95% confidence interval: 1.04–3.11). As the SARS-CoV-2 Omicron variant spreads rapidly across the globe, ongoing educational interventions are warranted to improve knowledge and perceptions of HCWs.

Broad Decline in Viral Infections During COVID-19 Lockdown: Association with Lung Function in Lung Transplant Recipients

2026-04-29T05:42:06Z

Broad Decline in Viral Infections During COVID-19 Lockdown: Association with Lung Function in Lung Transplant Recipients de Zwart, A.E.; Riezebos-Brilman, A.; Lunter, G.; Neerken, E.; Van Leer, C.; Alffenaar, J.C.; Van Gemert, J.P.; Erasmus, M.E.; Gan, C.T.; Kerstjens, H.A.; Vonk, J.M.; Verschuuren, E.A. Purpose In April 2020 COVID-19 lockdown measures were instigated leading to a dramatic drop in non-COVID respiratory virus infections (RVI). This provided a unique situation to assess the impact of RVI on annual FEV1 decline, episodes of temporary drop in lung function suggestive of infection (TDLF) and CLAD in lung transplant recipients (LTR). Methods All lung function tests (LFT) of LTR transplanted between 2009-April 2020 were used from post-transplant baseline onward. LFT were censored after COVID-19 infection. Weekly RVI counts from the virology department defined RVI pressure over time. TDLF was defined as sudden, reversible FEV1 drop compared to previous 4 values (any TDLF ≥10% and ≥200ml, severe TDLF ≥20% and ≥500ml). Annual FEV1 decline was estimated using linear mixed effects models with separate estimates for 2009/20 and 2020/21. Effect modification by TDLF frequency of individual LTR (two subgroups, split at median) and RVI pressure was tested. Rates of CLAD and TDLF were analyzed over time. Results 479 LTR (12,775 LFT) were included. Annual FEV1 change in 2009/20 was -114ml [95%CI -133; -94], while in 2020/21 this was significantly less: 5ml [-38; 48] (p<0.001). RVI pressure significantly affected FEV1 level (an increase in weekly RVI-count of 10 leading to a 7ml [-10; -5] lower FEV1 (p<0.001). FEV1 decline in 2009/20 was faster in frequent TDLF LTR vs. infrequent (-150ml [-181; -120] vs. -90ml [-115; -65] p=0.003 Fig A). 2020/21 showed significant decreases in number of any TDLF (OR 0.53 [0.33; 0.85], p=0.008) and severe TDLF (OR 0.34 [0.16; 0.71] p=0.005) and numerically lower CLAD (OR 0.53 [0.27; 1.02] p=0.060). Effect modification by RVI pressure (Figures B-D) indicated an association between the events and RVI. Conclusion During the lockdown year 2020/21 the broad decline in RVI coincided with substantially less FEV1 decline, TDLFs and possibly CLAD. All these outcomes were moderated by RVI pressure suggesting an important role for RVI in lung function decline in LTR.

Preparation and Characterization of Inhalable Ivermectin Powders as a Potential COVID-19 Therapy

2026-04-29T05:42:01Z

Preparation and Characterization of Inhalable Ivermectin Powders as a Potential COVID-19 Therapy Albariqi, Ahmed H.; Ke, Wei-Ren; Khanal, Dipesh; Kalfas, Stefanie; Tang, Patricia; Britton, Warwick J; Drago, John; Chan, Hak-Kim Background: Ivermectin has received worldwide attention as a potential COVID-19 treatment after showing antiviral activity against SARS-CoV-2 in vitro. However, the pharmacokinetic limitations associated with oral administration have been postulated as limiting factors to its bioavailability and efficacy. These limitations can be overcome by targeted delivery to the lungs. In this study, inhalable dry powders of ivermectin and lactose crystals were prepared and characterized for the potential treatment of COVID-19. Methods: Ivermectin was co-spray dried with lactose monohydrate crystals and conditioned by storage at two different relative humidity points (43% and 58% RH) for a week. The in vitro dispersion performance of the stored powders was examined using a medium-high resistance Osmohaler connecting to a next-generation impactor at 60_L/min flow rate. The solid-state characteristics including particle size distribution and morphology, crystallinity, and moisture sorption profiles of raw and spray-dried ivermectin samples were assessed by laser diffraction, scanning electron microscopy, Raman spectroscopy, X-ray powder diffraction, thermogravimetric analysis, differential scanning calorimetry, and dynamic vapor sorption. Results: All the freshly spray-dried formulation (T0) and the conditioned samples could achieve the anticipated therapeutic dose with fine particle dose of 300__g, FPFrecovered of 70%, and FPFemitted of 83%. In addition, the formulations showed a similar volume median diameter of 4.3__m and span of 1.9. The spray-dried formulations were stable even after conditioning and exposing to different RH points as ivermectin remained amorphous with predominantly crystalline lactose. Conclusion: An inhalable and stable dry powder of ivermectin and lactose crystals was successfully formulated. This powder inhaler ivermectin candidate therapy appears to be able to deliver doses that could be safe and effective to treat the SARS-COV-2 infection. Further development of this therapy is warranted.

Pharmacokinetics and safety of inhaled ivermectin in mice as a potential COVID-19 treatment

2026-04-22T03:37:07Z

Pharmacokinetics and safety of inhaled ivermectin in mice as a potential COVID-19 treatment Albariqi, Ahmed H; Wang, Yuncheng; Chang, Rachel Yoon Kyung; Quan, Diana H; Wang, Xiaonan; Kalfas, Stefanie; Drago, John; Britton, Warwick J; Chan, Hak-Kim Pharmacokinetic limitations associated with oral ivermectin may limit its success as a potential COVID-19 treatment based on in vitro experiments which demonstrate antiviral efficacy against SARS-CoV-2 at high concentrations. Targeted delivery to the lungs is a practical way to overcome these limitations and ensure the presence of a therapeutic concentration of the drug in a clinically critical site of viral pathology. In this study, the pharmacokinetics (PK) and safety of inhaled dry powders of ivermectin with lactose were investigated in healthy mice. Female BALB/c mice received ivermectin formulation by intratracheal administration at high (3.15 mg/kg) or low doses (2.04 mg/kg). Plasma, bronchoalveolar lavage fluid (BALF), lung, kidney, liver, and spleen were collected at predetermined time points up to 48 h and analyzed for PK. Histological evaluation of lungs was used to examine the safety of the formulation. Inhalation delivery of ivermectin formulation showed improved pharmacokinetic performance as it avoided protein binding encountered in systemic delivery and maintained a high exposure above the in vitro antiviral concentration in the respiratory tract for at least 24 h. The local toxicity was mild with less than 20% of the lung showing histological damage at 24 h, which resolved to 10% by 48 h.

"Never waste a good crisis": Opportunities and constraints from the COVID-19 pandemic on pharmacists' scope of practice

2026-04-29T05:42:00Z

"Never waste a good crisis": Opportunities and constraints from the COVID-19 pandemic on pharmacists' scope of practice Chiu, Kellia; Thow, Anne Marie; Bero, Lisa BACKGROUND: In response to the COVID-19 pandemic, many pharmacy-based or pharmacist-delivered services were introduced or amended to mitigate the pandemic's health and social impact. This happened within the context of pharmacists seeking more opportunities to increase their clinical responsibilities and play a larger role in primary care. OBJECTIVE(S): To analyse the policymaking context and pharmacy responses to COVID-19 that enable or constrain the expansion of pharmacists' scope of practice. METHODS: This study is a policy analysis of documentary data detailing changes in pharmacy policy in Australia, drawing on a "policy space analysis" framework to identify opportunities and constraints to policy reform. Data were collected from news for health professionals; federal/jurisdictional legislation and media releases; and guidelines and directives from government health departments and agencies. Changes to pharmacy practice were identified and classified according to type. For each change, potential opportunities and constraints for expanding pharmacists' scope of practice were identified. RESULTS: Four categories of changes were identified: medicines limits/restrictions; alternatives to paper prescriptions; public health measures; and community pharmacist-delivered services. Opportunities from the pandemic response that could expand scope of practice include the potential permanence of temporary measures that increase pharmacists' responsibilities; remuneration to legitimise services; political acknowledgement of medicines safety and access as a priority; and government need to quickly address crises. Constraints include the potential permanence of temporary measures that restrict pharmacists' practice; negative perceptions of pharmacists from other clinicians; intra-professional disagreements regarding pharmacy-based services; and lack of pharmacist representation in institutional structures. CONCLUSIONS: This analysis demonstrates that the pandemic responses and policy context may facilitate expansion of pharmacists' scope of practice, and identifies possible avenues to do so; it also highlights constraints that need to be further addressed to achieve this goal.

The experiences of pharmacists during the global COVID-19 pandemic: A thematic analysis using the jobs demands-resources framework

2026-04-29T05:42:06Z

The experiences of pharmacists during the global COVID-19 pandemic: A thematic analysis using the jobs demands-resources framework Johnston, Karlee; O'Reilly, Claire L; Scholz, Brett; Mitchell, Imogen BACKGROUND: COVID-19 has necessitated a change to the way pharmacists are providing healthcare and has impacted the psychological wellbeing of these frontline healthcare workers. OBJECTIVE: To use the job demands-resources framework of burnout to describe the experiences of pharmacists working during COVID-19. METHODS: An online survey investigating burnout, psychosocial, and work-related factors affecting pharmacists during COVID-19 was distributed to a convenience sample of pharmacists practising in Australia during April and June 2020. The survey was distributed via social media and professional organisations. This study was a thematic analysis of the free-text question of the survey that asked participants to provide comment on anything they considered important. The job demands-resources framework of burnout was applied to the themes. RESULTS: Of 647 total survey responses, 215 (33.2%) participants responded to the free text question. Thematic analysis explored the increase in demands on pharmacists with a decreased availability of resources during COVID-19. Themes associated with high demands included an increased workload, provision of education and support to the community, taking on roles traditionally performed by others, managing medication and stock supply issues, and poor consumer behaviour. Themes representing resources, which were inadequate, included feeling supported by management and colleagues, feeling adequately trained, receiving clear and consistent communication, feeling valued and appreciated, personal safety, and recovery time. CONCLUSIONS: Pharmacists have experienced increased demands and reduced resources during COVID-19 which is associated with burnout. Knowledge of these demands and resources can inform interventions at an individual, workplace, and external level. Recommendations made in this paper are aimed at increasing resources available to pharmacists.

A review of environmental contamination and potential health impacts on aquatic life from the active chemicals in sunscreen formulations

2026-05-07T02:24:20Z

A review of environmental contamination and potential health impacts on aquatic life from the active chemicals in sunscreen formulations Wheate, Nial The active chemicals in sunscreen formulations are released into the environment from human skin, and found in recreational-use waters like seawater, but can also be washed into fresh water from bathing and showering. The level of sunscreen chemicals found in samples varies considerably between regions, time of year (higher in summer months), and time of day. Average typical concentrations are only in the nanograms per litre (ng L−1) range in marine and fresh water systems, and typically, the highest levels are in waste-water sludge because of a concentrating effect during the treatment process. From numerous studies, it is known that the active chemicals in sunscreens can have potential hormonal/oestrogenic activity and non-hormonal effects, including: acting as teratogens, altering gene regulation, inducing changes in antioxidant and free radical production, and inducing coral bleaching. However, the effects of sunscreens on aquatic life under laboratory conditions typically occur only at concentrations (µg or mg L−1) that far exceed (10–10 000-fold) levels found in the environment. As such, when damage does occur to reefs and animal life, there are often other causes that are more likely impacting the aquatic life including changes in water temperature, water turbidity, elevated nutrient levels, and the presence of pesticides and medicines used for human and animal health.

Vaccines and vaccination: history and emerging issues.

2026-04-29T05:42:03Z

Vaccines and vaccination: history and emerging issues. Kayser, Veysel; Ramzan, Iqbal Prophylactic vaccines are crucial in modern healthcare and have been used successfully to combat bacterial and viral infectious diseases. Infections like polio and smallpox, which were dreaded historically, and which devastated the human race over many centuries, are now rare. Smallpox has been eradicated completely and polio is nearly eradicated because of vaccines. Vaccines differ fundamentally from other classes of medicines in that they are usually administered as a preventive measure to a healthy individual rather than to a sick person already with an infection, although exceptions to this practice exist. Most currently used prophylactic vaccines are based on established platforms, but many vaccine candidates, in late development stages, including several COVID-19 vaccines, use highly novel vaccine platforms not available historically. History of infectious diseases and prophylactic vaccines are filled with important scientific lessons, and thus provide valuable insights for the future. With hindsight, historically there were some ethically questionable approaches to testing vaccines and the germ warfare against native populations in the Americas and other regions. In this review, we examine key historical lessons learned with prophylactic vaccines with reflections on current healthcare dilemmas and controversies with respect to influenza and COVID-19 vaccines.

Using an online nominal group technique to determine key implementation factors for COVID-19 vaccination programmes in community pharmacies

2026-04-29T05:42:01Z

Using an online nominal group technique to determine key implementation factors for COVID-19 vaccination programmes in community pharmacies Michel, Dorothee Elsbeth; Iqbal, Ayesha; Faehrmann, Laura; Tadić, Ivana; Paulino, Ema; Chen, Timothy F.; Moullin, Joanna C. Background One vital strategy to fight the COVID-19 pandemic is the rapid roll-out of vaccination programmes. In a number of countries pharmacists are joining the vaccination programme workforce, including plans to involve community pharmacies. Objectives (1) to determine key implementation factors for rapid roll-out of COVID-19 vaccination programmes in European community pharmacies and (2) to trial an online nominal group technique to generate ideas and reach consensus on the first aim. Setting In February 2021, during a workshop at the 12th Working Conference of the Pharmaceutical Care Network Europe. Method An online nominal group technique workshop over 10 hours was conducted. Identified implementation factors were mapped to the Framework for the Implementation of Services in Pharmacy and assessed in terms of importance and changeability. Main outcome measure Consensus of key implementation factors. Results In total, 85 implementation factors were identified. The top 3 factors were the same for both criteria: "(Regular) Staff training on correct vaccination procedure/to perform hands-on injection technique"; "Training in basic life support/first aid (Cardiopulmonary resuscitation)", and; "Definition of process, roles and responsibilities in the team". Conclusion An online nominal group technique enabled international collaboration to gather diverse perspectives on the implementation of COVID-19 vaccination programmes in a time and cost-efficient manner. "Staff training on correct vaccination procedure", "training in basic life support" and "definition of process, roles and responsibilities in the team" were deemed the most important and changeable implementation factors. Online nominal group technique may be a suitable method for other implementation problems.

Advancing health care resilience through a systems-based collaborative approach: Lessons learned from COVID-19

2026-04-29T05:42:04Z

Advancing health care resilience through a systems-based collaborative approach: Lessons learned from COVID-19 Khalili, Hossein; Lising, Dean; Kolcu, Giray; Thistlethwaite, Jill; Gilbert, John; Langlois, Sylvia; Maxwell, Barbara; Kolcu, Mukadder İnci Başer; MacMillan, Kathleen M; Schneider, Carl; Freire Filho, José Rodrigues; Najjar, Ghaidaa; Al-Hamdan, Zaid; Pfeifle, Andrea

Developing a Global Community of Practice for Pharmacy Workforce Resilience-Meet GRiT

2026-04-29T05:42:05Z

Developing a Global Community of Practice for Pharmacy Workforce Resilience-Meet GRiT Whitfield, Karen; Arya, Vibhuti; Austin, Zubin; Bajis, Dalia; Bradley, Catriona; Clark, Bronwyn; Exintaris, Betty; Galbraith, Kirsten; Hajj, Maguy Saffouh El; Hall, Kat; Hughes, Louise; Kirsa, Sue; Langran, Catherine; Mantzourani, Efi; Wilby, Kyle John; Willis, Sarah Workforce resilience in pharmacy is required to ensure the practice, education, and administrative systems remain viable and sustainable over time and when facing challenges. Whether it is addressing burnout of pharmacists or students, or the structure and policies/procedures of employment and professional organizations, working to increase resilience across all individuals and sectors is essential to relieve pressure and promote better well-being, especially during the recent pandemic. The purpose of this article is to describe the development of a community of practice global group focused on development of resilience within the pharmacy workforce that is inclusive of students, pharmacy interns/preregistration and registered pharmacists. The steering group meets monthly and has representation of 24 members across eight countries. Members meet to discuss pertinent issues they are facing in practice, as well as to share and progress ideas on education, research, and practice initiatives. To date, members have collectively implemented resilience training in pharmacy education, researched burnout and resilience in both students and pharmacists, and facilitated international collaborations both within and outside core group members. Future activities will focus on strengthening the community of practice in order to harness the power of the collective.

Persistent postoperative opioid use after total hip or knee arthroplasty: A systematic review and meta-analysis

2026-04-29T05:42:00Z

Persistent postoperative opioid use after total hip or knee arthroplasty: A systematic review and meta-analysis Tay, Hui Ping; Wang, Xinyi; Narayan, Sujita W; Penm, Jonathan; Patanwala, Asad E DISCLAIMER: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: To identify the proportion of patients with continued opioid use after total hip or knee arthroplasty. METHODS: This systematic review and meta-analysis searched Embase, MEDLINE, the Cochrane Central Register of Controlled Trials, and International Pharmaceutical Abstracts for articles published from January 1, 2009, to May 26, 2021. The search terms (opioid, postoperative, hospital discharge, total hip or knee arthroplasty, and treatment duration) were based on 5 key concepts. We included studies of adults who underwent total hip or knee arthroplasty, with at least 3 months postoperative follow-up. RESULTS: There were 30 studies included. Of these, 17 reported on outcomes of total hip arthroplasty and 19 reported on outcomes of total knee arthroplasty, with some reporting on outcomes of both procedures. In patients having total hip arthroplasty, rates of postoperative opioid use at various time points were as follows: at 3 months, 20% (95% CI, 13%-26%); at 6 months, 17% (95% CI, 12%-21%); at 9 months, 19% (95% CI, 13%-24%); and at 12 months, 16% (95% CI, 15%-16%). In patients who underwent total knee arthroplasty, rates of postoperative opioid use were as follows: at 3 months, 26% (95% CI, 19%-33%); at 6 months, 20% (95% CI, 17%-24%); at 9 months, 23% (95% CI, 17%-28%); and at 12 months, 21% (95% CI, 12%-29%). Opioid naive patients were less likely to have continued postoperative opioid use than those who were opioid tolerant preoperatively. CONCLUSION: Over 1 in 5 patients continued opioid use for longer than 3 months after total hip or knee arthroplasty. Clinicians should be aware of this trajectory of opioid consumption after surgery.

Preparedness for Mass Gathering During Hajj and Umrah

2026-04-29T05:42:02Z

Preparedness for Mass Gathering During Hajj and Umrah Ridda, Iman; Mansoor, Sarab; Briggs, Revlon; Gishe, Jemal; Aatmn, Doaha The role of public health preparedness at mass gatherings (MGs) and a framework to ensure a safe and healthy mass gathering are provided in this chapter. The unique aspects of Hajj and Umrah events, including their massive size and the interplay of environmental conditions with the international nature of attendees, require proper and thorough public health preparation.The key aspects of a framework designed to promote public health at mass gatherings are also outlined in this chapter. The key aspects include risk assessment, public health surveillance; regulations, legislation and policy; emergency planning and response; environmental health; public health awareness; strengthening communication; and internal organizational and capacity building. Our search evaluates literatures pertaining to the frameworks of public health concerns at mass gatherings and analyzes the preparedness and effectiveness of such regulations and projections in current models of disaster preparedness and public health promotion. Such a model is crucial for setting the stage for decision-making and ensuring the safety of attendees; it should be implemented before the commencement of the event.Further, the health risks associated with attending a mass gathering such as Hajj/Umrah are discussed. Clinicians and attendees have specific roles to play in ensuring good public health during these pilgrimages. Clinicians have a role in ensuring attendees are well equipped with the knowledge and resources to stay healthy during Hajj/Umrah, which helps to protect the public from infectious disease transmission. Attendees have a role in ensuring personal health and maintaining hygiene standards. Infectious diseases of concern at such mass gatherings include Middle East respiratory syndrome-coronavirus (MERS-CoV), meningococcal disease, diarrheal disease and seasonal influenza. Other diseases of concern include the potential for pilgrims to contract Zika due to local populations of Zika vectors.Specific vaccine requirements and knowledge regarding health warnings are crucial to Hajj attendees when traveling to the Kingdom of Saudi Arabia (KSA). In addition, pilgrims are encouraged to seek accurate information related to travel and visas and requirements of Hajj-specific travel visas.

Nebulised Isotonic Hydroxychloroquine Aerosols for Potential Treatment of COVID-19

2026-04-22T03:37:06Z

Nebulised Isotonic Hydroxychloroquine Aerosols for Potential Treatment of COVID-19 Tai, Waiting; Chow, Michael Yee Tak; Chang, Rachel Yoon Kyung; Tang, Patricia; Gonda, Igor; MacArthur, Robert B; Chan, Hak-Kim; Kwok, Philip Chi Lip The coronavirus disease 2019 (COVID-19) is an unprecedented pandemic that has severely impacted global public health and the economy. Hydroxychloroquine administered orally to COVID-19 patients was ineffective, but its antiviral and anti-inflammatory actions were observed in vitro. The lack of efficacy in vivo could be due to the inefficiency of the oral route in attaining high drug concentration in the lungs. Delivering hydroxychloroquine by inhalation may be a promising alternative for direct targeting with minimal systemic exposure. This paper reports on the characterisation of isotonic, pH-neutral hydroxychloroquine sulphate (HCQS) solutions for nebulisation for COVID-19. They can be prepared, sterilised, and nebulised for testing as an investigational new drug for treating this infection. The 20, 50, and 100 mg/mL HCQS solutions were stable for at least 15 days without refrigeration when stored in darkness. They were atomised from Aerogen Solo Ultra vibrating mesh nebulisers (1 mL of each of the three concentrations and, in addition, 1.5 mL of 100 mg/mL) to form droplets having a median volumetric diameter of 4.3-5.2 m, with about 50-60% of the aerosol by volume < 5 m. The aerosol droplet size decreased (from 4.95 to 4.34 m) with increasing drug concentration (from 20 to 100 mg/mL). As the drug concentration and liquid volume increased, the nebulisation duration increased from 3 to 11 min. The emitted doses ranged from 9.1 to 75.9 mg, depending on the concentration and volume nebulised. The HCQS solutions appear suitable for preclinical and clinical studies for potential COVID-19 treatment.

Cross-sectional study of preprints and final journal publications from COVID-19 studies: Discrepancies in results reporting and spin in interpretation

2026-04-29T00:24:25Z

Cross-sectional study of preprints and final journal publications from COVID-19 studies: Discrepancies in results reporting and spin in interpretation Bero, L.; Lawrence, R.; Leslie, L.; Chiu, K.; McDonald, S.; Page, M.J.; Grundy, Q.; Parker, L.; Boughton, S.; Kirkham, J.J.; Featherstone, R. Objective To compare results reporting and the presence of spin in COVID-19 study preprints with their finalised journal publications. Design Cross-sectional study. Setting International medical literature. Participants Preprints and final journal publications of 67 interventional and observational studies of COVID-19 treatment or prevention from the Cochrane COVID-19 Study Register published between 1 March 2020 and 30 October 2020. Main outcome measures Study characteristics and discrepancies in (1) results reporting (number of outcomes, outcome descriptor, measure, metric, assessment time point, data reported, reported statistical significance of result, type of statistical analysis, subgroup analyses (if any), whether outcome was identified as primary or secondary) and (2) spin (reporting practices that distort the interpretation of results so they are viewed more favourably). Results Of 67 included studies, 23 (34%) had no discrepancies in results reporting between preprints and journal publications. Fifteen (22%) studies had at least one outcome that was included in the journal publication, but not the preprint; eight (12%) had at least one outcome that was reported in the preprint only. For outcomes that were reported in both preprints and journals, common discrepancies were differences in numerical values and statistical significance, additional statistical tests and subgroup analyses and longer follow-up times for outcome assessment in journal publications. At least one instance of spin occurred in both preprints and journals in 23/67 (34%) studies, the preprint only in 5 (7%), and the journal publications only in 2 (3%). Spin was removed between the preprint and journal publication in 5/67 (7%) studies; but added in 1/67 (1%) study. Conclusions The COVID-19 preprints and their subsequent journal publications were largely similar in reporting of study characteristics, outcomes and spin. All COVID-19 studies published as preprints and journal publications should be critically evaluated for discrepancies and spin. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial.

2026-04-29T00:24:21Z

Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial. Arabi, Yaseen M; Gordon, Anthony C; Derde, Lennie P G; Nichol, Alistair D; Murthy, Srinivas; Beidh, Farah Al; Annane, Djillali; Swaidan, Lolowa Al; Beane, Abi; Beasley, Richard; Berry, Lindsay R; Bhimani, Zahra|Bonten, Marc J M; Bradbury, Charlotte A; Brunkhorst, Frank M; Buxton, Meredith; Buzgau, Adrian; Cheng, Allen; De Jong, Menno; Detry, Michelle A; Duffy, Eamon J; Estcourt, Lise J; Fitzgerald, Mark; Fowler, Rob; Girard, Timothy D; Goligher, Ewan C; Goossens, Herman; Haniffa, Rashan; Higgins, Alisa M; Hills, Thomas E; Horvat, Christopher M; Huang, David T; King, Andrew J; Lamontagne, Francois; Lawler, Patrick R; Lewis, Roger; Linstrum, Kelsey; Litton, Edward; Lorenzi, Elizabeth; Malakouti, Salim; McAuley, Daniel F; McGlothlin, Anna; Mcguinness, Shay; McVerry, Bryan; Montgomery, Stephanie K; Morpeth, Susan C; Mouncey, Paul R; Orr, Katrina; Parke, Rachael; Parker, Jane C; Patanwala, Asad E; Rowan, Kathryn M; Santos, Marlene S; Saunders, Christina T; Seymour, Christopher W; Shankar-Hari, Manu; Tong, Steven Y C; Turgeon, Alexis F; Turner, Anne M; Van de Veerdonk, Frank Leo; Zarychanski, Ryan; Green, Cameron; Berry, Scott; Marshall, John C; McArthur, Colin; Angus, Derek C; Webb, Steven A; REMAP-CAP Investigators PURPOSE: To study the efficacy of lopinavir-ritonavir and hydroxychloroquine in critically ill patients with coronavirus disease 2019 (COVID-19). METHODS: Critically ill adults with COVID-19 were randomized to receive lopinavir-ritonavir, hydroxychloroquine, combination therapy of lopinavir-ritonavir and hydroxychloroquine or no antiviral therapy (control). The primary endpoint was an ordinal scale of organ support-free days. Analyses used a Bayesian cumulative logistic model and expressed treatment effects as an adjusted odds ratio (OR) where an OR > 1 is favorable. RESULTS: We randomized 694 patients to receive lopinavir-ritonavir (n = 255), hydroxychloroquine (n = 50), combination therapy (n = 27) or control (n = 362). The median organ support-free days among patients in lopinavir-ritonavir, hydroxychloroquine, and combination therapy groups was 4 (- 1 to 15), 0 (- 1 to 9) and-1 (- 1 to 7), respectively, compared to 6 (- 1 to 16) in the control group with in-hospital mortality of 88/249 (35%), 17/49 (35%), 13/26 (50%), respectively, compared to 106/353 (30%) in the control group. The three interventions decreased organ support-free days compared to control (OR [95% credible interval]: 0.73 [0.55, 0.99], 0.57 [0.35, 0.83] 0.41 [0.24, 0.72]), yielding posterior probabilities that reached the threshold futility (>= 99.0%), and high probabilities of harm (98.0%, 99.9% and > 99.9%, respectively). The three interventions reduced hospital survival compared with control (OR [95% CrI]: 0.65 [0.45, 0.95], 0.56 [0.30, 0.89], and 0.36 [0.17, 0.73]), yielding high probabilities of harm (98.5% and 99.4% and 99.8%, respectively). CONCLUSION: Among critically ill patients with COVID-19, lopinavir-ritonavir, hydroxychloroquine, or combination therapy worsened outcomes compared to no antiviral therapy.

Why did all the toilet paper disappear? Distinguishing between panic buying and hoarding during COVID-19.

2026-04-29T00:24:22Z

Why did all the toilet paper disappear? Distinguishing between panic buying and hoarding during COVID-19. David, Jonathan; Visvalingam, Shanara; Norberg, Melissa M The COVID-19 pandemic led to panic buying in many countries across the globe, preventing vulnerable groups from accessing important necessities. Some reports inaccurately referred to the panic buying as hoarding. Although hoarding is a separate issue characterised by extreme saving behaviour, the two problems may be influenced by similar factors. Participants from Australia and the United States (final N = 359) completed online self-report measures of panic buying, hoarding, shopping patterns, perceived scarcity, COVID-19 illness anxiety, selfishness, and intolerance of uncertainty. Our findings showed that panic buying was related to hoarding symptoms (r's = .23 - .36), and yet, both were uniquely associated with different psychological factors. Whilst panic buying was most strongly related to greater perceived scarcity (r's = .38 - .60), hoarding was most related to a general intolerance of uncertainty (r's = .24 - .57). Based on our findings, future strategies to prevent panic buying should focus on reducing perceived scarcity cues in the community, as this seems to be the primary driver of panic buying. Another preventative strategy to reduce excessive acquiring and saving may be to implement educational programs to increase people's ability to tolerate distress and uncertainty.

Proposed guidance on cost-avoidance studies in pharmacy practice

2026-04-22T03:37:04Z

Proposed guidance on cost-avoidance studies in pharmacy practice Patanwala, Asad E; Narayan, Sujita W; Haas, Curtis E; Abraham, Ivo; Sanders, Arthur; Erstad, Brian L Purpose: Cost-avoidance studies of pharmacist interventions are common and often the first type of study conducted by investigators to quantify the economic impact of clinical pharmacy services. The purpose of this primer is to provide guidance for conducting cost-avoidance studies pertaining to clinical pharmacy practice. Summary: Cost-avoidance studies represent a paradigm conceptually different from traditional pharmacoeconomic analysis. A cost-avoidance study reports on cost savings from a given intervention, where the savings is estimated based on a counterfactual scenario. Investigators need to determine what specifically would have happened to the patient if the intervention did not occur. This assessment can be fundamentally flawed, depending on underlying assumptions regarding the pharmacists' action and the patient trajectory. It requires careful identification of the potential consequence of nonaction, as well as probability and cost assessment. Given the uncertainty of assumptions, sensitivity analyses should be performed. A step-by-step methodology, formula for calculations, and best practice guidance is provided. Conclusions: Cost-avoidance studies focused on pharmacist interventions should be considered low-level evidence. These studies are acceptable to provide pilot data for the planning of future clinical trials. The guidance provided in this article should be followed to improve the quality and validity of such investigations. PURPOSE: Cost-avoidance studies of pharmacist interventions are common and often the first type of study conducted by investigators to quantify the economic impact of clinical pharmacy services. The purpose of this primer is to provide guidance for conducting cost-avoidance studies pertaining to clinical pharmacy practice. SUMMARY: Cost-avoidance studies represent a paradigm conceptually different from traditional pharmacoeconomic analysis. A cost-avoidance study reports on cost savings from a given intervention, where the savings is estimated based on a counterfactual scenario. Investigators need to determine what specifically would have happened to the patient if the intervention did not occur. This assessment can be fundamentally flawed, depending on underlying assumptions regarding the pharmacists' action and the patient trajectory. It requires careful identification of the potential consequence of nonaction, as well as probability and cost assessment. Given the uncertainty of assumptions, sensitivity analyses should be performed. A step-by-step methodology, formula for calculations, and best practice guidance is provided. CONCLUSIONS: Cost-avoidance studies focused on pharmacist interventions should be considered low-level evidence. These studies are acceptable to provide pilot data for the planning of future clinical trials. The guidance provided in this article should be followed to improve the quality and validity of such investigations.

Medications in Post-Acute and Long-Term Care: Challenges and Controversies

2026-04-29T05:42:03Z

Medications in Post-Acute and Long-Term Care: Challenges and Controversies Sloane, P.D.; Brandt, N.J.; Cherubini, A.; Dharmarajan, T.S.; Dosa, D.; Hanlon, J.T.; Katz, P.; Koopmans, R.T.C.M.; Laird,R.D.; Petrovic, M.; Semla, T.P.; Tan, E.C.K.; Zimmerman, S.

Treatment outcomes for COVID-19: a prospective cohort study

2026-04-29T05:42:03Z

Treatment outcomes for COVID-19: a prospective cohort study Bao, Z; Liu, J; Hu, Y; Li, Y; Gu, B; Zhu, J; Zheng, X; Wu, M; Shen, X; Alffenaar, J W

Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review

2026-04-29T05:42:04Z

Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review Gesesew, Hailay Abrha; Koye, Digsu Negese; Fetene, Dagnachew Muluye; Woldegiorgis, Mulu; Kinfu, Yohannes; Geleto, Ayele Bali; Melaku, Yohannes Adama; Mohammed, Hassen; Alene, Kefyalew Addis; Awoke, Mamaru Ayenew; Birhanu, Mulugeta Molla; Gebremedhin, Amanuel Tesfay; Gelaw, Yalemzewod Assefa; Shifti, Desalegn Markos; Muluneh, Muluken Dessalegn; Tegegne, Teketo Kassaw; Abrha, Solomon; Aregay, Atsede Fantahun; Ayalew, Mohammed Biset; Gebre, Abadi Kahsu; Gebremariam, Kidane Tadesse; Gebremedhin, Tesfaye; Gebremichael, Lemlem; Leshargie, Cheru Tesema; Kibret, Getiye Dejenu; Meazaw, Maereg Wagnew; Mekonnen, Alemayehu Berhane; Tekle, Dejen Yemane; Tesema, Azeb Gebresilassie; Tesfay, Fisaha Haile; Tesfaye, Wubshet; Wubishet, Befikadu Legesse; Dachew, Berihun Assefa; Adane, Akilew Awoke OBJECTIVE: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. DESIGN: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. DATA SOURCES: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. ELIGIBILITY CRITERIA: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. DATA EXTRACTION AND SYNTHESIS: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. RESULTS: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. CONCLUSIONS: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.

COVID-19 in Ethiopia: a geospatial analysis of vulnerability to infection, case severity and death

2026-04-29T05:42:05Z

COVID-19 in Ethiopia: a geospatial analysis of vulnerability to infection, case severity and death Alene, Kefyalew Addis; Gelaw, Yalemzewod Assefa; Fetene, Dagnachew Muluye; Koye, Digsu N.; Melaku, Yohannes Adama; Gesesew, Hailay; Birhanu, Mulugeta Molla; Adane, Akilew Awoke; Muluneh, Muluken Dessalegn; Dachew, Berihun Assefa; Abrha, Solomon; Aregay, Atsede; Ayele, Asnakew Achaw; Bezabhe, Woldesellassie M; Gebremariam, Kidane Tadesse; Gebremedhin, Tesfaye; Gebremedhin, Amanuel Tesfay; Gebremichael, Lemlem; Geleto, Ayele Bali; Kassahun, Habtamu Tilahun; Kibret, Getiye Dejenu; Leshargie, Cheru Tesema; Mekonnen, Alemayehu; Mirkuzie, Alemnesh H.; Mohammed, Hassen; Tegegn, Henok Getachew; Tesema, Azeb Gebresilassie; Tesfay, Fisaha Haile; Wubishet, Befikadu Legesse; Kinfu, Yohannes BACKGROUND: COVID-19 has caused a global public health crisis affecting most countries, including Ethiopia, in various ways. This study maps the vulnerability to infection, case severity and likelihood of death from COVID-19 in Ethiopia. METHODS: Thirty-eight potential indicators of vulnerability to COVID-19 infection, case severity and likelihood of death, identified based on a literature review and the availability of nationally representative data at a low geographic scale, were assembled from multiple sources for geospatial analysis. Geospatial analysis techniques were applied to produce maps showing the vulnerability to infection, case severity and likelihood of death in Ethiopia at a spatial resolution of 1 km×1 km. RESULTS: This study showed that vulnerability to COVID-19 infection is likely to be high across most parts of Ethiopia, particularly in the Somali, Afar, Amhara, Oromia and Tigray regions. The number of severe cases of COVID-19 infection requiring hospitalisation and intensive care unit admission is likely to be high across Amhara, most parts of Oromia and some parts of the Southern Nations, Nationalities and Peoples' Region. The risk of COVID-19-related death is high in the country's border regions, where public health preparedness for responding to COVID-19 is limited. CONCLUSION: This study revealed geographical differences in vulnerability to infection, case severity and likelihood of death from COVID-19 in Ethiopia. The study offers maps that can guide the targeted interventions necessary to contain the spread of COVID-19 in Ethiopia.

Can ultrasound novices develop image acquisition skills after reviewing online ultrasound modules?

2026-04-29T05:42:05Z

Can ultrasound novices develop image acquisition skills after reviewing online ultrasound modules? Situ-LaCasse, Elaine; Acuña, Josie; Huynh, Dang; Amini, Richard; Irving, Steven; Samsel, Kara; Patanwala, Asad E.; Biffar, David E.; Adhikari, Srikar BackgroundPoint-of-care ultrasound is becoming a ubiquitous diagnostic tool, and there has been increasing interest to teach novice practitioners. One of the challenges is the scarcity of qualified instructors, and with COVID-19, another challenge is the difficulty with social distancing between learners and educators. The purpose of our study was to determine if ultrasound-naïve operators can learn ultrasound techniques and develop the psychomotor skills to acquire ultrasound images after reviewing SonoSim® online modules.MethodsThis was a prospective study evaluating first-year medical students. Medical students were asked to complete four SonoSim® online modules (aorta/IVC, cardiac, renal, and superficial). They were subsequently asked to perform ultrasound examinations on standardized patients utilizing the learned techniques/skills in the online modules. Emergency Ultrasound-trained physicians evaluated medical students’ sonographic skills in image acquisition quality, image acquisition difficulty, and overall performance. Data are presented as means and percentages with standard deviation. All P values are based on 2-tailed tests of significance.ResultsTotal of 44 medical students participated in the study. All (100%) students completed the hands-on skills evaluation with a median score of 83.7% (IQR 76.7–88.4%). Thirty-three medical students completed all the online modules and quizzes with median score of 87.5% (IQR 83.8–91.3%). There was a positive association between module quiz performance and the hands-on skills performance (R-squared = 0.45; p

SARS-CoV-2, surgeons and surgical masks

2026-04-29T05:42:03Z

SARS-CoV-2, surgeons and surgical masks Khalil, Mohammad Ibrahim; Banik, Gouri Rani; Mansoor, Sarab; Alqahtani, Amani S; Rashid, Harunor The exact risk association of coronavirus disease 2019 (COVID-19) for surgeons is not quantified which may be affected by their risk of exposure and individual factors. The objective of this review is to quantify the risk of COVID-19 among surgeons, and explore whether facemask can minimise the risk of COVID-19 among surgeons. A systematised review was carried out by searching MEDLINE to locate items on severe acute respiratory syndrome coronavirus 2 or COVID-19 in relation to health care workers (HCWs) especially those work in surgical specialities including surgical nurses and intensivists. Additionally, systematic reviews that assessed the effectiveness of facemask against viral respiratory infections, including COVID-19, among HCWs were identified. Data from identified articles were abstracted, synthesised and summarised. Fourteen primary studies that provided data on severe acute respiratory syndrome coronavirus 2 infection or experience among surgeons and 11 systematic reviews that provided evidence of the effectiveness of facemask (and other personal protective equipment) were summarised. Although the risk of COVID-19 could not be quantified precisely among surgeons, about 14% of HCWs including surgeons had COVID-19, there could be variations depending on settings. Facemask was found to be somewhat protective against COVID-19, but the HCWs' compliance was highly variable ranging from zero to 100%. Echoing surgical societies' guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.

Burnout and the challenges facing pharmacists during COVID-19: results of a national survey

2026-04-29T05:42:04Z

Burnout and the challenges facing pharmacists during COVID-19: results of a national survey Johnston, Karlee; O’Reilly, Claire L.; Scholz, Brett; Georgousopoulou, Ekavi N.; Mitchell, Imogen Background COVID-19 has impacted the psychological wellbeing of healthcare workers and has forced pharmacists to adapt their services. Objective To measure burnout and describe the work and psychosocial factors affecting pharmacists during COVID-19, and to compare males and females. Setting An online survey was distributed to a convenience sample of pharmacists practicing in any setting in Australia during April and June 2020. Method The survey collected demographic data, burnout scores using the validated Maslach Burnout Inventory (MBI), psychosocial and work-related variables using questions adapted from previous surveys. It was tested for readability by a group of pharmacists and academic clinicians before distribution via social media and professional organisations. Main outcome measure Burnout was calculated using mean MBI scores, descriptive statistics were used to report work and psychosocial variables and Pearson’s chi-square compared males and females. Results Overall, 647 responses were analysed. Most participants were female n = 487 (75.7%) with hospital n = 269 (42.2%) and community n = 253 (39.9%) pharmacists well represented. Mean (SD) for emotional exhaustion (possible range 0–54) and depersonalisation (possible range 0–30) were 28.5 (13.39) and 7.98 (5.64), which were higher (increased burnout) than reported pre-COVID-19. Personal accomplishment (range 0–48, lower scores associated with burnout) mean (SD) 36.58 (7.56), was similar to previously reported. Males reported higher depersonalisation indicating more withdrawal and cynicism. Working overtime, medication supply and patient incivility were reported to affect work. Conclusion Pharmacists are experiencing burnout, with work and psychosocial factors affecting them during COVID-19. Knowledge of this and that males experience more depersonalisation is valuable to inform advocacy and interventions to support pharmacists.

Comparison of preprints and final journal publications from COVID-19 Studies: Discrepancies in results reporting and spin in interpretation

2026-04-22T03:37:04Z

Comparison of preprints and final journal publications from COVID-19 Studies: Discrepancies in results reporting and spin in interpretation Bero, Lisa; Lawrence, Rosa; Leslie, Louis; Chiu, Kellia; McDonald, Sally; Page, Matthew J; Grundy, Quinn; Parker, Lisa; Boughton, Stephanie L; Kirkham, Jamie J; Featherstone, Robin ABSTRACT Objective To compare results reporting and the presence of spin in COVID-19 study preprints with their finalized journal publications Design Cross-sectional Setting International medical literature Participants Preprints and final journal publications of 67 interventional and observational studies of COVID-19 treatment or prevention from the Cochrane COVID-19 Study Register published between March 1, 2020 and October 30, 2020 Main outcome measures Study characteristics and discrepancies in 1) Results reporting (number of outcomes, outcome descriptor, measure (e.g., PCR test), metric (e.g., mean change from baseline), assessment time point (e.g., 1 week post treatment), data reported (e.g., effect estimate and measures of precision), reported statistical significance of result, type of statistical analysis (e.g., chi-squared test), subgroup analyses (if any), whether outcome was identified as primary or secondary and 2) Spin (reporting practices that distort the interpretation of results so that results are viewed more favorably). Results Of 67 included studies, 23 (34%) had no discrepancies in results reporting between preprints and journal publications. Fifteen (22%) studies had at least one outcome that was included in the journal publication, but not the preprint; 8 (12%) had at least one outcome that was reported in the preprint only. For outcomes that were reported in both preprints and journals, common discrepancies were differences in numerical values and statistical significance, additional statistical tests and subgroup analyses conducted in journal publications, and longer follow-up times for outcome assessment in journal publications. At least one instance of spin occurred in both preprints and journals in 23 / 67 (34%) studies, the preprint only in 5 (7%) studies, and the journal publications only in 2 (3%) of studies. Spin was removed between the preprint and journal publication in 5/67 (7%) studies; but added in 1/67 (1%) study. Conclusions The COVID-19 preprints and their subsequent journal publications were largely similar in reporting of study characteristics, outcomes and spin. All COVID-19 studies published as preprints and journal publications should be critically evaluated for discrepancies and spin. EQUATOR REPORTING GUIDELINE STROBE What is already known on this topic Selective and incomplete reporting of results and spin are threats to the trustworthiness and validity of research. These reporting practices could be particularly dangerous for users of COVID-19 research as they can inflate the efficacy of interventions and underestimate harms. Given the high prevalence, visibility, and potentially rapid implementation of COVID-19 research published as preprints, it is important to compare components of results reporting and the presence of spin in COVID-19 studies on treatment or prevention that are published both as preprints and journal publications. What this study adds This comparison of 67 COVID-19 preprints related to treatment or prevention and their subsequent journal publications found they were largely similar in reporting of study characteristics, components of results reporting and spin in interpretation. Even a few important discrepancies could impact decision making.

Coronavirus Disease 2019: An Overview of the Complications and Management

2026-04-29T05:42:06Z

Coronavirus Disease 2019: An Overview of the Complications and Management Shao, Huimin; Ghaly, Hany Sadek Ayoub; Varamini, Pegah The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). Since the first report of COVID-19 emerging in Wuhan, China, authorities in 216 countries and territories have reported about 47.3 million COVID-19 cases and 1.2 million deaths. The WHO guidelines for the management of COVID-19 are very limited to recommendations for managing symptoms and advice on careful management of pediatric patients, pregnant women, and patients with underlying comorbidities. There is no approved treatment for COVID-19 and guidelines vary between countries. In this review, first, a brief overview is provided on the basic knowledge about the virus, clinical features of the disease, and different diagnostic methods. Then, the relationship between COVID-19, various body systems, and other complications is discussed. Finallly, different management strategies are discussed, including those drawn on computational chemistry analyses, pre-clinical investigations, and clinical trials which involve pharmacological and non-pharmacological interventions. In conclusion, despite the recent approval of different vaccine candidates, more virological characteristics of SARS-CoV-2 are required to be explored, which may result in the discovery of more potential therapeutic targets leading to safer and more effective treatment to COVID-19.

Pharmacists' Awareness of COVID_19 and Perceptions of their Roles, Barriers, and Roles of Policymakers: exploring the Middle East and North Africa (MENA)

2026-04-29T05:42:01Z

Pharmacists' Awareness of COVID_19 and Perceptions of their Roles, Barriers, and Roles of Policymakers: exploring the Middle East and North Africa (MENA) Basheti, Iman A.; El-hajji, Feras; Nassar, Razan; Thiab, Samar; Barakat, Muna; Basheti, Mariam; Berardi, Alberto; Saini, Bandana BACKGROUND: The coronavirus disease (COVID-19) was declared in January 2020 as a public health emergency of international concern. The Middle East and North Africa (MENA) suffered from several pandemics previously. Pharmacists have vital roles to play to prevent the spread of this virus. OBJECTIVES: To assess the COVID-19 awareness amongst pharmacists from Arabic-speaking countries located in the MENA region, and to assess their perspectives of their role, barriers, and roles of the educational institutions/pharmaceutical associations. METHODS: An online survey was conducted to run a descriptive cross-sectional study in Jordan from 12th to 22nd April 2020. The questionnaire was validated (face validity) and put on Facebook and directed for pharmacists only (clarified in the introduction of the questionnaire). Assessment of pharmacists' awareness (20 questions) about pandemics and COVID-19, their perceived roles and barriers, and roles of the educational institutions (e.g. universities) and pharmaceutical associations (e.g. Pharmacists Syndicate) was done. Data were analyzed using Statistical Package for the Social Science (SPSS). RESULTS: Study participants (n= 2589) had a mean age of 29.3 (8.2) years and 1329 (51.5%) were females. Most of the participants were from Egypt (n= 819, 40.8%), followed by Jordan, Algeria, and Syria. Regarding the sources of information about coronavirus management, 60.8% of participants got their information from the social media. Fear from contracting the coronavirus while performing their duties was reported by the majority of pharmacists as the main barrier to delivering their roles (82.3%). The majority of pharmacists identified positive roles for the pharmaceutical institutions (74.8%) and pharmaceutical associations (63.6%). CONCLUSION: Pharmacists from the MENA countries believe they got enough education previously about pandemics, and the majority follow the latest coronavirus updates from social media. Fear was reported as the major barrier that requires resolution by the policymakers. Certain gaps in the awareness about COVID-19 were identified.

The state-of-play and future of platinum drugs

2026-02-26T13:21:08Z

The state-of-play and future of platinum drugs Apps, Michael G.; Choi, Eugene H. Y.; Wheate, Nial J. The year 2015 marks the 50th anniversary since the discovery of the anticancer potential of cisplatin and it remains just as useful now as it did back then, especially for the treatment of some endocrine-related cancers like ovarian and testicular carcinomas. Since its discovery, five other platin drugs have received approval in various countries. While several new platin drugs are in preclinical development, in the last decade only two new platin drugs have entered clinical trials, LA-12 and dicycloplatin, reflecting a shift in research focus from new drug design to improved formulations of already approved platin drugs. These formulations include their encapsulation with macrocycles to slow and prevent their degradation by proteins and peptides; their attachment to nanoparticles to passively target solid tumours through the enhanced permeability and retention effect and their coordination to important nutrients, proteins, antibodies and aptamers for active tumour targeting. These formulation methods have all shown potential but none have yet yielded a new marketable medicine containing a platin drug. The reasons for this are problems of consistent drug loading, controlling the location and timing of drug release and the inherent toxicity of some of the drug delivery vehicles. In addition to drug delivery, functional genomics is now playing an increasing role in predicting patients’ responses to platin chemotherapy and their likelihood of experiencing severe side effects. N/A

Evidence for a role of executive functions in learning biology

2026-02-26T13:17:47Z

Evidence for a role of executive functions in learning biology Rhodes, Sinead; Booth, Josephine; Campbell, Lorna; Blythe, Richard; Wheate, Nial; Delibegovic, Mirela Research examining cognition and science learning has focused on workingmemory, but evidence implicates a broader set of executive functions. The current study examined executive functions and learning of biology in young adolescents. Fifty-six participants, aged 12–13 years, completed tasks of working memory (Spatial Working Memory), inhibition (Stop-Signal), attention set-shifting (ID/ED) and planning (Stockings of Cambridge), from the Cambridge Neuropsychological Test Automated Battery. They also participated in a biology teaching session, practical and assessment on the topic of DNA designed specifically for the current study that measured (a) memory for biology facts taught and (b) understanding of information learned in the practical. Linear regression analysis revealed that planning ability predicted performance on the factual assessment, and both spatial working memory and planning were predictive of performance on the conceptual assessment. The findings suggest that planning ability is important in learning biological facts but that a broader set of executive functions are important for conceptual learning, highlighting the role of executive functions in understanding and applying knowledge about what is learned within science teaching.