Probing protein aggregation through spectroscopic insights and multimodal approaches: A comprehensive review for counteracting neurodegenerative disorders.

Aberrant accumulation of protein misfolding can cause aggregation and fibrillation and is one of the primary characteristic features of neurodegenerative diseases. Because they are disordered, misfolded, and aggregated proteins pose a significant setback in drug designing. The structural study of intermediate steps in these kinds of aggregated proteins will allow us to determine the conformational changes as well as the probable pathways encompassing various neurodegenerative disorders. The analysis of protein aggregates involved in neurodegenerative diseases relies on a diverse toolkit of biophysical techniques, encompassing both morphological and non-morphological methods. Additionally, Thioflavin T (ThT) assays and Circular Dichroism (CD) spectroscopy facilitate investigations into aggregation kinetics and secondary structure alterations. The collective application of these biophysical techniques empowers researchers to comprehensively unravel the intricate nature of protein aggregates associated with neurodegeneration. Furthermore, the topics covered in this review have summed up a handful of well-established techniques used for the structural analysis of protein aggregation. This multifaceted approach advances our fundamental understanding of the underlying mechanisms driving neurodegenerative diseases and informs potential therapeutic strategies.

The implication of microbiome in lungs cancer: mechanisms and strategies of cancer growth, diagnosis and therapy.

Available evidence illustrates that microbiome is a promising target for the study of growth, diagnosis and therapy of various types of cancer. Lung cancer is a leading cause of cancer death worldwide. The relationship of microbiota and their products with diverse pathologic conditions has been getting large attention. The novel research suggests that the microbiome plays an important role in the growth and progression of lung cancer. The lung microbiome plays a crucial role in maintaining mucosal immunity and synchronizing the stability between tolerance and inflammation. Alteration in microbiome is identified as a critical player in the progression of lung cancer and negatively impacts the patient. Studies suggest that healthy microbiome is essential for effective therapy. Various clinical trials and research are focusing on enhancing the treatment efficacy by altering the microbiome. The regulation of microbiota will provide innovative and promising treatment strategies for the maintenance of host homeostasis and the prevention of lung cancer in lung cancer patients. In the current review article, we presented the latest progress about the involvement of microbiome in the growth and diagnosis of lung cancer. Furthermore, we also assessed the therapeutic status of the microbiome for the management and treatment of lung cancer.

Vaccine Hesitancy of COVID-19 among Parents for Their Children in Middle Eastern Countries-A Systematic Review.

The current systematic review presents COVID-19 vaccine hesitancy among parents for their children in Middle Eastern countries. Moreover, the vaccine acceptance rate of parents from the Middle East and the factors effecting the acceptance rate were reviewed and summarized. For this systematic review, basic electronic academic databases (Scopus, Science Direct, ProQuest, Web of Science and PubMed) were used for the search, along with a manual search on Google Scholar. This systematic review was conducted by following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" guidelines. Moreover, utilizing the framework of the PECO-S (Population Exposure Comparison Outcome Study design), various observational studies were recruited for this review. Out of 2123 studies, 25 studies meeting the inclusion criteria were included in the current review. All of the included studies were about parental vaccine hesitancy for COVID-19 in Middle Eastern countries and published during 2020-2022. Overall, 25 research papers comprising 10 different Middle Eastern countries with 33,558 parents were included. The average age of parents was 39.13 (range: 18-70) years, while the mean age of children was 7.95 (range: 0-18) years. The overall hesitancy rate was 44.2% with a SD of ± 19.7. The included studies presented enhanced COVID-19 vaccine hesitancy among parents in Middle Eastern countries. The lower vaccine acceptance rate among parents was mainly because of a fear of the potential side effects. Furthermore, the lack of information regarding vaccine safety and efficacy, the fear of unreported side effects and concerns about the authenticity of vaccine development and preparation were the predictors of parental COVID-19 vaccine hesitancy among Middle Eastern countries.

Parents' Concerns, Behavior, Perception, and Hesitancy Regarding COVID-19 Vaccinations for Children in Central Saudi Arabia.

In Saudi Arabia, the Ministry of Health (MoH) has implemented strict rules to ensure COVID-19 vaccination uptake by the general public. However, there is hesitancy about COVID-19 vaccination among parents for their children worldwide. We aimed to determine the concerns, behaviors, perceptions, and hesitancy of COVID-19 vaccination among parents for their children in Saudi Arabia. Parents of children aged 5-11 years were included in this cross-sectional study. A total of 1507 responses were obtained using the convenience sampling technique. The data were analyzed using SPSS version 25.0 by applying descriptive and inferential statistics. Of the parents who responded, 74.5% believed that the COVID-19 vaccination could affect the genes of children, and 72.8% believed that the COVID-19 vaccination could have a greater number of positive impacts on the overall health of children. In total, 87% of the parents were satisfied with the vaccination services and effective policies of the MoH, Saudi Arabia. This study concluded that there is a greater need to increase public awareness regarding the beneficial impact of COVID-19 vaccination on the overall health of children. Effective awareness campaigns are also required to provide empirical information to the public that COVID-19 vaccination for children is safe and effective.

An Efficient and Effective Framework for Intestinal Parasite Egg Detection Using YOLOv5.

Intestinal parasitic infections pose a grave threat to human health, particularly in tropical and subtropical regions. The traditional manual microscopy system of intestinal parasite detection remains the gold standard procedure for diagnosing parasite cysts or eggs. This approach is costly, time-consuming (30 min per sample), highly tedious, and requires a specialist. However, computer vision, based on deep learning, has made great strides in recent years. Despite the significant advances in deep convolutional neural network-based architectures, little research has been conducted to explore these techniques' potential in parasitology, specifically for intestinal parasites. This research presents a novel proposal for state-of-the-art transfer learning architecture for the detection and classification of intestinal parasite eggs from images. The ultimate goal is to ensure prompt treatment for patients while also alleviating the burden on experts. Our approach comprised two main stages: image pre-processing and augmentation in the first stage, and YOLOv5 algorithms for detection and classification in the second stage, followed by performance comparison based on different parameters. Remarkably, our algorithms achieved a mean average precision of approximately 97% and a detection time of only 8.5 ms per sample for a dataset of 5393 intestinal parasite images. This innovative approach holds tremendous potential to form a solid theoretical basis for real-time detection and classification in routine clinical examinations, addressing the increasing demand and accelerating the diagnostic process. Our research contributes to the development of cutting-edge technologies for the efficient and accurate detection of intestinal parasite eggs, advancing the field of medical imaging and diagnosis.

Analyzing economic growth, eco-innovation, and ecological quality nexus in E-7 countries: accounting for non-linear impacts of urbanization by using a new measure of ecological quality.

The rising urban population and accelerated resource consumption pose major environmental challenges. Given that around 75% of global resources are consumed in urban areas, understanding the true association between urbanization (UR) and ecological quality is necessary for better urban strategies. Alongside this, eco-innovation (ECO) can limit environmental pollution and thus, it is the cornerstone of environmental policies. On that note, this research discloses the nexus between eco-innovation, economic growth (EGR), and ecological quality by considering the non-linear effects of UR in the emerging seven (E-7) nations from 1992 to 2018. Unlike previous literature, the newly developed indicator of ecological quality (the load capacity factor (LCF)) is adopted to understand the connection between UR, eco-innovation, and ecological quality since this new comprehensive indicator is based on both biocapacity and ecological footprint (EF). In the methodology, the "Continuously Updated-Fully Modified" (CuP-FM) test is used since this method offers diverse benefits for panel data estimation by accounting for major panel data estimation issues including autocorrelation, endogeneity, heteroscedasticity, fractional integration, and cross-sectional dependence. The empirical estimates unveiled that the current levels as well as high levels of UR limit the LCF. This evidence suggests that UR in the E-7 nations expands ecological degradation. This finding contradicts the assertions of ecological modernization theory that expanding urbanization brings some ecological benefits. Similarly, economic growth alleviates ecological quality. However, eco-innovation and agricultural land (AGL) contribute to enhancing the LCF and promoting ecological quality. Further, UR and eco-innovation Granger cause the LCF. Lastly, comprehensive urban environmental strategies are discussed to promote sustainable urbanization backed by eco-innovation.

Frequency-Selective Surface-Based MIMO Antenna Array for 5G Millimeter-Wave Applications.

In this paper, a radiating element consisting of a modified circular patch is proposed for MIMO arrays for 5G millimeter-wave applications. The radiating elements in the proposed 2 × 2 MIMO antenna array are orthogonally configured relative to each other to mitigate mutual coupling that would otherwise degrade the performance of the MIMO system. The MIMO array was fabricated on Rogers RT/Duroid high-frequency substrate with a dielectric constant of 2.2, a thickness of 0.8 mm, and a loss tangent of 0.0009. The individual antenna in the array has a measured impedance bandwidth of 1.6 GHz from 27.25 to 28.85 GHz for S11 ≤ -10 dB, and the MIMO array has a gain of 7.2 dBi at 28 GHz with inter radiator isolation greater than 26 dB. The gain of the MIMO array was increased by introducing frequency-selective surface (FSS) consisting of 7 × 7 array of unit cells comprising rectangular C-shaped resonators, with one embedded inside the other with a central crisscross slotted patch. With the FSS, the gain of the MIMO array increased to 8.6 dBi at 28 GHz. The radiation from the array is directional and perpendicular to the plain of the MIMO array. Owing to the low coupling between the radiating elements in the MIMO array, its Envelope Correlation Coefficient (ECC) is less than 0.002, and its diversity gain (DG) is better than 9.99 dB in the 5G operating band centered at 28 GHz between 26.5 GHz and 29.5 GHz.

Green technologies, government stability, and green energy transition in a globalized world: evidence from E-7 nations.

Unsustainable development and rising environmental degradation are major challenges for emerging nations that tend to promote human welfare by expanding economic development. Green energy transition (GETR) can help these nations to continue their development, reduce fossil fuel utilization, and achieve environmental sustainability. However, previous literature overlooks the importance of green technologies, government stability, and economic globalization in the GETR process. Accordingly, this research takes a step forward and assesses the impacts of green technologies (GT), government stability (GOV), and economic globalization (EGL) on green energy transition including population density (POP) and economic growth (GDP) in emerging seven (E-7) countries from 1992 to 2020. The research applied the "continuously updated fully modified (CuP-FM)" methodology to acquire the long-run findings robust to endogeneity stationary regressors, autocorrelation, and cross-sectional dependence (CD). The results highlighted that green technologies can be enhanced to accelerate the energy transition process since GETR and green technologies are positively connected. Also, government stability and economic globalization support the green energy transition. However, both population density and economic growth obstruct the energy transition process. The Emirmahmutoglu and Kose test unveiled that green technologies, economic globalization, and government stability Granger cause the green energy transition. Based on these findings, policies are directed to promote the GETR by enhancing green technologies, economic globalization, and government stability for achieving ecological sustainability.

Decolorization of multicomponent dye-laden wastewater by modified waste fly ash: a parametric analysis for an anionic and cationic combination of dyes.

In this research study, waste fly ash (WFA) underwent acid activation and subsequent amine functionalization using ammonia solution. This treatment improves the porosity, thermal tendency and crystallinity of WFA. Modified WFA was tested under different experimental conditions to treat the wastewater consisting of different concentrations of cationic (methylene blue and rhodamine 6G) and anionic (methyl orange) dyes. As an individual, methylene blue (MB) and rhodamine 6G (Rh) showed ~ 100% and ~ 82% removal efficiencies respectively in an alkaline medium while methyl orange (MO) exhibited only ~ 20% adsorption in the same medium. An antagonistic effect was observed in adsorption when wastewater contains both cationic dyes whereas the combination of cationic and anionic dyes in solution manifested a synergistic effect. For all individual and binary dye combinations, there is a close agreement in observed and calculated uptakes when the data was fitted to the fractional order kinetic rate equation. The adsorption of all dyes is spontaneous and endothermic in nature except for MB/MO combination where the process is exothermic in nature. 24.93 mg/g, 24.83 mg/g, and 14.95 mg/g monolayer uptake capacities of MB, Rh, and MO were found respectively from isothermal analysis of single dye adsorption data. Further, extended sips model gave higher correlation coefficient (R2 = 0.99) and addressed the failed assumptions of both the Langmuir and Freundlich models. Overall, in the experimental results, the modified waste fly ash could act as successful adsorbent to treat dye bearing wastewater.

Exploring the intravenous narcotics and controlled drugs wastage and their financial impact: A descriptive single-center study.

Objective: The objectives of this study were to explore the wastage of narcotics and controlled medications and, their financial impact in a tertiary care setting over a one-year period. Methodology: The study period was of one year, i.e., October 2020 - September 2021. The venue of study was a tertiary care hospital. The narcotic medications included Fentanyl, Tramadol, Morphine, and Meperidine. The controlled medications included Midazolam, Phenobarbital, Diazepam, Ketamine and Lorazepam. The annual consumption and wastage of the narcotic and controlled medications were documented using data report generated by narcotics and controlled medication in-charge pharmacist through the hospital's online system. Data was reported using average, minimum and maximum values. Quantities of wastage is expressed in terms of ampoules. Costs per ampoule were calculated and expressed in both Saudi Riyal (SAR) and United States Dollar (USD). The study was approved by an ethics committee. Results: The annual wastage of narcotics was 3.19 % while the same for controlled medications was 21.3 %. An annual wastage of 3.81 % was reported for narcotics and controlled medications combined. The total wastage cost of narcotics and controlled medications was 15,443.1 SAR that was equivalent to USD 4085.5. Fentanyl 500mcg formulations had the highest consumption, i.e., 28,580 ampoules followed by Morphine 10 mg formulations, i.e., 27,122 ampoules. The highest ampoule wastage was observed for Morphine 10 mg formulations, i.e., 1956 ampoules. The highest % wastage was observed for Midazolam formulations, i.e., 29.3 %. Conclusion: The overall wastage was less than 5% of the total consumption, however, midazolam was observed to have the highest wastage. Shifting to prefilled syringes supplied by pharmacies, making protocols, and safely pooling costly drugs could result in significant savings.

Design of high gain base station antenna array for mm-wave cellular communication systems.

Millimeter wave (mm-Wave) wireless communication systems require high gain antennas to overcome path loss effects and thereby enhance system coverage. This paper presents the design and analysis of an antenna array for high gain performance of future mm-wave 5G communication systems. The proposed antenna is based on planar microstrip technology and fabricated on 0.254 mm thick dielectric substrate (Rogers-5880) having a relative permittivity of 2.2 and loss tangent of 0.0009. The single radiating element used to construct the antenna array is a microstrip patch that has a configuration resembling a two-pronged fork. The single radiator has a realized gain of 7.6 dBi. To achieve the gain required by 5G base stations, a 64-element array antenna design is proposed which has a bore side gain of 21.2 dBi at 37.2 GHz. The 8 × 8, 8 × 16, and 8 × 32 antenna array designs described here were simulated and optimized using CST Microwave Studio, which is a 3D full-wave electromagnetic solver. The overall characteristics of the array in terms of reflection-coefficient and radiation patterns makes the proposed design suitable for mm-Wave 5G and other communication systems.

Nanostructured material-based optical and electrochemical detection of amoxicillin antibiotic.

The penicillin derivative amoxicillin (AMX) plays an important role in treating various types of infections caused by bacteria. However, excessive use of AMX may have negative health effects. Therefore, it is of utmost importance to detect and quantify the AMX in pharmaceutical drugs, biological fluids, and environmental samples with high sensitivity. Therefore, this review article provides valuable and up-to-date information on nanostructured material-based optical and electrochemical sensors to detect AMX in various biological and chemical samples. The role of using different nanostructured materials on the performance of important optical sensors such as colorimetric sensors, fluorescence sensors, surface-enhanced Raman scattering sensors, chemiluminescence/electroluminescence sensors, optical immunosensors, optical fibre-based sensors, and several important electrochemical sensors based on different electrode types have been discussed. Moreover, nanocomposites, polymer, and MXenes-based electrochemical sensors have also been discussed, in which such materials are being used to further enhance the sensitivity of these sensors. Furthermore, nanocomposite-based photo-electrochemical sensors and the market availability of biosensors including AMX have also been discussed briefly. Finally, the conclusion, challenges, and future perspectives of the above-mentioned sensing techniques for AMX detection are presented.

Barriers and facilitators of childhood COVID-19 vaccination among parents: A systematic review.

Background: The acceptance of vaccination against COVID-19 among parents of young children plays a significant role in controlling the current pandemic. A wide range of factors that influence vaccine hesitancy in adults has been reported worldwide, but less attention has been given to COVID-19 vaccination among children. Vaccine hesitancy is considered a major challenge in achieving herd immunity, and it is more challenging among parents as they remain deeply concerned about their child's health. In this context, a systematic review of the current literature is inevitable to assess vaccine hesitancy among parents of young children to ensure a successful ongoing vaccination program. Method: A systematic search of peer-reviewed English literature indexed in Google Scholar, PubMed, Embase, and Web of science was performed using developed keywords between 1 January 2020 and August 2022. This systematic review included only those studies that focused on parental concerns about COVID-19 vaccines in children up to 12 years without a diagnosis of COVID-19. Following PRISMA guidelines, a total of 108 studies were included. The quality appraisal of the study was performed by Newcastle-Ottawa Scale (NOS). Results: The results of 108 studies depict that vaccine hesitancy rates differed globally with a considerably large number of factors associated with it. The highest vaccine hesitancy rates among parents were reported in a study from the USA (86.1%) and two studies from Saudi Arabia (>85%) and Turkey (89.6%). Conversely, the lowest vaccine hesitancy rates ranging from 0.69 and 2% were found in two studies from South Africa and Switzerland, respectively. The largest study (n = 227,740) was conducted in Switzerland while the smallest sample size (n = 12) was represented by a study conducted in the USA. The most commonly reported barriers to childhood vaccination were mothers' lower education level (N = 46/108, 43%), followed by financial instability (N = 19/108, 18%), low confidence in new vaccines (N = 13/108, 12%), and unmonitored social media platforms (N = 5/108, 4.6%). These factors were significantly associated with vaccine refusal among parents. However, the potential facilitators for vaccine uptake among respondents who intended to have their children vaccinated include higher education level (N = 12/108, 11%), followed by information obtained through healthcare professionals (N = 9/108, 8.3%) and strong confidence in preventive measures taken by the government (N = 5/81, 4.6%). Conclusion: This review underscores that parents around the globe are hesitant to vaccinate their kids against COVID-19. The spectrum of factors associated with vaccine hesitancy and uptake varies across the globe. There is a dire need to address vaccine hesitancy concerns regarding the efficacy and safety of approved vaccines. Local context is inevitable to take into account while developing programs to reduce vaccine hesitancy. There is a dire need to devise strategies to address vaccine hesitancy among parents through the identification of attributing factors.

Iron Oxide Nanoparticle-Based Ferro-Nanofluids for Advanced Technological Applications.

Iron oxide nanoparticle (ION)-based ferro-nanofluids (FNs) have been used for different technological applications owing to their excellent magneto-rheological properties. A comprehensive overview of the current advancement of FNs based on IONs for various engineering applications is unquestionably necessary. Hence, in this review article, various important advanced technological applications of ION-based FNs concerning different engineering fields are critically summarized. The chemical engineering applications are mainly focused on mass transfer processes. Similarly, the electrical and electronics engineering applications are mainly focused on magnetic field sensors, FN-based temperature sensors and tilt sensors, microelectromechanical systems (MEMS) and on-chip components, actuators, and cooling for electronic devices and photovoltaic thermal systems. On the other hand, environmental engineering applications encompass water and air purification. Moreover, mechanical engineering or magneto-rheological applications include dampers and sealings. This review article provides up-to-date information related to the technological advancements and emerging trends in ION-based FN research concerning various engineering fields, as well as discusses the challenges and future perspectives.

CRISPR/Cas-Based Biosensor As a New Age Detection Method for Pathogenic Bacteria.

Methods enabling rapid and on-site detection of pathogenic bacteria are a prerequisite for public health assurance, medical diagnostics, ensuring food safety and security, and research. Many current bacteria detection technologies are inconvenient and time-consuming, making them unsuitable for field detection. New technology based on the CRISPR/Cas system has the potential to fill the existing gaps in detection. The clustered regularly interspaced short palindromic repeats (CRISPR) system is a part of the bacterial adaptive immune system to protect them from intruding bacteriophages. The immunological memory is saved by the CRISPR array of bacteria in the form of short DNA sequences (spacers) from invading viruses and incorporated with the CRISPR DNA repeats. Cas proteins are responsible for triggering and initiating the adaptive immune function of CRISPR/Cas systems. In advanced biological research, the CRISPR/Cas system has emerged as a significant tool from genome editing to pathogen detection. By considering its sensitivity and specificity, this system can become one of the leading detection methods for targeting DNA/RNA. This technique is well applied in virus detection like Dengue, ZIKA, SARS-CoV-2, etc., but for bacterial detection, this CRISPR/Cas system is limited to only a few organisms to date. In this review, we have discussed the different techniques based on the CRISPR/Cas system that have been developed for the detection of various pathogenic bacteria like L. monocytogenes, M. tuberculosis, Methicillin-resistant S. aureus, Salmonella, E. coli, P. aeruginosa, and A. baumannii.

Evaluation of knowledge and barriers of influenza vaccine uptake among university students in Saudi Arabia; a cross-sectional analysis.

Background: Influenza vaccine hesitancy is a significant threat to global maneuvers for reducing the burden of seasonal and pandemic influenza. This study estimated the vaccine uptake, barriers, and willingness for influenza vaccines among university students in Saudi Arabia. Methods: A cross-sectional survey was conducted among health science (HS) and non-health science (NHS) university students. A 31-item questionnaire was used to ascertain the vaccination rate, barriers, and willingness for the flu vaccine. Results: This study included 790 students (mean age: 21.40 ± 1.94 years), 246 (31.1%) from HS and 544 (68.9%) from NHS disciplines. About 70% did not take flu shots before the arrival of the winter. The mean knowledge score was 7.81 ± 1.96, where 20.4%, 67.6%, and 12% of respondents had good, moderate, and poor knowledge regarding flu vaccines. The relative importance index (RII) analysis showed a lack of recommendation from physicians (51.5%, RI ranked: 1) was a top-ranked barrier to vaccine uptake, followed by negative perceptions and accessibility issues. Only 36.6% of the participants were willing to get vaccinated every year, 70% were willing to receive a vaccine on their doctor's recommendations, and 46% agreed to vaccinate if vaccines were freely available in the university. The knowledge, barriers, and willingness widely varied across students from two disciplines. Conclusions: Our analysis underscored low flu vaccine uptake among university students. In addition, the study participants' knowledge was unsatisfactory, and they were less inclined to receive the flu vaccine in the future. Lack of recommendation from the physicians, negative perceptions towards the flu vaccine, and difficult accessibility were found as significant barriers to the vaccine uptake. A multidimensional approach at educational institutes to cover the knowledge gap and address the barriers curtailing the vaccination rate among students is recommended.

Withania somnifera (L.) Dunal (Ashwagandha) for the possible therapeutics and clinical management of SARS-CoV-2 infection: Plant-based drug discovery and targeted therapy.

Coronavirus disease 2019 (COVID-19) pandemic has killed huge populations throughout the world and acts as a high-risk factor for elderly and young immune-suppressed patients. There is a critical need to build up secure, reliable, and efficient drugs against to the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Bioactive compounds of Ashwagandha [Withania somnifera (L.) Dunal] may implicate as herbal medicine for the management and treatment of patients infected by SARS-CoV-2 infection. The aim of the current work is to update the knowledge of SARS-CoV-2 infection and information about the implication of various compounds of medicinal plant Withania somnifera with minimum side effects on the patients' organs. The herbal medicine Withania somnifera has an excellent antiviral activity that could be implicated in the management and treatment of flu and flu-like diseases connected with SARS-CoV-2. The analysis was performed by systematically re-evaluating the published articles related to the infection of SARS-CoV-2 and the herbal medicine Withania somnifera. In the current review, we have provided the important information and data of various bioactive compounds of Withania somnifera such as Withanoside V, Withanone, Somniferine, and some other compounds, which can possibly help in the management and treatment of SARS-CoV-2 infection. Withania somnifera has proved its potential for maintaining immune homeostasis of the body, inflammation regulation, pro-inflammatory cytokines suppression, protection of multiple organs, anti-viral, anti-stress, and anti-hypertensive properties. Withanoside V has the potential to inhibit the main proteases (Mpro) of SARS-CoV-2. At present, synthetic adjuvant vaccines are used against COVID-19. Available information showed the antiviral activity in Withanoside V of Withania somnifera, which may explore as herbal medicine against to SARS-CoV-2 infection after standardization of parameters of drug development and formulation in near future.

Assessment of Knowledge Regarding Safety Profile, Use, and Boxed Warnings of Fluoroquinolones Among Healthcare Professionals in Saudi Arabia: A Potential Implication for Drug Regulatory Authorities.

Background: Despite a series of "boxed warnings" (BWs) issued by the US Food and Drug Administration (FDA), fluoroquinolones (FQs) are among the most prescribed antibiotics across the world. Moreover, few studies demonstrated that BW of FQs had less or no impact on prescribing patterns among healthcare professionals (HCPs), which might be attributed to the lack of knowledge toward such warnings. Since FQs contribute to a major proportion of antimicrobial prescriptions in the Kingdom of Saudi Arabia (KSA), this study aimed to ascertain the extent of knowledge toward safety profile, use, and BW of FQs among HCPs working in the KSA. Methods: This cross-sectional study (May-August 2021) was conducted among HCPs working in KSA through a validated questionnaire. The HCPs were requested to identify the indications, adverse effects (AEs), and BW of FQs. The knowledge score (out of 40) was estimated among participants, and its association with demographics was ascertained through the chi-square test, Student's t-test, or Mann-Whitney U-test and one-way ANOVA, or Kruskal-Wallis test, where appropriate. Results: Of the 573 participants (age: 36.1 ± 10.6 years, men: 59.7%), 262 (45.8%) were prescribers reporting frequent use of ciprofloxacin, levofloxacin, and ofloxacin. One-fourth (25.6%) of the prescribers did not recognize nalidixic acid as an agent from FQs class. About 60% of participants correctly identified the mechanism of action of FQs. The average knowledge score was 14.8 ± 6.4, where only 21.5% of respondents scored ≥50%. The average knowledge score for indications, AEs, and BW domains was 5.29 ± 3.05, 6.17 ± 4.05, and 2.3 ± 1.5, respectively. Only 75 (13.1%) participants recognized half of the BW, and 38.6% of participants identified at least one warning. The HCPs aged >40 years (p = 0.043), having non-Saudi's nationality (p < 0.001), working in Riyadh and Eastern regions (p < 0.001), having pharmacy and medicine disciplines (p < 0.001), practicing in public sectors (p = 0.004), and having more than 10 years of experience (p < 0.001) were significantly associated with high knowledge score. Conclusion: This study demonstrates the unsatisfactory knowledge toward safety profile, use, and BW of FQs among HCPs which may put patients at increased risks of AEs. The knowledge score differed among various socio-demographic groups. There is a dire need to initiate the antimicrobial-focused educational campaigns among HCPs regardless of their specialties and methods to improve education and disseminate FDA warnings in practice.

Development and Characterization of Eudragit® EPO-Based Solid Dispersion of Rosuvastatin Calcium to Foresee the Impact on Solubility, Dissolution and Antihyperlipidemic Activity.

Poor solubility is the major challenge involved in the formulation development of new chemical entities (NCEs), as more than 40% of NCEs are practically insoluble in water. Solid dispersion (SD) is a promising technology for improving dissolution and, thereby, the bioavailability of poorly soluble drugs. This study investigates the influence of a pH-sensitive acrylate polymer, EPO, on the physicochemical properties of rosuvastatin calcium, an antihyperlipidemic drug. In silico docking was conducted with numerous polymers to predict drug polymer miscibility. The screened-out polymer was used to fabricate the binary SD of RoC in variable ratios using the co-grinding and solvent evaporation methods. The prepared formulations were assessed for physiochemical parameters such as saturation solubility, drug content and in vitro drug release. The optimized formulations were further ruled out using solid-state characterization (FTIR, DSC, XRD and SEM) and in vitro cytotoxicity. The results revealed that all SDs profoundly increased solubility as well as drug release. However, the formulation RSE-2, with a remarkable 71.88-fold increase in solubility, presented 92% of drug release in the initial 5 min. The molecular interaction studied using FTIR, XRD, DSC and SEM analysis evidenced the improvement of in vitro dissolution. The enhancement in solubility of RoC may be important for the modulation of the dyslipidemia response. Therefore, pharmacodynamic activity was conducted for optimized formulations. Our findings suggested an ameliorative effect of RSE-2 in dyslipidemia and its associated complications. Moreover, RSE-2 exhibited nonexistence of cytotoxicity against human liver cell lines. Convincingly, this study demonstrates that SD of RoC can be successfully fabricated by EPO, and have all the characteristics that are favourable for superior dissolution and better therapeutic response to the drug.