Articles

Active Pharmaceutical Ingredients (APIs) serve as the cornerstone of pharmaceutical development, driving therapeutic efficacy and safety in drug formulations. This article provides a comprehensive overview of the lifecycle of APIs, starting from their discovery and development, through to manufacturing processes and regulatory oversight. The development of APIs begins with intensive research and discovery efforts, where medicinal chemists and pharmacologists identify and optimize potential compounds through computational modelling, high-throughput screening, and structure-activity relationship studies. Promising candidates undergo rigorous preclinical testing to assess pharmacological properties, safety profiles, and potential adverse effects in animal models. Upon successful preclinical outcomes, APIs progress to clinical trials, involving phases of testing in human subjects to evaluate efficacy, dosage regimens, and safety profiles under controlled conditions. Clinical trial data are meticulously analyzed to support regulatory submissions, demonstrating the API's therapeutic benefits and safety for eventual patient use. Manufacturing APIs involves complex chemical synthesis or biotechnological methods, ensuring precise control over reaction conditions, purity, and yield. The scale-up from laboratory synthesis to industrial production demands adherence to Good Manufacturing Practices (GMP), where stringent quality control measures verify consistency, potency, and stability throughout production batches. Regulatory oversight by authorities such as the Food and Drug Administration (FDA) in the United States and the European Medicines Agency (EMA) in Europe ensures that APIs meet stringent standards of safety, efficacy, and quality before market approval. Manufacturers must submit comprehensive Chemistry, Manufacturing, and Controls (CMC) data, detailing manufacturing processes, analytical methods, and stability studies to support regulatory filings.

An increasing number of adverse events are raising concern in the pharmaceutical supply chain due to contaminated active pharmaceutical ingredients (APIs). Most of the active pharmaceutical ingredients are not currently under the scope of environmental regulations, despite their negative impact on human health and the environment. API's life cycle plays a significant role in identifying potential supply chain sources and determining their impact on the environment. The Covid-19 pandemic's intermittent manufacturing interruptions and the increase in the frequency of drug shortages over the past ten years have sparked worries about how resilient the world's drug supply chains are. Many clinical trials were conducted on patients with COVID-19 during the SARS-CoV-2 pandemic and resulted in millions of deaths globally by 2022.

The operational performance of Active Pharmaceutical Ingredients (API) supply chains often suffers from significant disruptions attributed to inherent vulnerabilities. Despite theoretical discussions, empirical evidence validating these vulnerabilities remains sparse. This study endeavours to empirically substantiate the vulnerabilities arising from dynamic disruptions within the pharmaceutical supply chain. Its primary goal is to discern actionable insights that can inform the development of robust resilience strategies capable of effectively mitigating such disruptions. This study investigates vulnerabilities within the active pharmaceutical ingredient (API) supply chain in response to disruptions. Despite theoretical insights, empirical evidence validating these vulnerabilities remains limited. Through empirical analysis, this research aims to identify and elucidate the specific vulnerabilities exacerbated by dynamic disruptions in the API supply chain. The findings are intended to inform the development of resilient strategies capable of mitigating the impact of disruptions on pharmaceutical supply chains.

The pharmaceutical industry relies extensively on Active Pharmaceutical Ingredients (APIs) as essential components in the production of drugs. The supply chain supporting these APIs is complex, encompassing multiple stages from raw material sourcing to distribution to pharmaceutical manufacturers worldwide. This manuscript explores the intricate challenges encountered within the pharmaceutical API supply chain, focusing on regulatory compliance, quality control, supply chain disruptions, and global dependencies. Regulatory compliance poses a significant hurdle, with varying standards across regions necessitating meticulous adherence to ensure market access and product safety. Quality control and assurance are paramount to maintaining consistency and purity in APIs, yet they present ongoing challenges such as batch variability and contamination risks. Supply chain disruptions, ranging from natural disasters to geopolitical tensions, highlight vulnerabilities in global sourcing strategies, underscoring the need for resilient supply chain management practices. Global dependencies on a limited number of suppliers or regions expose the industry to supply shortages and pricing pressures, exacerbated by geopolitical events and trade policies. These dependencies necessitate strategic diversification and risk mitigation efforts to ensure continuity in API availability and affordability. By addressing these challenges collaboratively, stakeholders can enhance the resilience and reliability of the pharmaceutical API supply chain, thereby ensuring uninterrupted access to essential medications and improving global healthcare outcomes.

Background:</b> The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care during the pandemic is needed but lacking. <b>Methods:</b> We systematically searched PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and CINAHL for studies on telehealth for osteoporosis published between January 2021 and March 2023. Five studies met the inclusion criteria of: osteoporosis population, telehealth intervention, and COVID-19 pandemic timeframe. Data was extracted on study characteristics, COVID-19 outcomes, osteoporosis status, telehealth purpose, patient satisfaction, and clinical outcomes. <b>Result:</b> The five studies showed telehealth was used for monitoring data, delivering test results, adjusting medications, and assessments. Osteoporosis prevalence among telehealth users ranged 30-100%. High patient satisfaction was reported with telehealth versus in-person care. No major differences occurred in medication delays or fractures between telehealth and in-person groups. <b>Conclusion:</b> This review found telehealth enables effective osteoporosis care and monitoring during the pandemic, with high patient and provider satisfaction. However, more robust randomized controlled trials are needed to establish stronger evidence around telehealth's impacts on clinical osteoporosis outcomes. <b>Implications:</b> Though promising, further high-quality studies will help clarify telehealth's role in improving osteoporosis care and outcomes. Findings inform guidelines on integrating telehealth into routine management. Evidence on user perspectives optimizes telehealth implementation policies.

Authors describe autoptic findings of two cases whose COVID-19 diagnosis was supported by laboratory data. Both patients were Caucasian individuals of middle age (one male, 47 years old; the other a female aging 36 years) that were considered as previously healthy. Clinically they died from cardiorespiratory insufficiency while being treated in intensive care units. None of them was intubated and blood oxygen levels (SpO2) decreased below 90% only during the agonal phase. Myopericardial changes were visible from a macroscopic point of view, with hemorrhagic and necrotic areas involving pericardium. Fresh hemorrhage and severe hyperemia were both signs of vascular damage and extravasation leading to acute myocardial injuries. Lymphocytic presence was disparate and not constant.

The present article seeks to provoke a discussion into how video games can be used in anxiety treatments and social stimulation tools among middle-year students and children of that same age. To do so, we initially start this article by reflecting on how the covid-19 pandemic disparate all anxiety alerts in our society including mental health issues such as depression and special anxiety disorders. Then we compare how the numbers of anxiety among children and young adults were already alarming before the lockdowns imposition and the social distance measures, especially in urban centers. This rising anxiety condition can be felt especially in the years that followed the social isolation of children especially because their social connection and recognition were just starting to grow and to establish important connections between their peers in-person and in virtual environments, throwing light on how to screen media and children"s homes are related with the anxiety increase and how we can investigate that phenomenon without succumbing to excessive positivism to today"s technology or to a deconstructive pessimism that leads us to distrust those media that are already in contact with middle-year students and children"s in that same age. To do so, we will resort to philosophical tools such as Edusemiotics and Cultural Studies to understand how games such as <i>Minecraft</i> and <i>Roblox</i> can be used in school environments to help students and teachers manage anxiety levels and surpass socialization issues past covid-19 lockdowns. To finish our reflection we also bring some data related to how those same media and games helped middle-year students to surpass social isolation and family disconnection during the pandemic while their kept exercising school content in those games, sharing and debating with their peers on virtual platforms.

The aim of this article is to examine the impacts of Coronavirus Disease -19 (Covid-19) vaccines on economic condition and sustainable development goals. In other words, we are going to study the economic condition during Covid19. We have studied the economic costs of pandemic, benefits in terms of gross domestic product (GDP), public finances and employment, investment on vaccines around the world, progress and totally the economic impacts of vaccines and the impacts of emerging markets (EM) on achieving sustainable development goals (SDGs), including no poverty, good health and well-being, zero hunger, reduced inequality etc. The importance of emerging economies in reducing the harmful effects of the Corona has also been noted. We have tried to do experimental results and forecast daily new death cases from Feb-2020 to Aug-2021 in Iran using Artificial Neural Network (ANN) and Beetle Antennae Search (BAS) algorithm as a case study with econometric models and regression analysis. The findings show that Covid19 has had devastating economic and health effects on the world, and the vaccine can be very helpful in eliminating these effects specially in long-term. We observed that there is inequality in the distribution of Corona vaccines in rich countries compared to poor which EM can decrease the gap between them. The results show that both models (i.e., Artificial intelligence (AI) and econometric models) almost have the same results but AI optimization models can robust the model and prediction. The main contribution of this article is that we have surveyed the impacts of vaccination from socio-economic viewpoint not just report some facts and truth. We have surveyed the impacts of vaccines on sustainable development goals and the role of EM in achieving SDGs. In addition to using the theoretical framework, we have also used quantitative and empirical results that have rarely been seen in other articles.

This research is conducted with main aim of assessing the economic consequences of Covid-19 pandemic in Western Ethiopia. Primary data is collected through questionnaire and interview from 320 respondents living in three zones of Western Ethiopia. The study areas (zones) are selected purposively from Oromia region; however, the respondents are sampled by employing random sampling technique. The respondents were stratified as community members, daily laborer, business owners, government sector and NGOs employees. Exploratory research design was adopted to achieve the research objectives. Simple descriptive statistics and ordinary least square regression model are used to analyze and interpret the collected data. The study results disclose that majority of community have good awareness about the pandemic and social interaction is reduced due to social distancing. Majority of respondents realize the negative impact of Covid-19 on their economy; reduction of office services; and reduced access to market; and absence of strong support from the government. The great severity of Covid-19 impacts is failed on daily laborers. The regression result shows that sales, experience in business, education level in years, employment status of the respondent, number of workers in the business and work hours per week are positively and significantly influencing daily income of business owner before and after the pandemic outbreak. It is advised the stakeholders to give frequent follow-up and support particularly for daily laborers and small business holders to reduce the future socio-economic impacts of Covid-19 pandemic.

From 2020 to 2022 the Covid-19 was spread and many people died. Death is near to everyone. The aim of the study was to investigate differences of concept of good death and view of life and death cross cultural. Participants were 92 Japanese, 110 Korean and 100 American who were ordinary people. We used the Good Death questionnaire to measure desirable death and the Death Attitude Inventory to measure view of life and death. Participants completed both questionnaires. As for Good Death, Japanese and Korean regarded “not being burden to others” as important the most, and American regarded “feeling that one’s life is worth living” as important. The scores of “unawareness of death” and “religious and spiritual comfort” of Korean were the highest, following American, and Japan. As for the Death Attitude Inventory, the score of American was higher than Japanese and Korean totally. The scores of “Death as release” or “Death Avoidance” of American were the highest. These results suggest that although Japanese and Korean regard “Not being burden to others” as important in common, Korean regard religious and spiritual comfort as important. American may avoid to think of death and regard it as release. We can make use of these cultural differences in clinical situation.

<b>Background:</b><b> </b>Vascular thrombotic events such as pulmonary embolisms have been frequently reported in the course of SARS-Cov-2 infection. However, sagittal sinus thrombus is extremely rare, and patients may lack other appealing Covid-19 infection symptoms. <b>Case</b><b> </b><b>report:</b><b> </b>46-year-old female with past medical history of Hyperlipidemia, Hypertension presented to Emergency room with headache, chest pain, vomiting. SARS-CoV-2 IgG Antibodies were reactive. Except for elevated PTT-Lupus Anticoagulant at 50 Sec, Hypercoagulable workup was negative. The MRI venogram findings were consistent with the Dural thrombus of superior sagittal sinus. Patient subsequently developed chest pain, and Computed tomography angiography found pulmonary emboli within segmental branches of the right lower lobe pulmonary artery. Patient was managed in the ICU with Heparin and switched to Coumadin for discharged. <b>Conclusion:</b> The incidence of Cerebral Venous Sinus thrombus (CVST) among Covid-19 patients is inferior to 0.02%. And most of the patients lack typical Covid-19 presentations such as pneumonia. The lack of symptoms may promote the insidious course of pre-thrombotic events that lead to CVST. However more Retrospective studies are necessary to established consistent odd ratios. Due to the higher mortality associated with CVST and the ongoing of Covid-19 pandemic, we recommend a higher level of clinical suspicion.

The present study raises the problem of empathy of caregivers vis-à-vis patients in a covid/post-covid context. It is based on the observation that health workers are increasingly invaded by excessive fear and persistence of COVID-19 contamination. This induces avoidance, a certain suspicion, persecution and indifference/coldness towards patients, and plunges them into a strong insidious emotional deficiency. These attitudes, which are significantly close to paranoid and phobic access, seem to gradually dominate therapeutic interactions within hospitals. Freudian and Rogerian psychoanalysis advocates empathetic/benevolent listening, positive consideration and unconditional acceptance of the patient as ethical and deontological indispensable principles for any therapeutic evolution. Thus, it is predicted that within hospitals, the current non empathetic attitudes of care towards patients have their origin in a generalized covid-phobic atmosphere that develops a quasi-dominant paranoia in caregivers. Using a subscale of caregiver's Covid-phobic quasi-paranoia, and the one of caregiver's empathy in a covid/post-covid context, the data were collected from 126 participants including 55 nursing assistants, 61 state-certified nurses and 10 doctors, chosen at random from the staff of three (03) health facilities in the city of Bafoussam, MIFI department, West Cameroon region, including one (01) public district medical center (CMA) and two (02) private hospitals (clinics). After analysis, the results obtained sufficiently demonstrate that within the health institutions of West Cameroon, the higher the professional level of the caregiver, the more the severity of his quasi-paranoid covid-phobic accesses is significant, and the less he expresses an authentic empathy towards the patients who arrive at the hospital. This implies that in this period of health crisis, caregivers must reinvest in a real function of providers of affectivity and relay of empathy at the bedside of the patient both in hospital and outpatient. Thus, a real systematical vaccination operation may insure their total immunity and better reduce their quasi-paranoid empathy in this generalized Covid-phobic context.

The economic and social effects that the COVID-19 pandemic and the associated measures to address it are having in Latin America may lead to serious long-term consequences that would affect the achievement of the Sustainable Development Goals. In this article, the collaboration of environmental economists from eight countries in the region discusses the possible effects of the pandemic on air pollution, deforestation, and other relevant environmental aspects related to the SDGs. In addition to presenting an account of some of the initial effects of the health crisis on the environment, the paper discusses potential effects in terms of environmental regulations and public policy interventions. Finally, the paper presents an agenda on new research topics that arise due to the pandemic or have gained greater importance due to it, including the impacts on the achievement of the Sustainable Development Goals. Briefly, this paper is a novel view of the sustainable development in Latin America and the Covid-19 impacts on this process.

This article discusses the effect of the oil shock on some OECD oil-importing countries such as Canada, France, Italy, China, and the United States and some OPEC oil-exporting countries such as Algeria, Iran, Kuwait, Saudi Arabia, and Venezuela. The model is estimated for the years 1976-2021. five annual variables are used for each country. The variables within the model include real oil prices, GDP growth, inflation, real wages, and real effective exchange rates. Real GDP is the main variable that shows the effects of oil prices on the economy, and the impact of oil prices on other model variables will indirectly affect economic activities. For this purpose, we estimate the vector autoregression model. Estimates obtained for different countries show that oil price shocks are one of the variables affecting economic growth. Also, in oil-exporting countries, oil shocks on economic growth are positive and negative in oil-importing countries. Also, Covid-19 is studied as an effective parameter in creating oil shocks.

COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the populations burden of COVID-19, toward saving patients from becoming ill along with preserving the allocation of clinical resources and public safety standards. This paper explores environmental and public health evidence-based practices toward responding to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward retrieving research publications, “grey literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which include effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy making; conducting sound evaluation; do a thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioural, environmental, social as well as systems interventions (BESSI) toward reducing transmission.

After the outbreak of the covid-19 disease in the world of human life, living organisms and their environment were affected in various ways. The outbreak of the covid-19 virus has posed many opportunities and challenges to the world environment. This article aims to investigate the effects of the outbreak of covid-19 disease on the environment. This research has studied the effects of the covid-19 virus on the environment through library and review methods. It has been studied and analyzed in the form of articles and related researches. The results of published sources show that quarantine and the requirement of humans to stay at home to break the covid-19 transmission chain caused the animals to feel safe, move out of their natural territory and into urban and rural areas. Reducing noise and air pollution and greenhouse gas emissions by reducing vehicle traffic and shutting down factories are other positive effects of the covid-19 outbreak that has helped improve air quality and reduce global warming. In addition to these positive effects, reducing conservation activities during the Covid-19 era in some areas has increased habitat destruction and poaching. Increasing household and hospital waste production, increasing the consumption of plastics and disposable materials, and decreasing waste recycling are the negative effects of the covid-19 virus epidemic, which, by destroying resources, puts pressure on the environment. Increased consumption of detergents and disinfectants will have many detrimental effects on the environment. In general, the positive effects of the covid-19 virus on the temporary and short-term environment seem to be small compared to the long-term consequences. Therefore, by overcoming covid-19, we should focus on rebuilding society and a healthy economy, and by fully understanding the opportunities and threats of this virus, we should consciously train environmental behaviors.

Education stratum of India as well as world are worst-hit by Covid-19 and has imposed lockdown originating deleterious effect on academic life. A sheer number of learners ceased moving educational institutions and all pedagogies halted in India. Catastrophe has behaved as a stimulant for the educational institutions to cultivate and choose for platforms with technologies which were previously noviced. Education sector has been challenging to weather the crux with alternative strategy and digitizing the challenges to hoover the menaces of the pandemic. Hypothesis of digital study has prognosis to impact the ventures of higher education for eon. Findings evince that despite digital learning is a nice adventure for little skills, varying illiberalities partake. Learners are crunched and academy also exclusively in unstable job. It has yet to be established the scope whereupon digital study would climactically cover for conventional study. Covid-19 conundrum has divulged prefacing dilemma and disparities clamoring synergetic attempt to contemplate even so pandemic’s approach. This deliberate paper illuminates sparse impeccable education in India and has discussed the positive and negative impacts of Covid-19. The paper also contributes a methodical substantiation of the experience and lessons digested from the impact of the pandemic on the transitional education panorama, and the dissemination and acceptance of e-learning in education. To end, few suggestions along with policy recommendations have been made to meet didactics during the pandemic contingency.