Following my power hacksaw review a couple of days ago, I've decided to feature another type of this equipment, but now, a more advanced one: an automatic horizontal hacksaw. Actually, it wasn't too long ago when I first had my hand on this kind of hacksaw. Compared to other cutting machines, this particular equipment is more suitable for cutting tougher metals, such as alloys and steels, of different sizes. I find them great for problem-free sawing applications. They are also easy to use especially for people who don't have that much operator skill. Anyway, enough of the intro, let me proceed with my review of today's metalworking product, the Cosen C-420NC automatic hacksaw.
When I first saw the C-420NC automatic hacksaw, the first thing that I noticed is its huge precision ground and large dual columns that play a vital part since they guide the saw head through the entire cutting work process. I also noticed that the saw head features a back-tilted frame that allows the blade to make minimal twists between the wheel and the blade guide. This is actually great because it puts less stress on the blade, thus, giving it a much longer life. The two columns are also connected by a cross link that provides a more enhanced structural design.
As I mentioned earlier, automatic hacksaws are made for tougher metals. The Cosen C-420NC, fitted with a 7.5HP saw blade motor and 4770 x 41 x 1.3mm saw blade size, is strong enough to cut 420 mm square and round bar up to 420 x 420 mm rectangular sheets. And upon testing, it can also have a bundle cutting capacity of 190-360mm high x 100-180mm wide.
What I like about the C-420NC gearbox is that Cosen specially designed it to overcome high lateral pressure. Unlike the previous hacksaws that I've utilised before, Cosen's accepts more cutting pressure and does not create thermal distortion, which I guess is truly important if you want to prolong the life of the gearbox.
The Cosen C-420NC is armed with innovative features that make it an ideal choice for small to big cutting applications. First up, it is fitted with the Smart NC-100 (SNC-100) technology that allows operators to program up to 100 different jobs, including quantity and length of cut. It also has an Automatic First Cut function that automatically cuts the irregular end of the material without the need for any manual operation. A "Save-a-Blade" feature is also present to eliminate blade tooth deformities.
To add up, the C-420NC model, when you see it, also has an LCD screen with film type keypad that displays the blade speed and the vise position, and indicates the blade life.
Honestly, the Cosen C-420NC is one of the best hacksaws that I have ever tried. By looking back at the key features I wrote above, it is obvious that it boasts advanced technology features and superior cutting performance, making it one dependable equipment for your work shops. What I like more about it is that it is engineered to be operator-friendly, and to cut quickly and accurately to meet the demand of small to large businesses.
Now, in case you're thinking that investing in this particular machine will ruin your tight budget given that it's too good, don't fret, because hey, you don't have to go with a brand-new model. Getting your hands on a used version, that is less expensive of course, is fine as long as you purchase it from a reliable dealer. Until my next review!


I'm very new to this whole blogging world and I'm not sure if I'm supposed to admit this or not but hey it's too late now as I already have so here goes..
I start my course in hairdressing next week and have decided to do a blog on my journey through my learning. My aim is to share with you some great hair ideas, tips and pics!!


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Modern Trader's readers grade presidents Obama & Trump…
Modern Trader staff
In a survey of Modern Trader digital subscribers conducted through June 6, respondents graded both President Obama and President Trump on style and substance. Here are the results.
Trump's genial private meetings with CEOs jar with public attacks
Ginger Gibson and David Shepardson, Reuters
When the bosses of some of the world's largest pharmaceutical companies headed to Washington in January to meet U.S. President Donald Trump, it had all the makings of a potentially hostile meeting.
Former U.S. intelligence chief rejects Trump wiretap accusation
John Whitesides and James Oliphant, Reuters
The former top U.S. intelligence official rejected President Donald Trump's accusation that his predecessor, Barack Obama, wiretapped him even as the White House on Sunday urged Congress to investigate Trump's allegation.
Markets set to open lower on geopolitics, Trump's comments
Yashaswini Swamynathan, Reuters
U.S. stocks looked set to open lower on Monday as rising geopolitical tensions in Asia and President Donald Trump's accusation that his predecessor Barack Obama wiretapped him weighed on investors' risk appetite.
Markets turn to Trump for clarity
Lukman Otunuga
The rising uncertainty and growing unease ahead of Wednesday's news conference by President-elect Donald Trump has left financial markets on high alert.
Ringing in the New Year with a bullish case for gold
Frank Holmes
You could say gold miners struck gold in 2016. The group, as measured by the NYSE Arca Gold Miners Index, finished the year up an amazing 55%, handily beating all other asset classes.
Remarks of Chairman Timothy Massad before the London School of Economics
We find ourselves in a very different position than eight years ago when President Obama was about to take office. In January of 2009, the world was in the depths of the worst financial crisis since the Great Depression. Financial institutions across the globe were on the brink of collapse.
Job growth slows, but wages rebound strongly
Lucia Mutikani, Reuters
U.S. employment increased less than expected in December but a rebound in wages pointed to sustained labor market momentum that sets up the economy for stronger growth and further interest rate increases from the Federal Reserve this year.
APEC leaders vow to fight protectionism, look to China on trade
Mitra Taj and Jeff Mason, Reuters
Pacific Rim leaders vowed on Sunday to fight protectionism and Chinese officials said more countries are looking to join a China-led trading bloc after Donald Trump's election victory raised fears the United States would scrap free trade deals.
How will the U.S. election impact markets?
The seemingly never-ending spectacle that is the U.S. presidential election campaign is entering its final act.

redpajama_set_name: RedPajamaCommonCrawl


Is there an easy way for a regular person to find out if $100 bills (and $50s and $20s) are legit, without one of those special pen things?
Now, there are numerous ways to tell if a bill is fake without one of those "special pen things," but I'm going to be "that guy" for a minute and point out that they are only about $5 on Amazon.com.
If you're planning on having a yard sale or Craigslisting a bunch of stuff (two very common scenarios for counterfeiters to try to pass fake cash) this is a very, very cheap form of insurance.
Yes, they have their faults. If a bill has been through the wash, it may give a false negative, and very sophisticated fakes might still fool them.
So what can you do when you're getting that change back for your Big Mac? The good news is some observational skills, knowledge, and a bit of common sense will allow you to pick out most of the copycat cash.
Feel the texture of the bill. Take a minute and rub the paper between your hands. You may not handle as much cash as a bank teller does, but you've probably handled enough to pick out a poor fake. Genuine US cash has a slightly raised ink and you should be able to feel this by running your fingertips over it, especially if it's a new(er) bill.
Compare it with another of the same denomination. Just got a $20 back and you're not sure about it? Pull another $20 out of your wallet and look at them both side by side. Since everything but $1 and $2 bills have been redesigned at least once in the last 20 years, this works best with a bill of the same series.
Check out the printing quality. Real cash is printed with techniques that most counterfeiters are unable to duplicate. A good area to look at is the portrait. Are the lines sharp and distinct? Or do the fine details blur together and appear unsharp?
Pay attention to the serial numbers. Do the numbers match? Are the numbers perfectly spaced and aligned, or are they a little wiggly? Those are two sure signs of a fake. Also, if you got more than one of a denomination you're suspicious about… are the numbers the same on both bills? Every bill has a unique serial number.
Look for the security features. On all bills larger than $2, hold the bill up to the light and look for the security thread (a plastic strip running from top to bottom, embedded in the paper). It's in a different location on each denomination, so be sure to compare to another bill to see if it's been bleached and reprinted. Also, all bills $10 and larger have color-shifting ink — just tilt the bill to see if the color changes.
These are only a small handful of ways you can determine the legitimacy of a bill. I strongly encourage you to visit the United States Secret Service "Know Your Money" page for a full and current rundown on all US currency security features, and the US Treasury has info about what to do if you suspect you have a counterfeit bill.
So the good news: With some caution, observation, and basic knowledge, you should be able to spot all but the most sophisticated fakes.


The following inspiring quotes on happiness were written by a variety of well-known teachers and inspiring figures throughout the world . . .
The following quotes on happiness come from the book: How to Be Happy All the Time by Paramhansa Yogananda, author of the best-selling spiritual classic, and inspiration for the Finding Happiness movie, Autobiography of a Yogi.
A selection of happiness quotes by Swami Kriyananda (founder of the spiritual communities depicted in the film), from the companion book: Finding Happiness- Day by Day and talks by Swami Kriyananda on behalf of Treasures Along the Path.


How can you comprehend terms and conditions of card holder agreement?
Comprehending the wide array of information contained in the card holder agreement is not only time-consuming for several consumers but also boring too. The language, the technical jargons and long statements can be too overwhelming for some consumers. Moreover, most consumers don't have time or interest to read each word of the credit card agreement.
Although it is important to read the card holder agreement, yet you may avoid the hard work just by asking a few questions to the credit card issuer. Check out the 4 questions that you may ask the credit card issuer to understand the terms and conditions of the agreement correctly.
When will you have to pay the overlimit fees?
A lot of consumers still don't have any knowledge about credit limit and the overlimit fees, which is not good. You won't be able to cross your credit limit until you opt in for the overlimit fee. Ask the credit card issuer about the amount you'll have to pay for overlimit fee.
It's quite insulting to know from the cashier that your card has been declined. Overlimit fees save you from that disgrace after you cross the credit limit. However, as per the credit experts, it is best to not opt in for these fees since you may develop a habit of paying more than your means. You may get into severe financial problems at anytime.
When will you've to pay late payment fees?
You can never predict future. It is quite possible that you're confident about your payment capabilities. You may make a good amount of money every month. As such you don't have any worries about late payments. However, a fat paycheck doesn't guarantee that you'll make timely payments. You may just skip or forget the payment date.
Ask the card issuer about the consequences of making late payments. Find out when late payment fees will be imposed upon you. Ask questions regarding how much you've to pay for the late payment fees too and if they will increase your annual percentage rate as well.
How much will you have to pay for balance transfers?
Credit card balance transfer fees can drain funds from your account. If you're unable to calculate the fees properly, then you may have to pay a huge amount to the credit card issuer. Usually, card issuers charge a specific percentage of the overall transferred amount. Still, to be on the safer side, you can ask if there are extra charges. For instance: if a bank charges 4 percent fee, then you've to pay $400 for transferring $10,000 to the new low rate card. Don't forget to ask about how much will the interest rate increase after the introductory period is over. Usually, the rate gets doubled after the promotional offer expires.
Will you really benefit from the reward cards?
Usually, reward cards carry a high rate of interest. In fact, the interest rate is higher than that of a normal credit card. If you do carry a balance every month, then a reward card won't be that much beneficial for you.
As far as the airline miles card is concerned, you should ask the credit card issuer about the blackout dates. Ask when the credit card issuer will disqualify you for the reward programs. Will you lose reward points after getting delinquent on the credit card?
Secured credit cards help you repair your tarnished credit. The rate of interest is usually low and you can spend only up to a certain amount. However, some credit card issuers charge fees like annual fee, maintenance fee, application fee, etc. You may also have to pay fee for speaking with the customer care officer. It is better to know about these fees from beforehand so that you don't get a shock later. Ask if the card issuer will report to the credit reporting agencies. Your credit score will not improve unless the card issuer reports the payments to the credit reporting agencies.


text:
Lofstrom Loop
An beanstalk-like megaconstruction based on a stream of magnetically accelerated bars linked together. The stream is sent into space, where a station rides it using magnetic hooks, redirects it horizontally to another station, which sends it downwards to a receiving station on the ground. From this station the stream is then sent back to the launch station (a purely vertical version is called a space fountain). This structure would contain a large amount of kinetic energy but could be built gradually and would only require enough energy to compensate for losses when finished. Elevators could be run along the streams, and geostationary installations could be placed along the horizontal top. [Named after Keith Lofstrom, who did the first detailed calculations on it in: Lofstrom, Keith H., "The launch loop -- a low cost Earth-to-high orbit launch system," AIAA Paper 85-1368, 1985 ].
An beanstalk-like megaconstruction based on a stream of magnetically accelerated bars linked together. The stream is sent into space, where a station rides it using magnetic hooks, redirects it horizontally to another station, which sends it downwards to a receiving station on the ground. From this station the stream is then sent back to the launch station (a purely vertical version is called a space fountain). This structure would contain a large amount of kinetic energy but could be built gradually and would only require enough energy to compensate for losses when finished. Elevators could be run along the streams, and geostationary installations could be placed along the horizontal top. [Named after Keith Lofstrom, who did the first detailed calculations on it in: Lofstrom, Keith H., "The launch loop -- a low cost Earth-to-high orbit launch system," AIAA Paper 85-1368, 1985].
An beanstalk-like megaconstruction based on a stream of magnetically accelerated bars linked together. The stream is sent into space, where a station rides it using magnetic hooks, redirects it horizontally to another station, which sends it downwards to a receiving station on the ground. From this station the stream is then sent back to the launch station (a purely vertical version is called a space fountain). This structure would contain a large amount of kinetic energy but could be built gradually and would only require enough energy to compensate for losses when finished. Elevators could be run along the streams, and geostationary installations could be placed along the horizontal top. [Named after Keith Lofstrom, who did the first detailed calculations on it in: Lofstrom, Keith H., "The launch loop -- a low cost Earth-to-high orbit launch system," AIAA Paper 85-1368, 1985]. [AS]
Space Fountain
Megatechnology Or Megascale Engineering


text:
Post-marketing surveillance of anti-malarial medicines used in Malawi
Ibrahim Chikowe1,2,
Dorcas Osei-Safo1,
Jerry JEK Harrison1,
Daniel Y Konadu1 &
Ivan Addae-Mensah1
The growing concern over the extent of anti-malarial medicine resistance in sub-Saharan Africa, driven largely by administration of sub-therapeutic doses derived from falsified and substandard medicines necessitates regular monitoring of the quality of these medicines to avert any potential public health disaster. This study aimed at determining the active pharmaceutical ingredient (API) content of anti-malarial medicines available in Malawi with respect to the manufacturers' label claim and pharmacopoeia specifications.
Samples of anti-malarial medicines (112) collected from both licensed and unlicensed markets throughout Malawi were subjected to visual inspection of dosage form and packaging, and registration verification with the regulatory body. Basic (colourimetric) tests were employed to establish the presence and identity of the requisite APIs. Semi-quantitative thin layer chromatography (SQ-TLC) was employed as a quick assay for the verification of identity and estimation of the API content while HPLC assays were used to quantify the APIs. The results were compared with pharmacopoeia specifications and manufacturers' label claims. For combination therapies, a sample was considered to have failed if one or more of its component APIs did not meet pharmacopoeia specifications.
There was 86.6% registration status and 100% compliance with visual inspection and basic tests confirming the presence of requisite APIs. The identification test was confirmed by the SQ-TLC assay. API quantification by HPLC assay however, showed that 88.4% (99/112) of the samples failed the quality tests due to the presence of either insufficient or excessive API.
The results suggest the existence of substandard anti-malarial medicines in Malawi. The presence of both excessive and insufficient artemisinin-based and non-artemisinin-based API, clearly points to poor adherence to GMP and improper handling during storage or distribution. The country relies heavily on imported anti-malarial medicines so there is an urgent need to carry out regular and thorough post-market surveillance of medicines to ensure better quality health care delivery.
No other disease has killed more humans than malaria [1] and it is still claiming millions of lives worldwide. Approximately 3.2 billion people - about half of the world's population - are at risk of malaria. In 2013, about 198 million cases were reported worldwide with an estimated 584,000 deaths. The WHO African Region recorded 90% of these deaths, mostly among children under five years of age [2]. Although, preventive and control measures introduced since 2000 are yielding positive results, leading to the reduction of mortality rates by 47% globally and 54% in Africa, the disease continues to be a major public health problem in most malaria-endemic countries [2]. As in most of sub-Saharan Africa [2], one hundred percent of the population in Malawi lives in a region of high malaria transmission. There is an estimated five million cases annually; responsible for about 30% of the outpatients treated at health facilities and about 40% of all hospitalizations of children under five years of age [3].
Malaria control strategic plans in Malawi comprise the following four key interventions: prompt access to ACT, intermittent preventive treatment during pregnancy (IPTP), long-lasting insecticide-treated nets (LLITNs), and indoor spraying with residual insecticides [3]. Since 2007, artemether-lumefantrine has been adopted as the first-line treatment for uncomplicated and unconfirmed cases, after replacing sulphadoxine-pyrimethamine (SP), which also replaced chloroquine in 1993 due to parasite resistance. SP and other anti-malarial medicines, such as quinine (QN), are still being used for special cases [2].
Plasmodium resistance to malaria treatment has several devastating effects. It has led to an increase in morbidity and mortality rate, parasite transmission, severity of the pandemic and change in malaria distribution. As a result, this has caused pressure on the economy due to increase in cost of health services arising from prevalent treatment failures and deaths [4]. Thus, patients resort to illegal medicines, exposing them to poor quality medicines. Fake/spurious/substandard/degraded/counterfeit medicines are mostly blamed for the escalation of medicine resistance. For example, some pockets of parasite resistance to artemisinin-based medicines have been attributed to the sub-therapeutic doses derived from falsified and substandard medicines [5]. Various studies have reported the widespread circulation of poor quality medicines in some parts of Asia and Africa. Most of them have been shown to contain sub-therapeutic amounts of the APIs or no API at all or even toxic compounds [6-8].
Currently, the only hope for future malaria treatment rests on artemisinin-based combination therapy (ACT). However, with the high demand and cost of production of these medicines, the poor regulatory systems that exist in most endemic countries including Malawi allow unscrupulous persons to easily infiltrate the weak chain supply systems with both imported and/or domestic poor quality medicines [9,10]. Therefore, it is imperative to protect these medicines from any impending medicine resistance through GMP, relentless combat against the circulation of poor quality medicines and strict patient compliance to treatment regimen.
The WHO Expert Committee on Quality Assurance of Medicines calls for routine quality control activities to check this malpractice. Therefore, this study aimed at evaluating the quality of the anti-malarial medicines used in Malawi with respect to the active pharmaceutical ingredient (API) content in both ACT and non-ACT. To achieve this aim, the following specific objectives were set: to find out the registration status of the anti-malarial medicines available on the markets; to visually inspect dosage forms and packaging using the guidelines outlined in the WHO pharmacopoeia and the literature; to carry out a qualitative determination to establish the presence or otherwise of the APIs using the authenticated rapid tests outlined in the WHO publications; to carry out a quantitative determination of the API content.
Sampling procedures
Samples were collected by the first author after seeking permission from the regulatory boards; the Pharmacy, Medicines and Poisons Board and the National Health Sciences Research Committee (NHSRC) of Malawi. The medicines were bought under the guise of a patient, but in the case where pharmacy technicians refused to sell without prescription or many brands of medicine were being bought at once, it was explained that they were for research purposes. In the situation where the investigator introduced himself as a researcher, he ensured that he was sold the medicines from the open shelves to avoid a tendency where vendors give out only authentic goods to regulatory authorities or researchers.
The country was divided into four zones based on the National Malaria Control Programme (NMCP) strategy partitions designated as south west (1), south east (2), central (3) and north (4) zones. Few districts from each zone were selected based on malaria prevalence rates, economic activities and geographical position (border towns). A master list of pharmacies and private health facilities in the districts of interest was compiled. The pharmacies were considered based on proportionate sampling, called probability proportionality to size (PPS), i.e. more samples from districts with more pharmacies/health facilities. The districts of Lilongwe, Mzuzu and Blantyre were further divided into Enumeration areas (EAs) as these had pharmacies in separate townships as well, unlike the other districts that had few pharmacies/private health facilities all clustered at one place. Each township acted as an EA. The simple random sampling (SRS) procedures were used to select the EAs because the EAs were few per district. The random walk method was used in the selection of pharmacies/health facilities from the EAs while for the rest of the districts all pharmacies were selected as there were few pharmacies. Samples were collected between December and January (within the rainy season of November to April) when Malawi records peak malarial transmission due to abundance of stagnant water points, which are favourable breeding grounds for the mosquito vector. The anti-malarial medicines were purchased from both licensed and unlicensed markets such as private pharmacies and hospitals, street vendors and shops. The samples were purchased regardless of size, company name, brand, product name, dosage form and strength, though not more than one sample of the same name, batch number and characteristics were bought at one outlet. They were labelled, recorded and kept in containers that protected them from extreme light, moisture, crushing, heat and mechanical shock. For more details of the samples see Additional file 1. The sampling sites are shown in Additional file 2.
The Reference standards were purchased from the European Directorate for the Quality of Medicines and Healthcare (EDQM), France.
Medicine analysis
Registration verification and visual inspection
The samples were subjected to registration verification with the medicine regulatory authority - the Pharmacy, Medicines and Poisons Board of Malawi after the collection exercise. This was followed by visual inspection with respect to technical regulatory information as outlined in the WHO International Pharmacopoeia [11,12].
Basic/Colourimetric tests
To determine if the samples contained the APIs claimed by the manufacturers on the packaging materials, all of them were subjected to colourimetric tests using the suitable reactions and reagents outlined in the pharmacopoeias and the literature [13-15].
Semi-quantitative thin layer chromatography (SQ-TLC) assay
SQ-TLC was employed as a quick assay for the verification of identity and estimation of the API content in the medicine samples according to published protocols [16,17].
HPLC assay
HPLC procedures suitable for determining the API in each anti-malarial sample adopted from the pharmacopoeias and the literature [17-21] were employed. Calibration curves were prepared using varying concentrations of the various Reference Standards (RS). The Area Under the Curve (AUC) for each concentration was determined from six replicates and an average AUC was obtained. This data was used to generate calibration curves of a plot of average AUC against concentration (C) using Microsoft Excel and the slope of the graph, intercept, correlation coefficient (r2) as well as equation of the straight line, AUC = mC + b were deduced and calculated. The quantities of the APIs in the medicine samples then were calculated from their corresponding calibration curves. Six replicates were carried out for each API component and the mean and standard deviations were calculated (see Additional files 3 and 4).
Assay for artesunate in ATS/SP and ATS/SmP samples
The assay for ATS was adopted from Ranher et al. [18] with a few modifications as follows: column measurements: Discovery C-18 bonded, 5 μm, 25 cm x 4 mm; mobile phase: 70: 30 v/v, 1% triethylamine (TEA) in methanol: buffer (10 mM KH2PO4/ 85% H3PO4, pH = 2.5); retention time (average): 5.1 minutes; detection wavelength: 216 nm; flow rate: 1.2 mL/min.; volume of injection: 20 μL. For each ATS-containing sample, a quantity of the powdered dosage form equivalent to 10 mg of artesunate was weighed into a clean dry 10 mL volumetric flask. 5 mL of the mobile phase was then added and the mixture shaken for 15 minutes on an ultrasonic sonicator. Then, more mobile phase was added to the mark and the solution filtered through a 0.45 μm filter.
Assay for artemether and lumefantrine in ATM/LUM samples
The assay protocol for ATM and LUM was derived from modifications of a method developed by Arun and Smith [19]. The adapted method is as follows: column measurements: Hyperprep PEP 300A C4, 25 cm x 4.6 mm, 8 μm; mobile phase: 70: 30 v/v acetonitrile: 10 mM buffer consisting of KH2PO4 mixed with 1 mL of triethylamine per liter and pH changed to 2.5 using 85% H3PO4 mixture; retention time (average): ATM 2.5 minutes, LUM 3.0 minutes; detection wavelength: 216 nm; flow rate: 1.5 mL/min.; volume of injection: 20 μL. The counter-ion modifying agent triethylamine was added to obtain enhanced peak symmetry and minimize tailing. Furthermore, due to the large difference in the ratio of ATM to LUM (1:6), efforts were made to add a detectable amount of ATM without unnecessarily overloading the column with high concentrations of LUM. Sample solutions of the tablets were prepared by accurately weighing 4 mg of the powdered dosage form weighed into a clean dry beaker. 1 mL of acetic acid was added, allowed to react for a few minutes after which 5 mL of the mobile phase was added. The mixture was then shaken for 15 minutes on an ultrasonic sonicator, filtered into a 10 mL volumetric flask through a 0.45 μm filter, and made up to the mark through the filter with the mobile phase.
Assay for dihydroartemisinin in DHA/SP and DHA/Pp samples
A method outlined in the Ph. Int. [12] was modified as follows: column measurements: Kramasil C8, 25 cm x 4.6 mm, 5 μm; mobile phase: 50:50 v/v, water: acetonitrile; retention time (average): 5.2 minutes; detection wavelength: 210 nm; flow rate: 1.5 mL/min.; volume of injection: 10 μL. For each sample, a quantity of powdered tablets equivalent to 10 mg of DHA was accurately weighed into a clean dry beaker. This was extracted four times with diethyl ether as SP and Pp are practically insoluble in diethyl ether. This solution was evaporated to dryness. The residue was re-dissolved in 5 mL of the mobile phase, sonicated for 15 minutes, filtered through a 0.45 μm filter into a 10 mL volumetric flask and made up to the mark.
Assay for quinine in QN samples
QN was assayed according to a modified version in USP 24 [20]. Column measurements: Discovery C-18 bonded, 25 cm x 4.0 mm, 5 μm; mobile phase: 80:16:2:2 v/v, water: acetonitrile: methanesulfonic acid: TEA, pH 2.6; retention time (average): 5.7 minutes; detection wavelength: 235 nm; flow rate: 1.2 mL/min.; volume of injection: 20 μL. For the suspensions and mixtures, a certain amount was sonicated for about 15 minutes and a quantity equivalent to 5 mg was pipetted into a 10 ml volumetric flask. Methanol (8 ml) was added to the contents of the flask and made up to the mark with the mobile phase. Where necessary, the solution was also filtered.
For the injections, a 10 mL solution was prepared in a volumetric flask after 5 ampoules of quinine injections were mixed together and 20 μL aliquot was measured from the stock quinine solution using a microlitre syringe. The prepared solution was diluted with 8 mL of methanol and the mobile phase was added to the 10 mL mark.
Assay for sulphadoxine/sulphamethoxypyridazine and pyrimethamine
The experimental conditions employed in the analysis of S, Sm and P samples, were modified after a WHO-adopted monograph for inclusion into the Ph. Int. in 2010 [21]. Column measurements: Ascentis C-18, 15 cm x 4.60 mm, 5 μm; mobile phase: 65:10:25 v/v, 20 mM buffer (KH2PO4/Na2HPO4 of pH 5.6; methanol; acetonitrile; retention time (average): sulphadoxine/sulphamethoxypyridazine 3.9 minutes, pyrimethamine 8.7 minutes; detection wavelength: 240 nm; flow rate: 1 mL/min.; volume of injection: 10 μL. Solutions of sulphadoxine/sulphamethoxypyridazine and pyrimethamine containing tablets were prepared as follows: a quantity of the powdered dosage form equivalent to 100 mg of sulphadoxine/sulphamethoxypyridazine and 5 mg of pyrimethamine were weighed simultaneously into a clean dry beaker. The APIs were extracted three times for completeness using acetonitrile and finally made up to the mark with the mobile phase in a 50 mL volumetric flask.
Accuracy, precision, linearity and specificity parameters were evaluated for all the various determinations. Accuracy of results of an analytical method can also be established when validation parameters including precision (RSD values), linearity (R2 values), accuracy (% recovery) and specificity (retention times) were evaluated for all the various determinations (n = 6).
Poor quality medicines may be degraded, substandard or counterfeit. According to the WHO, Spurious/Falsely-Labelled/ Falsified/Counterfeit (SFFC) medicines (branded or generic) can be classified as "any medicines or pharmaceutical products that are deliberately and fraudulently mislabelled for identity and/or source" The definition includes products with correct or wrong ingredients, without active ingredients, with insufficient active ingredients, or with false packaging [22]. Substandard medicines, also known as Out of Specification (OOS) products are those that are genuine and legally produced but fall outside the specifications or acceptance criteria established in product dossiers, drug master files, pharmacopoeias or by the manufacturer. A degraded medicine can be classified along with substandard medicine. However, they differ in that they might be originally of specification, but in the course of time naturally or catalysed by external factors, fall out of specification within its shelf-life [5].
In this study, a sample was considered to have failed the quality evaluation if it did not meet any of the following criteria: 1) failure of visual inspection of dosage form and packaging, 2) failure to produce the expected colour reaction in the basic test and 3) failure to produce the expected spot colour or Rf on TLC compared to the reference standard. With respect to API content, a component API was classified as "compliant (C)" if its quantity fell within the acceptable International Pharmacopoeia limits of 90-110% of the amount of API stated on the label claim; "non-compliant (NC)" if the quantity was less than the lower (insufficient) or more than upper (excessive) acceptable limits [11,12]. Thus an ACT was considered compliant or to have passed the API content test only when both or all of its component APIs were compliant.
The anti-malarial samples analysed were 112, comprising 36 non-ACT, 4 ACT of single dose medicines co-packed on the same blister to be taken concomitantly and 72 ACT of fixed dose combinations. Artemether-lumefantrine (ATM/LUM) tablets, being the main ACT and serving as the first-line treatment for malaria in the country, formed the bulk of samples (36.6%) while SP tablets represented 20.5%. The formulations also included suspensions, injections and mixtures containing other APIs such as quinine (QN), piperaquine (Pp), sulphamethoxypyridazine (Sm), artesunate (ATS) and dihydroartemisinin (DHA). A total of 153 samples were collected, but the number analysed was limited by available assays and reference standards (RS). Table 1 shows a summary of the samples collected and analysed.
Table 1 Categories of collected anti-malarial medicine samples
Registration status of samples
The samples were subjected to registration verification with the Pharmacy, Medicine and Poisons Board of Malawi as soon as the collection exercise was completed. As of 31st December, 2011, 86.6% (97/112) of the collected samples as well as their formulation types were registered with the regulatory board, according to their annual registration publication. None of the samples was manufactured locally; all of them were imported samples with 60.7% manufactured in India and the rest originating from China, Kenya and Tanzania.
Visual inspection of dosage form and packaging
The visual inspection of the dosage forms and packaging showed total (100%) compliance of the samples with the requirements. Labelling information regarding dosage form, brand name, active ingredient/strength, batch number, manufacture and expiry dates were provided (see Additional file 1). Tablets did not present with non-uniform colouration or signs of breakage.
Basic tests
API content claims were confirmed by colourimetric tests, which demonstrated that all the samples contained the requisite APIs claimed by the manufacturers. However, it has been reported that with the advancement of counterfeiting, visual inspection and basic tests alone cannot qualify a medicine as genuine despite chemical and physical similarities. According to Bate et al., the determination of a medicine as counterfeit or substandard requires a forensic examination of the trademarks; product designs and holograms [23], but the present study did not go as far as that.
A major challenge in the simultaneous assay of ATM/LUM tablets was the choice of a solvent that would not interfere with the analyte peaks, dissolve both APIs long enough for the analysis to be carried out and also give well-resolved peaks. This was overcome by using acetic acid followed by acetonitrile to extract the active ingredients. From the chromatograms, acetic acid eluted first and did not interfere with the analyte peaks. Acetonitrile, with its low cut-off wavelength also did not interfere. The addition of the modifying agent triethylamine greatly enhanced peak symmetry and minimized tailing. A small shoulder appeared in the LUM peak and was observed in both the RS and the samples. Its presence did not hinder the computation of the AUC and was attributed to the column type, the mobile phase composition or both (Figures 1 and 2). Another challenge encountered was the difficulty in detecting artemether due to its low molar absorptivity and its low concentration (16.7%) in the fixed dose combination. Thus in the preparation of the calibration curves, different LUM concentrations were tried to obtain a range that would allow for the suitable detection of ATM and at the same time, not correspond to too high concentrations of LUM. The curves obtained were linear with R2 values of 0.994 for ATM and 0.993 for LUM (Figures 3 and 4).
Chromatogram of a 0.3 mg/mL and 1.7 mg/mL of ATM and LUM RS solutions.
Chromatogram for ATM/LUM tablet.
Calibration curve for lumefantrine.
Calibration curve for artemether.
The assay of SP samples was also problematic with respect to the high ratio of sulphadoxine to pyrimethamine, 20:1 respectively. Suitably high concentrations of sulfadoxine API were used to aid in the detection of pyrimethamine. The calibration curves obtained were linear with an R2 value of 0.999 and 0.998 for sulfadoxine and pyrimethamine respectively (Table 2). Details and sample chromatograms of all samples assayed together with their corresponding calibration curves are presented in Additional files 3 and 4.
Table 2 Results of analytical method validation
The accuracy of results of an analytical method can be established when validation parameters such as precision, linearity and specificity are clearly demonstrated. A summary of the method validation results is presented in Table 2, with details in Additional file 4. The average RSD values are ≤ 2%. The linearity values (R2) are also above 0.95 demonstrating a very good correlation between the peak area (AUC) and the concentration of the analyte APIs, linear across the 80-120% RS concentrations. The retention times of the analyte in the sample and the RS are also comparable, demonstrating high specificity.
Quality of anti-malarial medicines
Although all the samples passed the visual inspection and qualitative determination tests, the HPLC assay revealed that 88.4% (99/112) did not meet the requirements for API content (Table 3). The main cause of the failure was either the presence of insufficient API (i.e. < 90%) or excessive API (>110%). See Additional file 3 for detailed results.
Table 3 Level of compliance of individual API content and failing rates of anti-malarial samples
The 112 anti-malarial samples consisted of 9 APIs in various combinations with the exception of QN, which occurred as a monotherapy. Pp could not be assayed due to unavailability of a reference standard. Out of the 4 ATS/SP samples, ATS was compliant in all, P was compliant in 2 samples while S was compliant in none. The total noncompliance of the S component thus resulted in a 100% failure of all the ATS/SP samples.
ATS was compliant in only 2 out of the 5 ATS/SmP samples while Sm and P were compliant in 1 and 2 samples respectively. Regardless of having at least one case of compliance for each constituent API, this did not occur in the same sample. Hence, there was not a single sample in which all the individual APIs were compliant, resulting in 100% failure. In the 23 SP samples, compliance for S and P was in 3 and 12 samples respectively. Compliance for both constituents occurred together in only 2 samples resulting in 91.3% failure rate. There were 12 DHA/SP samples and although API content test for P was 100% compliant, 11 samples failed the S API content test while DHA was 100% noncompliant. Hence, no DHA/SP sample passed the quality test. Since Pp API in DHA/Pp could not be assayed, based on DHA alone, 4 out of the 14 samples were compliant (71.4% failure rate). In the case of the 41 ATM/LUM samples, only 2 samples had both APIs being compliant in the same sample. Overall, ATM was compliant in 14 samples while LUM was compliant in 11 samples. The failure rate of the samples was 91.5%. In the 13 QN monotherapy, 61.5% of the samples failed the quality test.
Failure rate of anti-malarial medicines versus registration status
Comparison of the failure rate of registered and unregistered samples suggested that registration status did not have significant influence on the quality of the anti-malarial medicines. Out of the 97 registered samples, 15.5% (15) of the samples were compliant, while 6.7% (1) of the 15 unregistered samples were compliant. Although the registered samples had a slight edge over the unregistered ones, the overall results (Figure 5) show that registration status does not necessarily always guarantee the quality a drug. These results are similar to the observations made in the 2008/2009 Ghana study [16].
A comparison of failure rates for registered and unregistered samples.
Samples with the same batch number
API content of samples within same batches was compared to ascertain their uniformity. Some of the batch numbers were unregistered while others were duly registered. The results (Table 4) revealed wide variations in API content within batches, regardless of registration status.
Table 4 Samples with the same batch number and their respective API content
Reporting of results
The findings of the study have not yet been made available to any of the regulatory bodies - the Pharmacy, Medicines and Poisons Board, the National Health Sciences Research Committee (NHSRC) of Malawi or the WHO Rapid Alert System.
The study showed a good correlation between both visual inspection of dosage form and packaging material on one hand and qualitative determination (basic tests) of API on the other because the labelled contents on the packaging materials were found to be correct. Thus, none of the samples can be considered as falsified with respect to visual inspection and qualitative determination. However, the quantitative assay revealed noncompliance of API content in a significant majority of the samples. There were 145 instances of the presence of a noncompliant API in the various categories of the anti-malarial medicines against 73 cases of compliance. In the combination formulations, more often than not, compliant APIs did not occur together in the same sample, resulting in the observed high failure rate in the quality evaluation (88.4%). Although the presence of insufficient API was the main cause of failing samples, there were cases of the presence of excessive API. In two previous studies on anti-malarial samples distributed in Ghana, where low quantities of API was also identified as a major contributory factor in failing rates, the artemisinin-based components of ACT were the insufficient APIs. Thus it was deduced that manufacturers could deliberately or otherwise be reducing quantities of the more expensive API as a means of cutting down on production cost. However, in the current quality evaluation, the artemisinin-based components have been detected in excessive quantities as well. This observation suggests poor adherence to SOPs, GMPs and proper registration procedures and is corroborated by the wide differences in API quantities of samples within batches (Table 4). In either case, there is the danger of sub-therapeutic doses of the noncompliant component promoting resistance or in the case where this component is present in excessive doses, posing a risk of toxicity to patients.
Although the registration status of anti-malarials used in Malawi was found to be quite satisfactory (13.4% unregistered), compared to countries such as Ghana and Togo where most recent studies indicated 55% and 78% unregistered anti-malarials in Ghana in 2008 and 2012 [16,17] respectively and 17% unregistered anti-malarials in Togo in 2012 [17], it has been established that registration of a medicine with the national regulatory authority does not necessarily guarantee its quality. ATM/LUM, SP and QN are the most commonly used medicines against malaria in Malawi, a country burdened with high transmission rate of malaria. Hence, the failure rate of these important medicines - ATM/LUM (95.1%), SP (91.3%) and QN (61.5%) - is alarming considering the fact most of the malaria cases in Malawi are diagnosed without microscopic determination. Most types of fever are presumed to be malaria first, and treated as such. If indeed, such ad hoc diagnoses are also treated with substandard anti-malarials, this could lead to treatment failure and/or fast development of resistance. This inference is based on the report by Bate et al. that resistance development of chloroquine and sulphadoxine in Africa in the 1990s and the devastating impact of malaria on the people were partly due to the use of substandard medicines [23].
Comparison of current results with recent results from other African countries
Recent surveys on the quality of medicines circulating in many African countries have shown similar trends of poor quality anti-malarial medicines [7,16,17,24]. Most regulated manufacturers bypassed their GMP compliance and set the standards of their medicine products based on the recipient countries' status with regard to the level of regulation capability and level of income as well as lack of prequalified standards by most developing countries to their suppliers [25]. Malawi, being a developing country and one of the poorest for that matter, is bound to suffer from poor regulatory capability and lack of expertise in routine rigorous medicine testing, considering the heavy reliance on imported anti-malarials. Most international surveys have rarely included samples from Malawi and efforts to locate any such internal activity at the required level have so far proved futile.
The findings of the study suggest a widespread use of substandard anti-malarial medicines throughout the country with respect to API content. The detection of indiscriminate cases of excessive as well as insufficient API in both artemisinin-based and non-artemisinin-based components can be attributed to improper GMP and lack of quality control in the distribution chain. Therefore, there is an urgent need for regular rigorous testing by the National Medicines Regulatory Authority to deter importers from flooding the markets with poor quality medicines. Despite the effort put in place by the Government and its partners to minimize the impact of malaria over the years, the disease remains the country's biggest health challenge. The post-marketing surveillance and pharmacovigilance system has been under development since 2009 and yet, it is still faced with severe limitations.
ATM:
Artemether
ATS:
Artesunate
EA:
Enumeration area
EDQM:
European Directorate for the Quality of Medicines and Healthcare
FDC:
Fixed dose combination therapy
GMP:
Good manufacturing practice
HPLC:
High pressure liquid chromatography
LUM:
NC:
Non-compliant
NMCP:
National Malaria Control Programme
Ph. Int.:
International pharmacopoeia
Probability proportionality to size
QN:
Quinine
RS:
Sulphadoxine
SM:
Sulphamethoxypyridazine
SOP:
Sulphadoxine-pyrimethamine
SQ-TLC:
Semi-quantitative thin layer chromatography
SRS:
Simple random sampling
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Osei-Safo D, Harrison JJEK, Addae-Mensah I: Validation and application of quality assurance methods developed for artemisinin-based antimalarial medicines to assess the quality of a selection of such medicines distributed in Accra, Ghana. African Journal of Pharmaceutical Sciences and Pharmacy 2010, 1: 1–25. Retrieved from [http://www.ajpspjournal.com/article/view/6206]
Osei-Safo D, Agbonon A, Konadu DY, Harrison JJEK, Edoh M, Gordon A, Gbeassor M, Addae-Mensah I: Evaluation of the quality of artemisinin-based antimalarial medicines distributed in Ghana and Togo. Malar Res Treat 2014, Article ID 806416, 12 pages. [http://www.hindawi.com/journals/mrt/2014/806416/]
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The study was carried out in the laboratories of the Department of Chemistry, University of Ghana Legon. Funding was received from the Department for International Development UK (DFID)/Wellcome Trust through the National Commission for Science and Technology (NCST) Malawi under the Health Research Capacity Strengthening Initiative (HRCSI). We would like to thank Mr. Wilford Mathiya of the Pharmacy, Medicines and Poisons Board (Malawi), Mr. Rage Majamanda of the National Health Sciences Research Committee (NHSRC) (Malawi) and Dr Mathildah Chithila, Dr Happy Phiri, Mr Andrew Mpesi and Mr George Ng'ambi of the HRCSI Secretariat (Malawi) for their prompt assistance(s) during the sample collection exercise.
Department of Chemistry, University of Ghana, Legon, Accra, Ghana
Ibrahim Chikowe, Dorcas Osei-Safo, Jerry JEK Harrison, Daniel Y Konadu & Ivan Addae-Mensah
Ministry of Education, Science and Technology, Lilongwe, Malawi
Ibrahim Chikowe
Dorcas Osei-Safo
Jerry JEK Harrison
Daniel Y Konadu
Ivan Addae-Mensah
Correspondence to Dorcas Osei-Safo.
IAM conceived the study and designed the experiment. IC carried out the sampling and wrote the first draft. IC and DYK performed the experiments. IAM, DOS and JJEK supervised the study. DOS produced the final manuscript. All authors read and approved the final manuscript.
List and details of anti-malarial medicines purchased.
Additional file 2: Figure S1.
Map of Malawi showing sampling sites.
Results of HPLC assay for API content in anti-malarial medicines.
Detailed analytical results.
Chikowe, I., Osei-Safo, D., Harrison, J.J. et al. Post-marketing surveillance of anti-malarial medicines used in Malawi. Malar J 14, 127 (2015). https://doi.org/10.1186/s12936-015-0637-z
Anti-malarial medicines
Post-marketing surveillance


text:
New "MAGESTIC" gene-editing technology makes precise changes to millions of cells at once
A new gene-editing technology enables scientists to make thousands of edits at once and track them with specific barcodes.
Author Hanae ArmitagePublished on May 8, 2018 May 8, 2018
There may be a new powerhouse gene-editing tool to add to the arsenal of disease researchers. And they say it's MAGESTIC.
No, I didn't spell that wrong, and no, the scientists aren't flat-out bragging. The tool's full name is "multiplexed accurate genome editing with short, trackable, integrated cellular barcodes" — MAGESTIC for short.
The work, led by Lars Steinmetz, PhD, professor of genetics at Stanford, and Bob St. Onge, PhD, a senior scientist in the Department of Biochemistry, appeared in Nature Biotechnology. Stanford postdoctoral scholars Kevin Roy, PhD, and Justin Smith, PhD; and Sibylle Vonesch, PhD, a postdoctoral fellow at the European Molecular Biology Laboratory, are co-first authors on the study.
"To really study the question of how genes relate to disease, we have to be able to look at multiple genetic variations at the same time, in a systematic way," Steinmetz told me. "At a species level, you can find thousands to millions of variants in the DNA, and as it stands, we have a very limited way of understanding how these affect the organism."
Steinmetz hopes that MAGESTIC can help remedy that, and he's been testing the new technique in yeast.
MAGESTIC harnesses CRISPR-Cas9 technology, but augments CRISPR's typical DNA-cutting function by adding two key elements: active recruitment of "donor" DNA to the cut site and a genomic "barcode." Typically, when CRISPR snips DNA, other helper molecules have to swoop in to stitch the nucleotides (the basic fabric of DNA) back together. Unfortunately, it's not the most accurate or efficient process; some nucleotides are accidentally edged out, some are accidentally added in.
Here, Steinmetz says, is where the "donor" DNA comes in. Instead of simply hacking at the strands of DNA, MAGESTIC makes a cut, and then with the help of an engineered protein, it actively recruits the highly specified replacement DNA to efficiently repair the severed strand and create a precise edit. The edit encoded by the donor DNA could be anything — it could be the normal, functional version of a gene; it could be a mutated sequence; it could even be an entirely new sequence foreign to that species.
One of the unique aspects of the MAGESTIC technique, Steinmetz says, is its ability to track the edits reliably using a genome-integrated barcode. This tactic allows for millions of yeast cells to undergo distinct edits all at once, and enables the scientists to infer which cell got what edit later on.
Before administering MAGESTIC to yeast, they make a one-to-one chart that lists the type of the genetic variant and its tracking number, or barcode. Then later, once all the cells are edited, it's as easy as reading off the sequence "tracking number" to figure out what edit occurred in the cell.
The idea is to flood the yeast with various designed mutations and see how they react. Does it make them grow faster or slower, or survive longer? Does it make them more resilient to chemicals that typically kill them?
Turns out, some mutations made mini "super-yeasts" that were more resilient to drugs; but some mutations weakened the yeast's defenses, rendering them more susceptible to drugs.
Steinmetz notes that in other model organisms, the technique would require a little tweaking. For now, he and his team are sticking to yeast cells, though they are currently planning to take MAGESTIC into human cells.
"More and more people are thinking about using the CRISPR system to edit in live animals, and so it's incredibly important that unintended edits are minimized," Steinmetz said. "The technologies that boost precision and efficiency are welcome and needed, so we hope that MAGESTIC provides one tenable way in which this could happen."
Photo by qimono
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text:
Health Care District vaccine appointments open for everyone 16 and up
Updated: 3:50 AM EDT Apr 6, 2021
Ana Espinosa
DAY THAT ALL ADULTS IN FLORIDA IN CERTAIN TEENAGERS WERE ABLE TO BOOK AN APPOINTMENT FOR A COVID-19 VACCINE BUT ONE LOCAL I SPOKE WITH SAID ALTHOUGH SHE HAS AN APPOINTMENT SCHEDULED TO GET HER VACCINE. SAYS SHE ISN'T LOOKING FORWARD TO IT. ESPECIALLY SINCE YOU CAN GET GET A DIFFERENT STRAIN OF THE VIRUS, SO BUT I'M MORE WANT TO GET IT BECAUSE I WOULDN'T WANT TO HAVE ASYMPTOMATIC AND PASS IT SOMEBODY WHO DIDN'T RECOVER EMBRACING A MAJOR STEP FORWARD IN FLORIDA VACCINE ELIGIBILITY IN THE STATE OFFICIALLY MEANS ALL ADULTS AND EVEN 16 AND 17 YEAR OLDS. SO I THINK I'M GONNA DO IT AND IT'S A GOOD IDEA TO SAVE THE WORLD ON MONDAY AT 10 AM THE HEALTHCARE DISTRICT COUNTY BEGINS SCHEDULING VACCINE APPOINTMENTS WHICH WILL BEGIN ON TUESDAY AT SITES INCLUDING THE SOUTH FLORIDA FAIRGROUNDS TEENS AGES 16 AND OLDER ARE ALSO ELIGIBLE TO RECEIVE THE FISER VACCINE IF A PARENT OR GUARDIAN IS PRESENT WHICH SOME PARENTS LIKE GARDENER THINK IS A GOOD IDEA. YES, BECAUSE THERE ARE A LOT OF PEOPLE WHO HAVE UNDERLYING CONDITIONS THAT WOULD GET IT AND WOULDN'T RECOVER IN AN EFFORT TO MAKE THE APPOINTMENT PROCESS MORE USER FRIENDLY THE COUNTY CREATED A SCHEDULING SYSTEM FOR THEIR VACCINE SITES, BUT GARDENER SAYS SHE HAS HEARD OF SOME THAT DON'T WANT TO GET THE VACCINE REGARDLESS OF AVAILABILITY. THERE ARE A LOT OF VULNERABLE PEOPLE THAT WOULDN'T RECOVER AND I JUST DON'T THINK THAT'S REALLY THE RIGHT THING TO DO. FOR MORE INFORMATION ON HOW TO BOOK A VACCINE APPOINTMENT THROUGH THE HEALTHCARE DISTRICT OF PALM BEACH COUNTY. YOU CAN HEAD TO OUR WEBSITE AT WPBF.COM REPORTING LIVE IN WEST PALM BEACH
April 5, 2021, marked the first day all adults in Florida and certain teenagers were able to book appointments to receive their COVID-19 vaccine.One local, Molly Gardner, said although she is scheduled to get an appointment, she tells me she isn't looking forward to it."Especially, since you can get a different strain of the virus," Gardner said. "But I would more want to get it because I wouldn't want to be asymptomatic and pass it to someone who didn't recover."Everyone 18 years old and older in Florida is eligible for the vaccine following Gov. Ron DeSantis' new executive order. "I think I am going to do it and it's a good idea to save the world," said Yoan Curcis, Florida resident. On Monday at 10 a.m., the Health Care District of Palm Beach County began scheduling vaccine appointments, which will begin on Tuesday at several sites including the South Florida Fair Grounds.Teens age 16 and older are also eligible to receive the Pfizer vaccine if a parent or guardian is present."Yes, because there are a lot of people who have underlying conditions and would get it and wouldn't recover," Gardner said. In an effort to make the appointment process more user-friendly, the county created a new scheduling system for their vaccine sites.Click here for the new scheduling system.For those with no internet access, the Health Care District's helpline at 561-804-4115 is available to assist in English, Spanish and Creole. Appointments are available based on demand and vaccine supply that is received weekly. The Health Care District of Palm Beach County will reopen the appointment scheduler at 9 a.m. on Wednesday, April 7.
PALM BEACH COUNTY, Fla. —
April 5, 2021, marked the first day all adults in Florida and certain teenagers were able to book appointments to receive their COVID-19 vaccine.
One local, Molly Gardner, said although she is scheduled to get an appointment, she tells me she isn't looking forward to it.
"Especially, since you can get a different strain of the virus," Gardner said. "But I would more want to get it because I wouldn't want to be asymptomatic and pass it to someone who didn't recover."
Everyone 18 years old and older in Florida is eligible for the vaccine following Gov. Ron DeSantis' new executive order.
"I think I am going to do it and it's a good idea to save the world," said Yoan Curcis, Florida resident.
On Monday at 10 a.m., the Health Care District of Palm Beach County began scheduling vaccine appointments, which will begin on Tuesday at several sites including the South Florida Fair Grounds.
Teens age 16 and older are also eligible to receive the Pfizer vaccine if a parent or guardian is present.
"Yes, because there are a lot of people who have underlying conditions and would get it and wouldn't recover," Gardner said.
In an effort to make the appointment process more user-friendly, the county created a new scheduling system for their vaccine sites.
Click here for the new scheduling system.
For those with no internet access, the Health Care District's helpline at 561-804-4115 is available to assist in English, Spanish and Creole.
Appointments are available based on demand and vaccine supply that is received weekly.
The Health Care District of Palm Beach County will reopen the appointment scheduler at 9 a.m. on Wednesday, April 7.


City 2nd Edition by Phil Hubbard and Publisher Routledge. Save up to 80% by choosing the eTextbook option for ISBN: 9781315471235, 131547123X. The print version of this textbook is ISBN: 9781138203594, 1138203599.