Generic pramipexole is widely prescribed for Parkinson's disease (PD), yet clinical equivalence to the brand-name formulation remains debated. We aimed to compare generic and brand-name pramipexole dihydrochloride tablets in real world. We conducted a multicenter retrospective propensity score-matched cohort study. Prescription data of outpatients using either generic or brand-name pramipexole dihydrochloride tablets for PD or Parkinson's syndrome were extracted at five research hospitals from July 1, 2018, to June 30, 2023. Effectiveness was assessed by changes in levodopa equivalent dose (LED) over time, while safety was evaluated by adverse events (AEs) from enrollment to follow-up completion. Medication costs were also compared between the two groups. A total of 1,063 patients in the brand-name drug group and 1,287 in the generic drug group were included. A total of 161 AEs occurred in the generic drug group and 182 in the brand-name drug group. There was no significant difference in AE occurrence between the two groups (P = 0.898). And no significant difference was found in the change degree of LED level between generic drug and brand-name drug group over time (H = 1.514, P = 0.824). The daily cost of pramipexole and antiparkinsonian drug, as well as the average prescription cost over 1 year of follow-up in the generic drug group were significantly lower than those in the brand-name drug group (P < 0.05). With comparable efficacy and safety, our results indicate the generic pramipexole should be considered a valuable alternative to the brand-name drug. Future prospective research is needed to confirm these findings in clinical practice.
Plastic pollution is an established environmental crisis, but the responsibility of specific producers remains poorly understood particularly in freshwater systems. The present study applies brand audit-based attribution to identify the manufacturers associated with branded plastic litter collected during a large-scale citizen science clean-up campaign across the Tanzanian shorelines of the African Great Lakes (Lakes Victoria, Tanganyika, and Nyasa (Malawi), A dataset of 11,207 litter items with visible and validated branding was dominated by plastics (9951 items, 88.8%), mainly comprised of single use "fast-moving consumer goods". Beverage bottles constituted the largest plastic item category (64.9%), followed by soft packaging (1379 items, 13.9%) and food wrappers (1242 items, 12.5%). In total, 292 brands and 148 manufacturers were identified. Corporate contributions were highly concentrated, with three manufacturers (Jambo Group of Companies, Bakhresa Food Products Ltd, and MeTL Group) accounting for 52.9% of branded plastic litter, while 29 manufacturers explained 95.1%. Overall, 91.4% of branded plastic litter was attributable to Tanzanian manufacturers, with regional and international manufacturers representing minor fractions. This pronounced concentration and national embedding of responsibility suggest that Extended Producer Responsibility (EPR) frameworks may be particularly feasible in this context. Coordinated and transparent action to finance waste infrastructure and implement EPR mechanisms, such as bottle return schemes, would send a clear and credible signal of commitment to pollution mitigation. Whilst community-led clean-ups have an important role, without parallel producer responsibility measures and infrastructure development, the burden of waste management continues to fall disproportionately on local communities.
Kratom may pose some health risks (e.g., liver toxicity, seizures, dependence), and interstate commerce is federally illegal; however, kratom is sold widely in the US. The extent of interstate commerce is unclear, but may be indicated by brands present across states/territories. Thus, this study examined kratom brands sold in US vape shops. Using Google Maps, we identified vape shops in all 50 states, DC, and Puerto Rico. Stores were called in November/December 2023. To achieve our target sample of 520 (n=10 per state/territory), 661 stores were called (contact rate=78.7%). Kratom was sold in 372/520 shops (71.5%), of which 153 (41.1%) provided brand information. Among 129 brands reported, OPMS was sold in 90.20% of shops across 42 states/territories, Remarkable Herb in 34.64% across 30 states/territories, and MIT 45 in 33.33% across 31 states/territories. Interstate brand presence indicates likely violations of federal laws and the need to strengthen regulation and enforcement.
Formulary exclusions and drug utilization management, including prior authorization and step therapy, reduce drug spending but may limit timely treatment access. To estimate formulary-based rejections and subsequent dispensing of initial attempts to fill single-source branded drug prescriptions. Retrospective, national, all-payer cohort study using IQVIA Formulary Impact Analyzer, which represents anonymized, patient-level, adjudicated US outpatient pharmacy claims, from January 2018 through September 2024. The study focused on 1.17 million individuals attempting to fill 2 million single-source branded drug prescriptions for the first time. Attempt to fill a single-source branded drug prescription for the first time. The primary outcomes were (1) rejection for formulary exclusion or utilization management (prior authorization or step therapy) of an initial prescription fill attempt and (2) failure of dispensing of the rejected molecule or another member of the same therapeutic class within 90 days of the initially attempted fill. Among more than 2 million initial fill attempts (commercial insurance, 0.84 million; stand-alone Medicare prescription drug plan, 0.40 million; Medicare Advantage prescription drug plan, 0.39 million; Medicaid fee-for-service, 0.21 million; Medicaid managed care, 0.10 million; health insurance marketplace [exchange] plan, 0.06 million), 68.0% were paid on the initial fill attempt, while the remainder were rejected for formulary exclusion (14.8%) or rejected due to requiring prior authorization or step therapy, ie, utilization management (17.2%). Formulary-based rejections increased 67.4% over the time frame examined, from 24.3% (2018) to 40.7% (2024), and rejections were most common among exchange (48.7%) and Medicaid managed care (49.8%) compared with Medicare prescription drug plans (24.0%) and Medicare Advantage prescription drug plans (19.8%). Of the 32% of attempts that were initially rejected, 38.6% ultimately resulted in the rejected molecule being filled within 90 days and nearly half (48.4%) resulted in no medication fill in the same therapeutic class within that time frame. Treatment initiation was delayed an average of 12.2 days (SD, 17.8 days) after initial rejection among those ultimately receiving the same molecule or a therapeutic substitute. Among this large, diverse sample of individuals in the United States, formulary rejections were frequent and often resulted in delayed or absent treatment, highlighting trade-offs between cost and access to medicines.
Generation Z consumers are reshaping food consumption patterns in urban digital environments, particularly in restaurant contexts characterized by high choice complexity and uncertainty. In Mexico, the evolution of the restaurant industry has intensified the need to understand how digital cues shape consumer food choices. Addressing this gap, this study examines how Social Media Marketing (SMM), Social Media electronic Word of Mouth (Social Media eWOM), and Social Media Influencers (SMIs) shape food consumption intention among Generation Z in Mexico City. Grounded in the Stimulus-Organism-Response (SOR) model and integrating the attitudinal foundations of the Theory of Reasoned Action (TRA) and the Theory of Planned Behavior (TPB), this study analyzes how these digital factors impact food consumption intention (operationalized as restaurant purchase intention) through the mediating psychological mechanism of Consumer Brand Engagement (CBE). A quantitative, non-experimental design was employed using a sample of 406 respondents, and data were analyzed through Structural Equation Modeling (SEM). The results indicate that the model explains 73.6% of the variance in food consumption intention. SMM emerged as the strongest direct predictor, followed by Social Media eWOM and SMIs. Crucially, CBE mediates only the relationship between influencers and consumption intention. Conversely, both SMM and Social Media eWOM exert direct effects that bypass affective engagement. These findings highlight the role of digital ecosystems as cognitive proxies in restaurant selection, providing actionable insights for restaurant SMEs to optimize digital strategies and enhance economic resilience. They also suggest potential implications for healthier and more sustainable urban food environments.
The US tobacco landscape is constantly changing, with the commercial tobacco industry regularly flooding the market with new brands, flavors, and styles. Rutgers Center for Rapid Surveillance of Tobacco (CRST) examines tobacco product marketing, the tobacco product marketplace, and tobacco use behaviors. This paper describes how findings from tobacco marketing surveillance are integrated with other data sources to provide timely and actionable information about changes in tobacco products to inform the U.S. Food and Drug Administration's (FDA) regulatory efforts that reduce tobacco harms. CRST conducts regular surveillance of consumer-facing advertisements via print and online, business-to-business publications, direct-to-consumer marketing, branded tobacco company websites, and social media posts for over 50 brands. Information is disseminated through publication in peer-reviewed journals, public fact sheets, and weekly online newsletters to stakeholders. Geek Bar, an e-cigarette brand, illustrates how findings from CRST tobacco marketing surveillance are triangulated with data from other CRST activities to provide rapid information on an emerging brand. The presence of the brand was identified as a signal of interest in early sales data, whereafter surveillance of the brand's marketing activities showed frequent product releases and marketing targeting young people. This systematic tobacco marketing surveillance, when combined with other CRST activities, keeps regulators and the public health community informed in a constantly changing marketplace. CRST findings help to identify tobacco and nicotine products that pose the greatest threat to population health.
The goal of this study is to describe the methods of the Rutgers Center for Rapid Surveillance of Tobacco Youth and Young Adult Cohort. Participants completed a multi-phase online screening process with 155 youth (ages 12-17) and 551 young adults (ages 18-25) in six U.S. states (CA, KY, NC, NJ, OH, VT) retained in the Cohort. Quarterly surveys conducted from Fall 2024-Summer 2025 assessed tobacco use behaviors and beliefs. Analyses describe retention and data quality, as well as descriptive findings on ever use, new use, susceptibility, access and sources of tobacco, and tobacco/nicotine brands used. Survey retention between waves ranged from 86 to 90 %. Over nine months, new use of a specific tobacco/nicotine product occurred in 5-11 % of youth and 10-23 % of young adults who had never used that product; trial was greatest for cigars. Susceptibility was lowest among never users for smokeless tobacco and highest for electronic nicotine products (ENP). Most participants under age 21 perceived tobacco or nicotine products to be easy to access (63 %), with few reporting perceived difficulty buying in a store (29 %) or online (10 %). Geek Bar, JUUL, and RAZ were the most popular ENP brands; two write-in brands were reported consistently in VT (Loon) and NJ (Lava), with other write-in brands suggesting regional variation in brand availability. The Cohort complements state and national surveys, with timely findings and assessment of longitudinal patterns of behavior. Flexibility in the survey instrument allows for triangulation of product and brand uptake across the Center's activities.
Changing cigarette sales trends can indicate shifts in tobacco marketing, consumer preferences, and smoker demographics. This study examines trends in US convenience store sales for cigarettes (2016-2024) by brand tier, flavor, and leading brands. Using Nielsen market scanner cigarette data (2016-2024) for US convenience stores, annual market shares and sales trends for each brand tier (premium, value, deep-discount), flavor (menthol, non-menthol), and leading brands were determined. Sales trends were assessed using Joinpoint for average annual percentage changes (AAPCs-primary outcome), with annual percent changes (APCs) describing shorter-term trends. Sales declined from 9.23 to 5.61 billion packs from 2016 to 2024 (AAPC: -5.82% [95% CI: -6.40%, -5.21%]). Premium cigarettes declined more slowly between 2016 and 2021 (APC: -4.22% [95% CI: -5.47%, -1.93%]) than 2021 to 2024 (APC: -10.78% [95% CI: -15.38%, -8.29%]). Value cigarettes declined steadily (AAPC: -7.54%, [95% CI: -8.56%, -6.49%]). Deep-discount cigarettes were the only segment to grow (AAPC: 5.56% [95% CI: 3.81%, 7.39%]) and decrease in price. Non-menthol cigarettes declined steadily (AAPC: -4.97% [95% CI: -5.43%, -4.51%]). Menthol cigarettes declined slowly between 2016 and 2021 (APC: -2.65% [95% CI: -3.90%, -1.29%]) before rapidly declining (2021-2024 APC: -14.83% [95% CI: -16.94%, -12.13%]). Research assessing potential impacts of the growing deep-discount segment on smoking patterns and health disparities, as well as continued monitoring of menthol cigarettes, is needed.
The Youth Tobacco Product Monitoring Project provides timely data on the characteristics of products obtained from youth in the United States (U.S.). This manuscript documents the methodology and findings from the initial two years of collection. Launched in November 2023, as part of the Rutgers Center for Rapid Surveillance of Tobacco, U.S. school staff and community partners voluntarily upload images of products obtained from youth to an online survey. Images are coded for brand and product features. Between November 1, 2023, and September 31, 2025, we received 1535 images of 9589 nicotine products. Most (n = 9503, 99.1 %) were electronic nicotine devices (e-cigarettes), with the majority (n = 8642) disposable e-cigarettes. Other products were nicotine pouches (n = 34, 0.4 %), cigarettes and rolling papers (n = 21, 0.2 %), smokeless tobacco (n = 17, 0.2 %), cigars (n = 9, 0.1 %), and nicotine gum (n = 5, 0.1 %). Over 99 % of products with an identifiable flavor were non-tobacco flavored, most often fruit. Of 404 distinct nicotine brands, the most common were Geek Bar (n = 2014, 24.8 %), Hyde (n = 1206, 14.8 %), and Lost Mary (n = 738, 9.1 %). Nicotine brand popularity differed by school year and state. Monitoring nicotine products confiscated in schools can provide timely insights into product types, flavors, and brands U.S. youth are obtaining.
While bevacizumab may benefit patients with recurrent, platinum-sensitive epithelial ovarian cancer (EOC), its use is inconsistent. In part, this may be due to its cost. To assess whether a lower-cost biosimilar (bevacizumab-awwb) could be cost-effective, we evaluated the cost-effectiveness of bevacizumab-awwb in combination with platinum-based chemotherapy versus chemotherapy alone in this setting. We evaluated the incremental cost-effectiveness of 1) bevacizumab-awwb and 2) brand-name bevacizumab, when used with standard, platinum-based chemotherapy. Lifetime costs and median overall survival were compared to those with chemotherapy alone. Treatment regimens and survival estimates were based on the GOG-0213 trial. Costs were obtained from Centers for Medicare & Medicaid Services data. We assumed brand-name bevacizumab and bevacizumab-awwb, the lowest-price biosimilar, were differentiated by cost only ($74 vs $24 per 10 mg). In threshold analysis, we identified bevacizumab and biosimilar costs that would achieve cost-effectiveness at a willingness-to-pay (WTP) threshold of $150,000 per life-year gained (LYG). Total costs of treatment with platinum-based chemotherapy alone were $198,440; median survival was 3.11 years. Adding brand-name bevacizumab increased total costs and median survival ($362,206, 3.52 years), resulting in an ICER of $399,400/LYG. Substituting bevacizumab-awwb for brand-name bevacizumab reduced total costs and the ICER ($252,512, ICER = $131,900/LYG vs. chemotherapy alone). For bevacizumab (or a biosimilar) to be cost-effective within the above-specified WTP threshold, its price would need to be under $27/10 mg; bevacizumab-awwb is within this range. Bevacizumab has the potential to be cost-effective in treating recurrent, platinum-sensitive EOC, provided its cost is similar to current, lowest-cost biosimilars.
There are reports of oral nicotine pouches (ONPs) being marketed in high-income countries. The aim of this study was to report online promotions and marketing claims about ONPs in Malaysia, which currently does not regulate nicotine pouches. We did a content analysis of ONPs sold on e-stores. We searched the terms: 'Velo', 'Zyn', 'Onz', 'nicotine pouch', and 'oral nicotine pouch' on Google Malaysia, Facebook, Reddit, TikTok, and Instagram during March-April 2024. Three trained coders independently coded the e-stores, using a codebook developed based on previous research. Visual and textual information about brands, prices, discounts, flavors, nicotine strength, and marketing claims, was collected. Results are presented in both descriptive and free text formats. A sample of 41 e-stores was analyzed. ONP marketing was present on TikTok and e-commerce stores. Brands such as 'Velo', 'Zyn', and 'Boltbe' offered discounts, free deliveries, and an array of flavors, with nicotine strengths of 2-50 mg. All brands displayed nicotine strength (mg). Only 51% of the e-stores explicitly stated that the product contained 'nicotine', and 5% disclosed that nicotine is addictive; 41% of the stores displayed ONPs as 'tobacco-free'. About half of the e-stores had marketing claims of 'product appeal' (56%), 'convenient to use anywhere, everywhere' (46%), and 'smoking cessation' (49%). Age verifications and identification proofs were not available at all, whereas health warnings against usage by minors, non-smokers, and pregnant women, were present on only 5%. Online marketing and sales promotions were present on e-commerce websites and some social media platforms. The range of flavors and strengths, sales promotions, marketing claims such as appeal and convenience of use, the lack of nicotine disclaimers, and age verification were noted. Surveillance of ONPs is needed to inform regulatory policy.
The U.S. Food and Drug Administration has authorized 41 electronic nicotine delivery systems (ENDS) that meet its public health standard. This clinical lab study utilized behavioral economic and subjective measures to index the abuse liability of currently authorized ENDS that varied in nicotine flux (i.e., μg nicotine/s) and flavor among adults who smoke cigarettes. Using a Latin square-ordered, within-subject design, adults who smoke cigarettes (n = 30; 20 menthol preferring [MP]) completed four sessions: one with own-brand cigarettes and three with tobacco and menthol flavors of three NJOY-branded ENDS: 2.4% nicotine (58 μg/s flux), 5% nicotine (118-123 μg/s flux), 6% nicotine (61-65 μg/s flux). Outcomes included behavioral economic indices (e.g., price sensitivity) and subjective measures (e.g., product acceptability). Mixed analysis of variance was used to examine the effects of ENDS nicotine flux, flavor, and MP. MP participants were less price sensitive than those who smoked nonmenthol, particularly for menthol-flavored ENDS. Those who smoked nonmenthol were less price sensitive for tobacco-flavored versus menthol-flavored ENDS. MP participants substituted all ENDS for own-brand cigarettes, while those who smoked nonmenthol only substituted with lower flux tobacco-flavored and higher flux menthol-flavored ENDS. Greater positive ratings on some acceptability measures were observed for menthol-flavored than tobacco-flavored ENDS. Those who smoked nonmenthol reported greater aversive ENDS-related sensory effects than MP participants. Menthol flavoring in ENDS increased some abuse liability measures, particularly product acceptability. ENDS abuse liability and substitution potential also varied by MP. Lower flux tobacco and higher flux menthol ENDS may support switching. Findings support further investigation on menthol-flavored, higher flux ENDS for public health benefit. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
This study addresses current gaps in the 3D printing literature for filament composition (polymer type, color, and brand), aerosol emissions, and human health risks. Six metals (aluminum, magnesium, manganese, chromium, iron, and copper) were found in nonmetal filaments depending on polymer type, color, and brand using inductively coupled plasma-mass spectrometry. For copper- and steel-filled filaments, scanning electron microscopy and elemental analysis indicated a higher metal concentration within the filaments than on the surface. More VOCs were emitted from acrylonitrile butadiene styrene (ABS) filaments compared to polylactic acid (PLA) filaments, according to thermal desorption unit samples analyzed by gas chromatography. Styrene, emitted from ABS filaments, appears to pose the greatest potential health risk among known VOCs, given its concentration and reported effects. Toluene and benzaldehyde were emitted in lower concentrations from both ABS and PLA filaments and may pose a potential risk to human health. Based on three inflammatory markers across two exposure times using BEAS-2B epithelial lung cells, steel showed the highest proinflammatory response, possibly due to chromium and overall particulate matter. 3D printer users should minimize aerosolized emissions by taking proper precautions, such as ensuring adequate ventilation and wearing face masks, particularly during extended exposure.
Social media influencers (SMIs) have emerged as vital media entities that shape consumer attitudes and behavior. Followers' buying decisions are influenced by influencer attributes such as authenticity, trustworthiness, and credibility. This study examines how sports influencer characteristics shape Indian Instagram users' attitudes and purchase behavior by integrating the Theory of Planned Behavior (TPB) and congruence theory. Data collected from 1133 respondents were analyzed using partial least squares structural equation modeling (PLS-SEM) in SmartPLS version 4.0. The findings reveal that authenticity and credibility significantly influence parasocial interactions and consumer attitudes (p < 0.001). Follower-influencer congruence also had strong positive effects on parasocial interactions and attitudes, highlighting the importance of value alignment. In contrast, trustworthiness does not significantly influence parasocial interaction, indicating that emotional engagement is driven more by relatability than by cognitive evaluations of trust. Furthermore, parasocial interaction and consumer attitudes serve as significant antecedents to purchase behavior (p < 0.01), highlighting their central role in follower decision-making. The model explains a substantial proportion of the variance in purchase behavior, demonstrating its strong predictive ability. The findings suggest that follower-influencer fit, authenticity, and parasocial interaction are important drivers of purchasing behavior. The findings highlight the interactive nature of influencer marketing, in which influencers, brands, and consumers jointly shape engagement and purchase outcomes. Collaborations with authentic and congruent sports influencers can strengthen consumer attitudes, foster parasocial bonds, and influence purchase behavior, providing practical implications for brands targeting digitally engaged sports consumers.
The tobacco/nicotine retail landscape is continuously evolving. Monitoring product availability is critical to identifying industry response to regulatory action and shifts in consumer behavior and patterns of use. Beginning January 2024, a rapid retail surveillance system was implemented in brick-and-mortar retailers across six U.S. sentinel sites (California, Kentucky, New Jersey, North Carolina, Ohio, Vermont) with diverse policy environments and tobacco use patterns. At each site, biannual audits were conducted in approximately 60 retailers. Between January 2024 and May 2025, audits were staggered across months and used a standardized Qualtrics-based tool to document tobacco/nicotine product availability, including flavors, brands, and novel products. Nicotine pouch availability increased from 71.6 % to 81.3 % across waves. Cigarillos and cigarettes remained consistently available in 90 % of retailers, while e-cigarettes were found in ∼75 %. Flavored products were available across categories. The number of unique nicotine pouch brands increased over time, with variation by retailer type and site. Rapid surveillance enables timely detection of market trends and potential policy non-compliance. Continued data collection and integration with other surveillance tools will enhance tobacco control monitoring.
The literature does not have any sustainable high-performance thin-layer chromatographic (HPTLC) methods for concurrently identifying tenofovir (TEN) and emtricitabine (ECT). Therefore, the proposed study develops and verifies a sustainable reverse-phase HPTLC methodology for determining TEN and ECT concurrently in their fixed-dose combination (FDC) products. The wavelength at which TEN and ECT were simultaneously identified was 255 nm. A 70:30 v/v binary mixture of ethanol and water served as the green development system. The method was validated for accuracy, precision, robustness, sensitivity, and specificity according to ICH guidelines. The validated method was applied for the simultaneous determination of TEN and ECT in commercial FDC tablets. The method's greenness, blueness, and whiteness profiles were evaluated using eight different tools: "the analytical eco-scale (AES), chloroform toxicity (ChlorTox), analytical GREEnness (AGREE), modified green analytical procedure index (MoGAPI), complex MoGAPI, blue applicability grade index (BAGI), carbon footprint reduction index (CaFRI), and click analytical chemistry index (CACI)". For both medications, the devised technique was linear in the range of 25-1000 ng/band. In addition, the created approach was proven to be accurate (% recoveries = 99.12-100.70 for TEN and 100.57-101.83 for ECT), precise (% RSD = 0.85-0.99 for TEN and 0.88-0.97 for ECT), sensitive (LOD = 8.50 ng/band for TEN and 8.39 ng/band for ECT, LOQ = 25.51 ng/band for TEN and 25.19 ng/band for ECT), and robust (% RSD = 0.82-0.86 for TEN and 0.94-0.99 for ECT). Using the current method, the amount of TEN in commercial FDC tablet brands A and B was 98.58 ± 1.21% and 101.13 ± 1.30%, respectively. The amount of ECT in FDC brands A and B was 99.82 ± 1.29 and 100.64 ± 1.37%, respectively. The findings of all the greenness, blueness, and whitening tools, such as AES (93), ChlorTox (0.72 g), AGREE (0.77), MoGAPI (85), complex MoGAPI (90), BAGI (85), CaFRI (89), and CACI (87), demonstrated that the current method had the notably sustainable profiles. The greenness parameters of present method were better than reported HPTLC approaches. The findings of the study suggested that the recommended method may be applied to precisely evaluate TEN and ECT in commercial formulations.
To improve understanding about measurement of smokeless tobacco and nicotine products, we conducted a survey experiment to investigate the effect of question order on calculated prevalence of use. We embedded a split sample experiment within the May 2025 Rutgers Omnibus Study; 1891 US adults aged 18-45 were recruited from Amazon MTurk for an online survey about health behaviors, randomized to answer questions about nicotine pouches before smokeless tobacco or vice versa. We compared prevalence by experimental condition using chi-square tests, with alpha = 0.05. Prevalence of ever smokeless tobacco use was significantly higher among those who received the smokeless tobacco questions first (21.5 % vs 16.4 %, p = .005); however, there was only a small and non-significant difference in prevalence of ever nicotine pouch use (15.5 % vs 17.6 %, p = .23). Those who saw smokeless tobacco questions first were also more likely to name a nicotine pouch brand as their regular brand, suggesting that the smokeless tobacco prevalence in this group was overestimated. Nicotine pouch use may be misreported as SLT use on surveys that assess smokeless tobacco first. Consequently, efforts to monitor prevalence of smokeless tobacco use as nicotine pouches gain popularity may be undermined by measurement error.
Reported adverse events (AEs) to the Food and Drug Administration Adverse Event Reporting System (FAERS) have suggested an increased rate of serious AEs (SAEs) during the COVID-19 pandemic, but the extent to which this may be related to overall changes in reporting during this time period is uncertain. Accordingly, we aimed to evaluate trends in SAE reporting across commercially available ultrasound enhancing agent (UEA) brands as a function of overall trends in AE reporting. We retrospectively analyzed the FAERS public database, 2014-2024, to evaluate risks of UEAs overall and by brand, compared to similar contrast media. Between 2014 and 2024, 21,960,760 AEs were reported to FAERS, of which 11,450,891 (52.1%) were categorized as SAEs. Overall SAE reports to FAERS increased from 678,953 in 2014 to 1,368,393 in 2021 before subsequently declining to 1,065,845 in 2024 (-7.9% change from 2021 to 2024). During the same period, overall death reports to FAERS increased from 124,055 in 2014 to 195,207 in 2018 before declining to 147,046 in 2024. During this period of decline, there was a 23.9% relative increase in SAEs to UEAs which peaked in 2023 at 350 before declining to 326 in 2024. Deaths attributed to SAEs increased from 1 in 2014 to 19 in 2023 before declining to 9 in 2024. Overall, these data suggest that 11.2% of the observed increase in SAEs to UEAs can be attributed to reporting changes. Despite changes in relative risks for SAEs, absolute SAE rates remained small and lower than other types of contrast media. In this analysis of the FAERS dataset, 2014-2024, 11.2% of SAEs to UEAs were attributable to temporal changes in AE reporting. Absolute risks are small and declining, suggesting broad safety of UEAs as a class. Collectively, these results support continued use of UEAs, but motivate improved safety screening and preparedness to mitigate small but existing risks.
The Venus flytrap (Dionaea muscipula Ellis) is a carnivorous plant that captures invertebrates using an electrically excitable trap mechanism. Invertebrates stimulate trigger hairs, initiating action potentials (APs) that drive rapid closure. Trap lobes are electrically isolated from one another by non-excitable petioles. We examined thermal wounding to leaf petiole's ability to produce detectable electrical activity in the isolated trap and if wounding stimulation is sufficient to trigger closure. Using a within-subject design across 15 mature plants, we compared trap-recorded electrical signals following trigger hair (TH) stimulation and petiole branding with a heated soldering iron. Primary spike morphology did not differ significantly between treatment groups for either Spike/Baseline Ratio or Depolarization Fraction. Within-Brands primary-to-secondary Spike/Baseline Ratios differed significantly consistent with non-regenerative signal attenuation rather than canonical AP propagation from the petiole. Differences are consistent with thermal petiole wounding disrupting xylem continuity and generating a hydraulic pressure transient that initiates trap-derived APs through the trap's own excitation machinery. The trap's closure threshold is accessible via sufficiently large, likely non-electrical, systemic perturbation.