Irritant and allergic contact dermatitis (ACD) caused by sunscreens may affect patient adherence and photoprotection. We aimed to compare the presence of inactive allergens from the North American 80 Comprehensive Series (NAC-80) across top-selling sunscreens. We conducted a cross-sectional analysis of inactive ingredient lists from all reported best-selling sunscreens from the three largest American online retailers: Amazon.com, Target.com and Walmart.com. Using a custom text-matching algorithm and manual review, we identified NAC-80 allergens and quantified allergen counts per product. We compared inactive allergen load in tinted versus non-tinted, organic versus inorganic ultraviolet (UV) filters, vehicle and various marketed features in sunscreens. We reviewed 176 products. Vitamin E was the most common allergen, followed by acrylate-containing copolymers/crosspolymers, fragrance, and parabens. Organic, spray and sport sunscreens had significantly more allergens than inorganic, stick and non-sport sunscreens, respectively. Tinted and face sunscreens had significantly fewer allergens than non-tinted and body sunscreens. Allergen content in inactive ingredients varies among best-selling sunscreens, potentially affecting their safety and tolerability. Dermatologists should consider the allergenic potential of not only active but also inactive ingredients of sunscreens when counselling patients.
Drugs represent unique commodities whose value is determined not only by their therapeutic efficacy but also by their commercial performance. This perspective presents an analysis of the top 20 small-molecule neurology drugs with the highest global retail sales in 2024. These medications not only provide therapeutic benefits to patients and improve their life quality but also generate significant revenue for the pharmaceutical companies that have invested in their development. We examine each drug's approved indications, sales performance, and the factors that contribute to their excellence in the field of neurology. Furthermore, from a medicinal chemistry perspective, key aspects of their design or origins, pharmacology, and synthesis are presented, aiming to offer a comprehensive understanding of the discovery and commercial successes of these blockbuster drugs, thereby fostering the development of more novel therapeutic treatments for neurological disorders.
Currently, no standardized quantitative criteria have been established globally for regulating heavy metals (HMs) in cigarettes. The basic levels of arsenic (As), cadmium (Cd), and lead (Pb) were quantified in 15 best-selling cigarette brands in middle China, and the distribution pattern of HMs was investigated. A human respiratory tract model was introduced to estimate particulate deposition rates and regional respiratory deposition doses. Simulated lung fluid experiments were conducted to simulate HM bioaccessibility, and an improved health risk model incorporating regional exposure parameters and triangular fuzzy number was finally developed. The mean (range) concentrations of Cd, As, and Pb were 1.95 (0.62-2.81), 1.33 (0.17-2.88), and 1.13 (0.41-1.65) mg/kg, respectively. After fuzzification, deposition rates were [27.5%, 29.2%] for PM2.5 and [28.5%, 30.5%] for PM5. Bioaccessibility was ranked as Pb (11.4%) > Cd (3.93%) > As (3.91%) in mainstream smoke, and Cd (49.1%, 56.0 mg/kg) > As (36.2%, 41.5 mg/kg) > Pb (20.5%, 165 mg/kg) in environmental smoke. Carcinogenic risk was evaluated as Cd (II-V) > As (II-IV) > Pb (very low), and Cd and As were identified as priority control HMs. Based on tobacco-related mortality rates, a Class II risk threshold (1.00E-05) was adopted as the control criterion. Inverse exposure modeling indicated that the acceptable daily intake was 4-6 cigarettes for thick and menthol cigarettes and 5-7 for slim cigarettes. For daily smokers, the daily smoking level should first be controlled within the limit corresponding to a 1.00E-05 risk threshold, and then gradually transition to a 1.00E-06 risk threshold.
Knowledge of the high-sale medicinal plants and their authentication are essential parameters to ensure the safety of people using herbal medicine and to plan the safeguarding of medicinal species threatened with extinction. The present study, carried out in Lubumbashi, Democratic Republic of Congo, aimed to geolocate medicinal plant sales points, list the best-selling species, and authenticate samples of the most popular species on the market. A survey was conducted among the medicinal plant sellers in Lubumbashi's markets and other public spaces, to identify the best-selling species. Samples of the species reported as the most sold were purchased for sales unit weight measurement, and authentication. For the 3 most popular plant species, the identity of 92 samples, purchased from some 25 herbalists, was assessed by combining the microscopic characteristics of powdered drugs with the HPTLC fingerprints of methanolic extracts; for each species, these samples were compared with 1 or 2 botanically authenticated reference samples. As abundant starch granules were detected by microscopy, some samples were suspected of heavy flour contamination, which was confirmed by an enzymatic determination of their starch content. A total of 108 herbalists (48.1 % women) with a median age of 37 years (range, 20-67 years), and a median seniority of 5 years (0.7-30) were interviewed. From a total of 514 purchased samples, 396 (77.0 %) corresponded to 56 species that could be identified, including 92 samples representing the 3 most frequently sold plant species. The identities of 118 samples (having 82 different vernacular names), could not be determined, due to the lack of voucher specimen. Roots were the most sold organ (56.0 %; n = 514), mainly in powder form (78.7 %), and the median price was 21 USD/kg, at the time of the survey (January to May 2021). The identified specimens were, predominantly, the roots of Terminalia mollis M.A.Lawson (33.3 %), Securidaca longepedunculata Fresen (28.7 %), and stem barks of Nauclea pobeguinii Hua ex Pobég. (23.1 %); from the recorded sales figures, the amounts of material annually sold for these 3 species are estimated at about 5.7, 6.0, and 3.1 tons, respectively. Some sellers reported problems in identifying and/or preserving S. longepedonculata and T. mollis. Among the 92 samples analyzed for the three species, 18.5 % raised problems, including species substitutions (14/17), dilution with flour (1/17), dilution with flour and species substitution (1/17), and detection of a phytochemical variant (1/17), that could arise either from contamination by another species, a particular plant growth environment, or poor storage conditions. The confusion/adulteration rate measured here for highly popular species is quite alarming (18.5 %); but, indeed, roots, especially as powders, are often difficult to differentiate based on the coarse organoleptic examination practiced by herbal traders. Microscopic and phytochemical characteristics reported in this study, quite easy to obtain with basic laboratory equipment, should be systematically applied by the health products regulatory authorities to control the quality of herbals and ensure that patients get the drug desired for their treatment.
Personal lubricants vary appreciably in ingredient composition. Although some products are labeled hypoallergenic, these claims are seldom evidence-based. The objective was to determine the potential allergenicity of popular lubricants and elucidate the validity of hypoallergenic product claims. This cross-sectional study involved publicly available data on Amazon's 50 best-selling lubricants as of July 2023. Product ingredient lists were cross-referenced with the North American Contact Dermatitis Group and American Contact Dermatitis Society allergen series. Associations were explored between lubricant price per ounce, average customer rating, number of customer reviews, hypoallergenic claim, lubricant base, and allergen quantity using descriptive statistics, Kruskal-Wallis tests, Wilcoxon tests, ?2 tests, and Spearman correlation analyses. Of all studied, 30% (n=15) of products were allergen-free. Nine personal lubricants (18%) were advertised as hypoallergenic, 5 of which were among the 15 products without allergens. Hypoallergenic products were less likely to contain allergens than lubricants without this claim (P=0.03). Silicone-based lubricants contained fewer allergens than water-based lubricants (P<0.01) but were more expensive (P=0.01). Understanding potential allergenicity of personal lubricants should inform clinicians' product recommendations and differential diagnosis of anogenital contact dermatitis. Silicone-based lubricants labeled as hypoallergenic may be the safest option for sensitive skin but are not guaranteed to be allergen-free.
With rising obesity rates in Western societies, analyzing changes in dietary patterns is paramount. While nutritional surveys have been informative, traditional cookbooks have historically shed light on national cuisines and its changes. Despite the growing popularity of online platforms for food information, cookbooks might still reflect prevalent dietary trends and the diets people follow. This study examined (1) the changes in nutritional content and food group usage in the best-selling cookbooks from 2008 to 2018, and (2) the correlation between the food groups in these cookbooks and dietary patterns (inferred from household purchases) over the same timeframe. An exploratory ecological study was conducted on 20 main course recipes of each of the five best-selling cookbooks in Flanders annually between 2008 and 2018. Trends in macronutrients and food group usage in these recipes were analyzed using generalized linear models. Additionally, these trends were compared to household purchase data in Flanders using correlation matrices. Our results reveal a rising trend towards the use of plant-based ingredients and meat alternatives in cookbooks over the period 2008-2018. There was an increase in the usage of vegetables, nuts & seeds, and cheese. Conversely, there was a decline in the usage of meat, sugar & sweeteners, alcohol, and dairy (all p-values < 0.05). In terms of macronutrient content, there was an upswing in carbohydrate, fibre, and sugar levels, while the total fat content showed a decrease (all p-values < 0.05). The levels of protein and saturated fat remained consistent over time. Notably, shifts in plant-based and animal-based food group preferences in popular cookbook recipes align with the trends seen in actual household purchases of these food groups (all p-values < 0.05). These findings indicate that cookbook content evolves over time, potentially reflecting shifts in population dietary patterns. Future research is needed to determine (Buisman ME, Jonkman J. Dietary trends from 1950 to 2010: a Dutch cookbook analysis. J Nutr Sci [Internet]. 2019 ed [cited 2022 Apr 19];8. https://www.cambridge.org/core/journals/journal-of-nutritional-science/article/dietary-trends-from-1950-to-2010-a-dutch-cookbook-analysis/AB281ADE0F09FF8F518B8AC4A2A5BEA8#supplementary-materials ) any causative link between cookbooks and dietary habits, and (Ashwell M, Barlow S, Gibson S, Harris C. National Diet and Nutrition Surveys: the British experience. Public Health Nutr. 2006;9(4):523-30.) the potential for cookbooks to aid in health promotion.
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Many baby cleansers are promoted as hypoallergic products; however, these claims are not typically validated. This study assessed the 50 best-selling baby cleansers from online retailer Amazon for potential allergens. We found that the presence of most marketing claims, including "hypoallergenic" or "allergy-tested," did not correlate with the number of potential allergens in a cleanser. Furthermore, the total number of marketing claims of a cleanser was positively correlated with the number of allergens, highlighting the discordance between marketing claims and allergen content in baby cleansers.
are that the contents of this article are their own original unpublished findings. Title: Comparison of potential contact allergens in best-selling adult and baby cleansers Authors: Jayden Galamgam1 MD, Sasan D Noveir2 BA, Carol E Cheng1 MD Affiliations: 1Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA, 2 David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA Corresponding Author: Jayden Galamgam MD, Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, Email: jgalamgam@mednet.ucla.edu.
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This study evaluates the performance of six large language models (LLMs) in generating content relevant to oral and maxillofacial surgery (OMFS), focusing on their ability to provide accurate, comprehensive, and relevant information across five specific tasks. Each LLM was assessed based on its responses to five prompts: (1) postoperative instructions for third molar surgery; (2) a list of best-selling books on orthognathic surgery; (3) the most cited articles in OMFS; (4) novel ideas for systematic reviews; and (5) emerging trends in OMFS. Responses were scored for relevance, comprehensiveness, and accuracy using predefined criteria. Statistical analysis was performed using the Kruskal-Wallis test to compare tool performance. The LLMs performed similarly overall, with varying strengths and weaknesses. For postoperative instructions, they all provided comparable recommendations, though Perplexity underperformed. In identifying best-selling books, Gemini and Perplexity excelled, while ChatGPT and Copilot struggled with retrieving highly cited articles. Copilot and Claude were more effective in suggesting novel systematic review topics, while ChatGPT, Claude, Copilot, and DeepSeek identified emerging trends most accurately. LLMs demonstrate significant potential in supporting OMFS-related tasks, but their performance varies depending on the specific application. While they excel at synthesising existing information and identifying trends, limitations in accuracy and occasional hallucinations highlight the need for human oversight. These findings underscore the importance of integrating artificial intelligence (AI) as a supplementary tool in clinical, academic, and research settings, ensuring its use complements, rather than replaces, human expertise.
The popularity of over-the-counter (OTC) supplements has led to their increased utilization among patients for kidney stone management.9,11 However, a more thorough understanding of the ingredients in OTC supplements marketed to treat nephrolithiasis is needed. These supplements are often bought online, given the substantial increase in online information and shopping in the past decade. Therefore, it is also important to evaluate public interest and the reliability of online information for these purportedly antilithogenic ingredients. The best-selling supplements marketed to treat kidney stones on Amazon.com were compiled to identify the most common ingredients. A literature review was completed to assess clinical support for common ingredients. BuzzSumo software was used to quantify online engagement with articles on each ingredient, as well as the overall topic of alternative treatments for kidney stones. Articles were evaluated for reliability using the DISCERN tool. Ion chromatography coupled with mass spectrometry was used to assess oxalate content in the most commonly found ingredients in OTC kidney stone supplements. Evidence for stone prevention for the most common supplement ingredients was limited or lacking altogether, based on literature review. Public interest in supplement ingredients was between 2-fold and 10-fold greater than potassium citrate, a commonly prescribed stone prevention medication. Online articles for all ingredients showed poor reliability. Oxalate analysis showed chanca piedra, turmeric, and cinnamon contained 8.2, 8.6, and 14.0 mg oxalate per dose. These findings suggest that patients and providers should exercise caution while using OTC supplements for stone management, and that additional investigations of the composition and clinical efficacy of these ingredients are needed.
Enhancing brand value is critical for new energy vehicle (NEV) enterprises amid fierce competition. This study leverages online consumer reviews as core big data to drive brand equity improvement via advanced big data analytics. A large-scale dataset of 5564 reviews for top five best-selling NEVs was collected from "Dongche Di" via web scraping, followed by a big data processing pipeline (data cleaning, Jieba segmentation, and stop-word filtering). To mine unstructured text big data, we used word cloud visualization, semantic network analysis, and an Latent Dirichlet Allocation (LDA)-Long Short-Term Memory (LSTM) fusion model: LDA identified key consumer concern dimensions, while LSTM enabled deep sentiment classification. Big data analysis revealed five core NEV brand perception dimensions (range, driving experience, interior space, price, and high-speed performance) and quantified emotions-prominent negativity in driving experience, minimal negativity in interior space, and overall dominant negativity. Guided by the Consumer-Based Brand Equity model, we proposed brand enhancement strategies. This study showcases big data analytics' power in scaling consumer perception understanding, offering a data-centric framework for NEV firms to optimize branding.
The liver supplement market is rapidly expanding, yet the efficacy and safety of these products remain largely unsubstantiated. The aim of this study was to analyze the best-selling liver "cleansing" supplements on Amazon, the leading online retailer in the United States. We identified the top 20 liver cleanse supplements on Amazon using specific search criteria. Product composition, marketing claims, customer reviews, sales data, and revenue were analyzed. AMZScout was used for sales analytics and FakeSpot for review authenticity assessment. The most common ingredients were identified, and their scientific evidence evaluated through structured PubMed searches with predefined criteria for evidence quality assessment. The 20 top-selling supplements generated total annual sales of 1,420,584 units with a revenue of $38,783,937. All products claimed to "eliminate toxins" or provide "liver detox/cleanse," whereas 85% claimed to "enhance liver function." The average product rating was 4.4 of 5 stars, with review reliability averaging 73% ± 20%. Milk thistle was the most common ingredient (19/20 products), followed by dandelion and turmeric root (13/20 each). Scientific evidence supporting these ingredients' efficacy in liver health was limited and inconclusive. This study reveals a thriving market for liver supplements, despite limited scientific evidence supporting their efficacy. The prevalence of bold health claims, high consumer satisfaction, and significant sales highlight the need for more rigorous evaluation and regulation of these products. Healthcare providers should be aware of these trends to better counsel patients on evidence-based approaches to liver health.
Monoclonal antibodies (mAbs) are increasingly being launched on the German market and account for a growing share of total drug costs every year. In 2021 alone, eleven monoclonal antibodies were among the 30 best-selling drugs, accounting for 9.91% of total drug costs. In contrast, a considerable additional benefit of the newly introduced monoclonal antibodies is not predominantly demonstrable. Therefore, our objective was to analyze the drug prescriptions and associated costs in comparison to the benefit assessment of the Federal Joint Committee (GBA). This paper analyzes 62 monoclonal antibodies that were approved by the European Medicines Agency in the period from 2010 to 2021 and newly launched on the German market. The data basis is provided by the Drug Prescription Report (AVR) and the Statutory Health Insurance (SHI) Drug Index for outpatients. The SHI index is compiled by the Wissenschaftliches Institut der AOK (WIdO). The GBA provides a further data basis for the assessment of additional benefits. The relevant parameters used for each drug include the number of prescriptions, net costs, defined daily doses (DDD) and costs of the defined daily doses (DDD costs) at the time of the year of approval and as of 2021. There is only a slight correlation between the number of DDDs, prescriptions and net costs of the respective drug and the additional benefit assessed by the GBA. There is a certain correlation between the advertisements in the journal "Oncology Research and Treatment" and the drug benefit. In summary, the high costs of monoclonal antibodies cannot be justified by the additional benefit assessed by the GBA, as no overriding significant additional benefit can be proven for the drugs analyzed. More precise regulation of drugs with little or no additional benefit, as well as regulation of the price of drugs with considerable additional benefit, is crucial to ensure a better balance between costs and benefits.
Media coverage of celebrity suicides can shape population-level suicidal behavior, yet most existing evidence focuses on mortality rather than non-fatal attempts. This study investigates the impact of media coverage following the suicide of Chiung Yao, an 86-year-old best-selling novelist and cultural figure in Chinese-speaking societies, on suicide mortality and suicide attempts in Taiwan. We drew on suicide attempt data from Taiwan's National Suicide Surveillance System and mortality data from the Taiwan Death Registry. Using an interrupted time-series design with quasi-Poisson regression, we analyzed seven-day rolling counts of suicide attempts and deaths during the four weeks before and after her death (December 4th, 2024), stratified by sex, age group, and suicide method. No significant overall changes in suicide attempts or mortality were observed. However, suicide attempts increased by 12.3 % among women aged 45-64 (IRR = 1.123; 95 % CI: 1.030-1.225), with a slight increase of the post-death trend among women aged 25-44. Suicide deaths by charcoal burning, the method used by the celebrity, increased by 47.0 % (IRR = 1.470; 95 % CI: 1.195-1.807), and mortality among men aged 25-44 and ≥65 rose by 35.5 % (IRR = 1.355; 95 % CI: 1.095-1.679) and 20.7 % (IRR = 1.207; 95 % CI: 0.992-1.468), respectively. Media coverage of the suicide of an older celebrity was not associated with population-level increases in suicide, but associated with method- and subgroup-specific changes in suicide attempts and mortality. These findings highlight the importance of monitoring media practices with attention to differential vulnerability following highly publicized suicides.
Background/Objectives: Mental diseases are one of the leading groups of health disorders worldwide, with depressive and anxiety disorders being the most prevalent. Depressive disorders can be treated with pharmacotherapy, psychotherapy, or a combination of both. In cases where these approaches prove ineffective, electroconvulsive therapy may be considered as an alternative. The drugs of choice for treating depressive disorders are selective serotonin reuptake inhibitors (SSRIs). In the Republic of Serbia, commonly prescribed SSRIs include fluoxetine, citalopram, paroxetine, sertraline, and escitalopram. Methods: Data on drug sales for human medicine from the Agency for Medicines and Medical Devices of Serbia (ALIMS) were used for the analysis of consumption in the period 2018-2022. Data on drug consumption in other European countries were obtained from the respective national registers. Results: From 2018 to 2021, sertraline was the best-selling drug in this group, but with a statistically significant decrease (R2 = 0.7948, p = 0.042), while escitalopram showed a statistically significant increase (p = 0.006) and became the best-selling drug in the SSRI group in 2022. Overall, SSRI group consumption fluctuated from 2018 to 2022, with the highest values in 2020. However, these variations were not statistically significant (p = 0.6223). Compared to Serbia, out of 12 European countries, 8 had higher and 4 had lower consumption in 2019 and 2020. A positive correlation was found between antidepressant consumption and GDP per capita. Conclusions: Sertraline was the most commonly prescribed SSRI drug in Serbia from 2018 to 2021. However, in 2022, escitalopram became the most commonly used drug in this group both in Serbia and worldwide, with a consistent increase in consumption.
Background: Tinted sunscreens are gaining popularity among skin of color populations due to their protection against visible light-induced hyperpigmentation and elimination of the white cast. Despite growing use, little is known about their allergenicity or the reliability of safety-oriented marketing claims.Objective: To assess the relationship between allergen content, active ingredients, marketing claims, and price in top-rated, best-selling tinted sunscreens.Methods: We conducted an analysis of 49 tinted sunscreens from 3 major online retailers. Products were evaluated for allergens listed in the 2020 American Contact Dermatitis Society Core Allergen Series, presence of marketing claims, UV filters, and price per ounce.Results: Ninety-eight percent of products contained at least 1 allergen (mean 3.1). The average price per ounce was $18.95. Products with multiple shade options were more expensive ($22.92 vs $16.65/oz; P = 0.04), while "nano-particle free" products were less expensive ($14.26 vs $20.83/oz; P = 0.04). Marketing claims were abundant (mean 11.7). "Fragrance free," "cruelty free," "reef friendly," and "nano-particle free" claims were associated with fewer allergens (P < 0.05). Octisalate and octinoxate correlated with more allergens; zinc oxide with fewer (P < 0.05).Conclusions: Tinted sunscreens frequently contain allergens despite safety-related marketing claims. Clinicians should guide product selection based on allergenic potential, active ingredients, and cost.
Colds are the most common cause of incapacity to work in 2023 and therefore have a significant impact on the German economy. Echinacea preparations are considered a non-specific immune stimulant that is used as a phytotherapeutic agent for the treatment and prevention of colds. In the 2021 ZEIT ranking of the best-selling pharmacy-only medicines in Germany, four Echinacea preparations were among the top ten, and they experienced a new hype during the SARS-CoV-2 pandemic. In this study, 22 Echinacea monopreparations, which are approved as herbal medicinal products, were analyzed based on their package inserts. The preparations used in clinical studies were compared with the preparations available on the market with regard to the criteria of plant species used, plant part used, preparation (extract or pressed juice), drug-extract ratio, single dose administered, standardization of the preparations, prior performance of an ingredient analysis, galenics, dosage, duration of administration, and daily dose administered. The analysis revealed that the preparations available on the market are very heterogeneous. The composition can vary considerably in terms of ingredients. For customers, these products appear homogeneous in terms of their presentation on the market. The legal framework conditions promote this situation. The clinical studies are also unable to adequately reflect the market situation. New studies based on market reality, with an analysis of ingredients in the preparations used, a standardized study design, and the inclusion of hematological and biochemical parameters in the evaluation should improve this situation. Days of incapacity for work as an outcome parameter could be well suited.
This article stemmed from an acceptance speech for the Global Alliances' 2022 Presidential Award made by Dr. Gail Christopher and her daughter, Heather McGhee. Heather McGhee is a New York Times best-selling author of the book The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together. The history, transformative impact, and importance of the truth, racial healing, and transformation movement in exposing and eradicating the fallacy of a hierarchy of human value are outlined. Dr. Christopher shares insights into the past and provides hope for the future through her Rx Racial Healing model for authentic storytelling and changes in perspective. The article also discusses the momentum of public health jurisdictions declaring racism as a public health crisis and presents a resource, Healing Through Policy: Creating Pathways to Racial Justice, that has been developed to assist jurisdictions in related work. (PsycInfo Database Record (c) 2025 APA, all rights reserved).