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Chroho M, Bailly C, Bouissane L. Ethnobotanical Uses and Pharmacological Activities of Moroccan Ephedra Species. PLANTA MEDICA 2024; 90:336-352. [PMID: 38423032 DOI: 10.1055/a-2269-2113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Ephedra species are among the most popular herbs used in traditional medicine for a long time. The ancient Chinese medical book "Treatise on Febrile Diseases" refers to the classic traditional Chinese medicine prescription Ge Gen decoction, which consists of seven herbs, including an Ephedra species. Ephedra species are utilized all over the world to treat symptoms of the common cold and coughs, and to combat major human diseases, such as asthma, cancers, diabetes, cardiovascular and digestive disorders, and microbial infections. This study aimed at identifying specific Ephedra species used traditionally in Morocco for therapeutic purposes. The plant parts, their preparation process, and the treated pathologies were identified and analyzed. The results revealed five ethnobotanically important species of Ephedra: Ephedra alata Decne, Ephedra altissima Desf., Ephedra distachya L., Ephedra fragilis Desf., and Ephedra nebrodensis Tineo. These species are used traditionally in Morocco for treating people with diabetes, cancer, rheumatism, cold and asthma, hypertension, influenza virus infection, and respiratory ailments. In addition, they are occasionally used as calefacient agents, to regulate weight, or for capillary care. Few studies have underlined the antibacterial and antioxidant activities of some of these Moroccan Ephedra species, but little information is available regarding the natural products at the origin of the bioactivities. Further phytochemical investigations and clinical data are encouraged to better support the use of these plants.
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Affiliation(s)
- Mounia Chroho
- Molecular Chemistry, Materials and Catalysis Laboratory, Faculty of Sciences and Technologies, Sultan Moulay Slimane University, Beni-Mellal, Morocco
| | - Christian Bailly
- OncoWitan, Scientific Consulting Office, Lille, France
- Institute of Pharmaceutical Chemistry Albert Lespagnol, Faculty of Pharmacy, University of Lille, France
| | - Latifa Bouissane
- Molecular Chemistry, Materials and Catalysis Laboratory, Faculty of Sciences and Technologies, Sultan Moulay Slimane University, Beni-Mellal, Morocco
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Arnocky S, Brennan H, Denomme B, Davis AC. Female intrasexual competitiveness interacts with body mass index to predict willingness to use a risky diet pill. Front Psychol 2023; 14:1167115. [PMID: 37325770 PMCID: PMC10267438 DOI: 10.3389/fpsyg.2023.1167115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/11/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Previous research has highlighted the putative role of intrasexual competition (IC) in predicting women's body dissatisfaction, weight loss effort, and, at its extreme, eating disorders. However, extant research reporting on these links is limited by its exclusion of potential confounds, including psychopathologies such as depression. Moreover, it is presently unclear whether women higher in body mass index (BMI) may be more prone to the influence of IC in taking dieting risks. Methods To address these gaps in the literature, 189 young adult women completed measures of IC, depressive symptoms, willingness to use a risky diet pill, and had their height and weight measured. Results Results showed that IC interacted with BMI to predict willingness to use a risky diet pill, such that women high in both IC and BMI were most likely to take the risky diet pill. Further exploratory analyses considering potential directional links between BMI and depression supported mediating roles of depression (from BMI) and BMI (from depression) in predicting willingness to use a risky diet pill. Discussion Results suggest that links between IC and dieting risks may be moderated by women's BMI, and that these links hold when considering depressive symptoms. Future longitudinal research would benefit from a better understanding of the potential directional links between BMI, depression, and diet pill use.
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Affiliation(s)
- Steven Arnocky
- Department of Psychology, Nipissing University, North Bay, ON, Canada
| | - Hillary Brennan
- Department of Psychology, Nipissing University, North Bay, ON, Canada
| | - Brittany Denomme
- Department of Psychology, Nipissing University, North Bay, ON, Canada
| | - Adam C. Davis
- Department of Social Sciences, School of Access, Language, and Preparatory Studies, Canadore College, North Bay, ON, Canada
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Austin SB, Beccia AL, Raffoul A, Jackson DA, Sarda V, Hart JE, Chavarro JE, Rich-Edwards J. Financial precarity, food insecurity, and psychological distress prospectively linked with use of potentially dangerous dietary supplements during the pandemic in the US. Front Public Health 2023; 11:1120942. [PMID: 36935695 PMCID: PMC10018192 DOI: 10.3389/fpubh.2023.1120942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Supplements sold with claims to promote weight loss, cleansing/detoxing, increased energy, or boosted immunity can be dangerous, and consumers experiencing extreme stressors may be especially vulnerable to deceptive claims. The purpose of our study was to investigate associations of financial strain and psychological distress during the COVID-19 pandemic with use of supplements sold for weight loss, cleanse/detox, energy, or immunity. Methods We used repeated-measures data gathered over five survey waves from April/May 2020-April 2021 from the COVID-19 Substudy (N = 54,951), within three prospective US national cohorts (Nurses' Health Study 2, Nurses' Health Study 3, and Growing Up Today Study), to investigate longitudinal associations between financial strain and psychological distress and risk of use of potentially dangerous types of supplements. Surveys assessed use of supplements prior to and during the first year of the pandemic, as well as financial precarity, food insecurity, depressive and anxiety symptoms, perceived stress, and daily hassles. We fit sociodemographic-adjusted modified Poisson GEE models to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for associations between baseline or lagged time-varying predictors and prevalent or incident (i.e., new-onset) use of each supplement type. Results At baseline in April/May 2020, soon after pandemic onset, current use of supplement types was: weight loss 2.7%; cleanse/detox 3.2%; energy 4.4%; immune 22.6%. By the end of the study period, cumulative incidence was: weight loss 3.5%; cleanse/detox 3.7%; energy 4.5%; immune 21.3%. In prevalent-use analyses, financial precarity, food insecurity, and psychological distress were associated with up to 2.4 times the risk of use of these types of supplements across the study period. Similarly, in incident-use analyses, financial precarity and psychological distress were associated with up to 2.1 times the risk of initiating use; whereas, high food insecurity was associated with nearly 1.8 times higher risk of onset of weight-loss supplements use but was not associated with onset of use of other types of supplements. Discussion We found consistent evidence that during the first year of the pandemic, participants experiencing elevated financial strain and psychological distress were at heightened risk of initiating use of potentially dangerous types of supplements. Our findings raise concerns about deceptive claims about the safety and product effectiveness by manufacturers of these supplements to profit from vulnerable consumers during the pandemic.
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Affiliation(s)
- S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Ariel L. Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Destiny A. Jackson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Jorge E. Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Janet Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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de Jonge MLL, Kieviet LC, Sierts M, Egberink LB, van der Heyden MAG. Review of Case Reports on Adverse Events Related to Pre-workout Supplements Containing Synephrine. Cardiovasc Toxicol 2023; 23:1-9. [PMID: 36639595 PMCID: PMC9859859 DOI: 10.1007/s12012-022-09777-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023]
Abstract
The use of pre-workout supplements has become increasingly popular, including the use of supplements containing synephrine. Synephrine might stimulate weight loss and improve sports performance by its proposed adrenergic properties. However, with its increasing popularity, numerous cases of adverse events related to synephrine use have been reported. This study provides a comprehensive overview and analysis of current case reports related to the supplemental use of synephrine. The scientific literature on cases of adverse events related to synephrine intake was collected through August 2021 using Pubmed and Google Scholar and subsequently reviewed and analysed. We obtained 30 case reports describing a total of 35 patients who suffered from medical complaints following use of synephrine-containing supplements. The patients most often presented with chest pain, palpitations, syncope and dizziness. Commonly raised diagnoses were ischaemic heart disease, cardiac arrhythmias and cerebrovascular disease. Five patients were left disabled or remained on medication at last follow-up. We here show an association between the use of pre-workout supplements containing synephrine and adverse events, mainly related to the cardiovascular system. However, we cannot exclude a role of possible confounding factors such as caffeine. Thus, the use of pre-workout supplements containing synephrine may lead to serious adverse health events, and therefore, caution is needed.
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Affiliation(s)
- M L L de Jonge
- Honours Program CRU+, University Medical Center Utrecht, Heidelberglaan 100, 3584 CM, Utrecht, The Netherlands
| | - L C Kieviet
- Honours Program CRU+, University Medical Center Utrecht, Heidelberglaan 100, 3584 CM, Utrecht, The Netherlands
| | - M Sierts
- Honours Program CRU+, University Medical Center Utrecht, Heidelberglaan 100, 3584 CM, Utrecht, The Netherlands
| | - L B Egberink
- Honours Program CRU+, University Medical Center Utrecht, Heidelberglaan 100, 3584 CM, Utrecht, The Netherlands
| | - M A G van der Heyden
- Division of Heart & Lungs, Department of Medical Physiology, University Medical Center Utrecht, Yalelaan 50, 3584 CM, Utrecht, The Netherlands.
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Differences in the Perception of Dietary Supplements between Dietary Supplement/Medicine Users and Non-Users. Nutrients 2022; 14:nu14194114. [PMID: 36235766 PMCID: PMC9572052 DOI: 10.3390/nu14194114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 12/03/2022] Open
Abstract
Some patients use dietary supplements and medicines concomitantly, with an inappropriate perception of their safety and efficacy. To clarify the perception between dietary supplement and medicine users and non-users, we conducted an internet survey. In this survey, 38.9% of participants used dietary supplements, 32.6% used prescription medicines, and 14.7% used dietary supplements and prescription medicines concomitantly. Then, we conducted a further survey on four groups, dietary supplement and prescription medicine users, dietary supplement only users, prescription medicine only users, and non-users (500 each). Dietary supplement users had favorable outcomes in terms of both the safety and efficacy of dietary supplements compared to dietary supplement non-users. This perception of dietary supplements was independent from medicine use. The awareness of the Health Food Network consumer navigation site, which provides information about dietary supplements for consumers, was the highest among dietary supplement and prescription medicine users, but it was still low (2.2%). In conclusion, consumers who use dietary supplement and prescription medicine concomitantly have favorable outcomes for their safety and efficacy and a low awareness of their interaction. There is a need to provide information, especially regarding the risk of interaction, that takes into account the consumer's situation.
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O'Mathúna D, Larimore WL. Dietary Supplements - The Wild West of Good, Bad, and a Whole Lotta Ugly. Med Clin North Am 2022; 106:881-898. [PMID: 36154706 DOI: 10.1016/j.mcna.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The popularity of and market for natural medicines (herbal remedies, dietary supplements, and vitamins) is accelerating. At the same time, evidence for their effectiveness (both in general and for specific conditions) and safety remains poor in many instances. Independent evaluations have identified products that are poorly manufactured, contaminated, or mislabeled. We examine data on cannabidiol (CBD) to exemplify these problems. Yet consumers often are unaware of these concerns and problems and continue to believe that "natural" means "safe." The current US regulatory framework founded in the 1994 Dietary Supplement Health and Education Act (DSHEA) does not adequately protect the health of US consumers and urgently needs to be revised. At the same time, clinicians should update themselves regularly with the best available evidence on the natural medications most relevant to their areas of practice. We recommend some evidence-based resources that will help clinicians and their patients remain current in this area.
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Affiliation(s)
- Dónal O'Mathúna
- College of Nursing, Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, The Ohio State University, Columbus, OH 43210, USA.
| | - Walter L Larimore
- UCHealth Occupational Medicine Clinic, 13445 Voyager Pkwy, Colorado Springs, CO 80921, USA
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Knapik JJ, Trone DW, Steelman RA, Farina EK, Lieberman HR. Adverse effects associated with use of specific dietary supplements: The US Military Dietary Supplement Use Study. Food Chem Toxicol 2022; 161:112840. [PMID: 35093428 DOI: 10.1016/j.fct.2022.112840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 12/15/2022]
Abstract
Dietary supplements (DSs) are used by 50% of Americans and 70% of United States military service members (SMs); some have adverse effects (AEs). This cross-sectional investigation examined AEs associated with specific DSs. A stratified random sample of SMs from the Air Force, Army, Marine Corps, and Navy was obtained. Volunteers completed a questionnaire reporting AEs for 96 generic and 62 specific DSs. The highest prevalence (≥1 AE) in specific DS categories was 35% prohormones, 33% weight loss supplements, 26% pre/post workout supplements, 14% herbal products, 12% multivitamin/multiminerals, 11% protein/amino acids, 9% muscle building supplements, 7% other DSs, 6% joint health products, and 5% individual vitamins/minerals. Specific DSs of concern (with proportion reporting AEs) included: Libido Max® (35%), Hydroxycut Hardcore® (33%), OxyElite® (33%), Roxylean® (31%), Growth Factor 9® (30%), Super HD® (29%), Hydroxycut Advanced® (29%), Lipo 6® (28%), The Ripper® (27%), Test Booster® (27%), Xenadrine Xtreme Thermogenic® (27%), C4 Extreme® (26%), and C4 Origional® (25%). Products marketed for weight loss, use before/after workout, and prohormones had the highest AE prevalence. DSs can contain substances with independent/additive AEs and/or interact with other ingredients or prescribed medications. Methods described here could provide a continuous surveillance system detecting dangerous DSs entering the market.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Ryan A Steelman
- Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Emily K Farina
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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Vitamin and mineral supplement exposures: cases reported to Australia's largest Poisons Information Centre, 2014-2015 to 2018-2019. Br J Nutr 2021; 126:1788-1793. [PMID: 33597065 DOI: 10.1017/s0007114521000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Vitamin and mineral supplements (VMS) are widely available and commonly used. Little is known about patterns of poisoning exposures to VMS in the Australian population. We performed a retrospective study of calls to the New South Wales Poisons Information Centre (NSWPIC), July 2014-June 2019. NSWPIC is Australia's largest PIC, taking approximately 100 000 calls/year (50 % of Australian poisoning calls) from healthcare professionals and members of the public. We conducted additional analyses on Fe exposures due to their high risk of acute toxicity. There were 10 944 VMS exposures reported to NSWPIC during the study period, increasing 9·6 % per annum over a 5-year period (95 % CI, 7·2, 12·1 %). Toddlers (1-4 years) accounted for 41·5 % (4546) of cases. Agents most commonly involved were multivitamins (n 3610), vitamin D (n 2080), Fe (n 1533) and Mg (n 804). In 17·7 % (1934) of cases, the call originated from hospital or the patient was referred to hospital by NSWPIC. Fe exposures increased by 14·0 % per year (95 % CI, 9·5, 18·5 %), and most were associated with high-strength products (> 45 mg elemental Fe per unit dose, n 1036). Fe exposures were hospitalised in 38 % of cases (n 583). We conclude that VMS exposures are increasing in Australia. Although most exposures can be managed at home, many required hospitalisation. Fe exposures are increasing and had higher rates of hospitalisation than other agents. VMS are often considered safe and without the potential for adverse effects, highlighting the importance of public education into the potential risks of misuse of these products.
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Mitchell CA, Dever JT, Gafner S, Griffiths JC, Marsman DS, Rider C, Welch C, Embry MR. The Botanical Safety Consortium: A public-private partnership to enhance the botanical safety toolkit. Regul Toxicol Pharmacol 2021; 128:105090. [PMID: 34863907 DOI: 10.1016/j.yrtph.2021.105090] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/16/2021] [Accepted: 11/29/2021] [Indexed: 12/31/2022]
Abstract
Botanical dietary supplement use is widespread and growing, therefore, ensuring the safety of botanical products is a public health priority. This commentary describes the mission and objectives of the Botanical Safety Consortium (BSC) - a public-private partnership aimed at enhancing the toolkit for conducting the safety evaluation of botanicals. This partnership is the result of a Memorandum of Understanding between the US FDA, the National Institute of Environmental Health Sciences, and the Health and Environmental Sciences Institute. The BSC serves as a global forum for scientists from government, academia, consumer health groups, industry, and non-profit organizations to work collaboratively on adapting and integrating new approach methodologies (NAMs) into routine botanical safety assessments. The objectives of the BSC are to: 1) engage with a group of global stakeholders to leverage scientific safety approaches; 2) establish appropriate levels of chemical characterization for botanicals as complex mixtures; 3) identify pragmatic, fit-for-purpose NAMs to evaluate botanical safety; 4) evaluate the application of these tools via comparison to the currently available safety information on selected botanicals; 5) and integrate these tools into a framework that can facilitate the evaluation of botanicals. Initially, the BSC is focused on oral exposure from dietary supplements, but this scope could be expanded in future phases of work. This commentary provides an overview of the structure, goals, and strategies of this initiative and insights regarding our first objectives, namely the selection and prioritization of botanicals based on putative toxicological properties.
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Affiliation(s)
| | | | | | | | | | - Cynthia Rider
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Cara Welch
- US Food and Drug Administration, Silver Spring, MD, USA
| | - Michelle R Embry
- Health and Environmental Sciences Institute, Washington, DC, USA
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Du E, Ji M. Analyzing the regional economic changes in a high-tech industrial development zone using machine learning algorithms. PLoS One 2021; 16:e0250802. [PMID: 34157015 PMCID: PMC8219165 DOI: 10.1371/journal.pone.0250802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/26/2021] [Indexed: 11/18/2022] Open
Abstract
The aims are to improve the efficiency in analyzing the regional economic changes in China's high-tech industrial development zones (IDZs), ensure the industrial structural integrity, and comprehensively understand the roles of capital, technology, and talents in regional economic structural changes. According to previous works, the economic efficiency and impact mechanism of China's high-tech IDZ are analyzed profoundly. The machine learning (ML)-based Data Envelopment Analysis (DEA) and Malmquist index measurement algorithms are adopted to analyze the dynamic and static characteristics of high-tech IDZ's economic data from 2009 to 2019. Furthermore, a high-tech IDZ economic efficiency influencing factor model is built. Based on the detailed data of a high-tech IDZ, the regional economic changes are analyzed from the following dimensions: economic environment, economic structure, number of talents, capital investment, and high-tech IDZ's regional scale, which verifies the effectiveness of the proposed model further. Results demonstrate that the comprehensive economic efficiency of all national high-tech IDZs in China is relatively high. However, there are huge differences among different regions. The economic efficiency of the eastern region is significantly lower than the national average. The economic structure, number of talents, capital investment, and economic efficiency of the high-tech IDZs show a significant positive correlation. The economic changes in high-tech IDZs can be improved through the secondary industry, employee value, and funding input. The ML technology applied can make data processing more efficient, providing proper suggestions for developing China's high-tech industrial parks.
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Affiliation(s)
- ErLe Du
- Department of Strategic Development, Harbin Bank, Harbin, China
| | - Meng Ji
- Department of Strategic Development, Harbin Bank, Harbin, China
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11
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Mullin GE, Limketkai BN, Parian AM. Fish Oil for Inflammatory Bowel Disease: Panacea or Placebo? Gastroenterol Clin North Am 2021; 50:169-182. [PMID: 33518163 DOI: 10.1016/j.gtc.2020.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Dietary supplements have increasingly gained popularity over the years not only to replete micronutrient deficiencies but for their use in treatment of disease. The popularity of dietary supplements for inflammatory bowel diseases (IBD) arises from their perceived ease of use, potential disease-modifying benefits, and perceived safety. Overall, randomized controlled trials have not consistently shown a benefit of fish oil for the maintenance of remission with Crohn's disease. The inconsistency of these findings highlights the need for more studies that are powered to clarify the context in which omega-3 fatty acids might have a role in the treatment algorithm of IBD.
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Affiliation(s)
- Gerard E Mullin
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Berkeley N Limketkai
- Division of Digestive Diseases, UCLA School of Medicine, 100 UCLA Medical Center Plaza, Suite 345, Los Angeles, CA 90095, USA
| | - Alyssa M Parian
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21205, USA
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Brodziak-Dopierała B, Fischer A, Ahnert B. Polish students’ knowledge of dietary supplements. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01481-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
The increasing intake of dietary supplements (DS) can be observed worldwide. These preparations are classified as a special category of foods and are subject to food law, not pharmaceutical regulations. As a result, the requirements for DS are much less restrictive than for medications.
Methodology
This research was conducted in a group of young Polish students of pharmacy at the Medical University of Silesia in Katowice (SUM) and of finance and accounting at the University of Economics in Katowice (UE). The survey contained questions concerning DS, such as difference to drugs, scope of use, and safety.
Results
The respondents answered questions about taking DS and the effects of their use. DS were used either currently or in the past by about 70% of the respondents, while about 30% of the surveyed population declared that they did not use these preparations. Women and UE students predominated among those not taking DS.
Conclusion
Multi-component products taken for a period of less than 3 months to supplement a deficit for a given component were used the most often. One product was taken at a time. The respondents read product information and followed the recommended doses. Over 50% of the studied population was aware of the negative effects of DS. Adverse symptoms of DS use were observed by 5% of the respondents.
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Pharmacology of Herbal Sexual Enhancers: A Review of Psychiatric and Neurological Adverse Effects. Pharmaceuticals (Basel) 2020; 13:ph13100309. [PMID: 33066617 PMCID: PMC7602496 DOI: 10.3390/ph13100309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022] Open
Abstract
Sexual enhancers increase sexual potency, sexual pleasure, or libido. Substances increasing libido alter the concentrations of specific neurotransmitters or sex hormones in the central nervous system. Interestingly, the same pathways are involved in the mechanisms underlying many psychiatric and neurological disorders, and adverse reactions associated with the use of aphrodisiacs are strongly expected. However, sexual enhancers of plant origin have gained popularity over recent years, as natural substances are often regarded as a safer alternative to modern medications and are easily acquired without prescription. We reviewed the psychiatric and neurological adverse effects associated with the consumption of herbal aphrodisiacs Areca catechu L., Argemone Mexicana L., Citrus aurantium L., Eurycoma longifolia Jack., Lepidium meyenii Walp., Mitragyna speciosa Korth., Panax ginseng C. A. Mey, Panax quinquefolius L., Pausinystalia johimbe (K. Schum.) Pierre ex Beille, Piper methysticum G. Forst., Ptychopetalum olacoides Benth., Sceletium tortuosum (L.) N. E. Brown, Turnera diffusa Willd. ex. Schult., Voacanga africana Stapf ex Scott-Elliot, and Withania somnifera (L.) Dunal. A literature search was conducted on the PubMed, Scopus, and Web of Science databases with the aim of identifying all the relevant articles published on the issue up to June 2020. Most of the selected sexual enhancers appeared to be safe at therapeutic doses, although mild to severe adverse effects may occur in cases of overdosing or self-medication with unstandardized products. Drug interactions are more concerning, considering that herbal aphrodisiacs are likely used together with other plant extracts and/or pharmaceuticals. However, few data are available on the side effects of several plants included in this review, and more clinical studies with controlled administrations should be conducted to address this issue.
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Policy Recommendations to Address Energy Drink Marketing and Consumption by Vulnerable Populations in the United States. J Acad Nutr Diet 2020; 120:767-777. [PMID: 32201065 DOI: 10.1016/j.jand.2020.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/17/2020] [Indexed: 01/30/2023]
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Abstract
The popularity of pre-workout supplements is rising amongst professional athletes and fitness enthusiasts. Despite increased usage, the safety profile of pre-workout supplements is likely to be not well understood. Additionally, many different brands use various undisclosed proprietary blends of active ingredients creating safety regulation difficulties. This lack of oversight could prove unsafe for certain patients. This patient MK is a 33-year-old healthy housewife who presented with central chest tightness, pre-syncope and mild dyspnoea to the emergency department via ambulance. The presentation was in the context of recent strenuous exercise and ingestion of a pre-workout supplement (Alpha Lean-7). Most striking in her presentation was a troponin rise of 50 ng/L, while not very high it is unusual given her lack of cardiac risk factors. She had a 3-day uneventful admission with a downtrending troponin prior to discharge. This case highlights the possible dangers of pharmacologically active ingredients in pre-workout supplements.
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Affiliation(s)
- Samuel S Y Wang
- Department of Emergency Medicine, Prince of Wales Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
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16
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Abstract
PURPOSE OF REVIEW Energy drinks and energy shots are functional supplements with higher caffeine content marketed toward adolescents and young adults with the intention of boosting energy. Parallel to its rising popularity, there are safety concerns with the consumption of these beverages. Herein, we reviewed the impact these supplements produce on health and well-being. RECENT FINDINGS Most of the promoted benefits of the beverages can be attributed to caffeine. The physiologic effects, if any, of other ingredients such as vitamins and herbal extracts are unclear. The presence of a higher caffeine content as compared to soft drinks may predispose to caffeine intoxication in susceptible individuals. Also, the practice of co-ingestion of these beverages with alcohol is still prevalent and associated with serious consequences. Strict regulations (restriction of sales, clear warning labels, capping caffeine levels) and public education may help prevent the adverse outcomes from these beverages.
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17
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Hypertensive Urgency: An Undesirable Complication of a "Male Performance" Herbal Product. J Emerg Med 2019; 57:43-46. [PMID: 31031073 DOI: 10.1016/j.jemermed.2019.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 02/01/2019] [Accepted: 03/04/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hypertensive urgency is a clinical scenario that may be associated with herbal supplement use and that requires special consideration with regard to emergency department management. CASE REPORT A 49-year-old man presented to the emergency department with palpitations and severely elevated blood pressure without evidence of end organ dysfunction. Hypertension failed to be controlled with multiple doses of oral clonidine and intravenous labetalol. The patient later admitted to using an herbal supplement containing yohimbine, a selective ⍺2-adrenoreceptor antagonist specifically linked to cases of refractory hypertension. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Between 17-35% of the U.S. adult population may use herbal supplements on a sporadic or regular basis; pharmacologically active agents in herbal supplements may affect both a patient's presentation and response to treatment. Most patients do not mention over-the-counter and herbal products in their medication profile unless specifically asked, and therefore it is important for emergency physicians to be aware of the pharmacologic effects of herbal supplements in the evaluation and treatment of refractory severe hypertension.
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18
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Abstract
Background Despite a lack of good scientific evidence for their benefit, Canadians take a lot of natural health products (NHPs). The objectives of this study were to determine patients' perception of the efficacy, safety and quality of NHPs and to characterize NHP use. Methods A standardized, 18-question survey was distributed to the general public through a variety of methods. Results A total of 326 individuals completed the survey. Eighty-five percent of respondents take 1 or more NHPs. Forty-seven percent agreed/strongly agreed that NHPs are safer than prescription medications and 24% disagreed/strongly disagreed that prescription medications are more effective than NHPs. Three-quarters of respondents agreed/strongly agreed that health care providers should recommend NHPs more often, as most stated they preferred to take an NHP for both a minor ailment (82%) and chronic medical condition (60%). Respondents used 124 different NHPs, most commonly vitamin D, vitamin B and magnesium. Respondents purchased NHPs primarily from health/vitamin stores (66%) and accessed the Internet for information about them (64%). Younger, female respondents were more likely to take NHPs. Discussion Patients appear to be comfortable foregoing education from health care professionals about the benefits and risks of NHPs. Patients' comfort with self-prescribing NHPs seems to stem from a perception of general efficacy and quality with little to no concern about harm and appears to be strongly influenced by lay sources of information. Conclusion Most respondents take 1 or more NHPs, preferring to use NHPs over prescription medications for minor and chronic health concerns seemingly based on a perception of safety and quality.
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Affiliation(s)
- Arden R Barry
- Lower Mainland Pharmacy Services, Chilliwack General Hospital, Chilliwack and the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia
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19
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Comment on “An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers”. J Med Toxicol 2018; 14:108-109. [PMID: 29185195 PMCID: PMC6013735 DOI: 10.1007/s13181-017-0638-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/07/2017] [Indexed: 10/25/2022] Open
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20
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Monitoring of essential and toxic elements in multi-ingredient food supplements produced in European Union. J Verbrauch Lebensm 2018. [DOI: 10.1007/s00003-018-1148-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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21
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Sirico F, Miressi S, Castaldo C, Spera R, Montagnani S, Di Meglio F, Nurzynska D. Habits and beliefs related to food supplements: Results of a survey among Italian students of different education fields and levels. PLoS One 2018; 13:e0191424. [PMID: 29351568 PMCID: PMC5774790 DOI: 10.1371/journal.pone.0191424] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/04/2018] [Indexed: 01/11/2023] Open
Abstract
The increasing availability of food supplements, aggressive media advertising, and common beliefs that these substances have only positive effects on health and sport performance indicate a need for continuous monitoring of this phenomenon. The aim of this study was to investigate the habits and beliefs related to diet supplementation among medical, health professional, and other university/high school students by means of a cross-sectional anonymous survey online. Among the respondents aware of supplements, 37.4% were taking or had taken them in the past. Food supplement use was more common among university students (in particular, those in health professional graduate courses) than high school students. Individual sport practice, rather than team sport, was associated with higher likelihood of food supplement use. Multivitamins were most commonly used, while weight-loss formulations were the least popular. Strikingly, filling nutrient gaps was statistically not considered the main reason for taking food supplements. Instead, they were used to enhance mental performance or enhance well-being. There was statistical evidence that students not enrolled in health or medical professional studies strongly agreed more often than medical students that taking food supplements prevents illness. These results indicate a striking difference between the evidence-based and personal reasons for food supplement use. Arguably, it calls for an improvement in education about diet supplementation and a change in attitude of health care providers to its implementation.
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Affiliation(s)
- Felice Sirico
- Department of Public Health, University of Naples Federico II, Naples, Italy
- * E-mail:
| | - Salvatore Miressi
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Clotilde Castaldo
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Rocco Spera
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Stefania Montagnani
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Franca Di Meglio
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Daria Nurzynska
- Department of Public Health, University of Naples Federico II, Naples, Italy
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22
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Abstract
By the turn of the twenty-first century, the use of nutraceuticals became increasingly popular in both humans and animals due to their easy access, cost-effectiveness, and tolerability with a wide margin of safety. While some nutraceuticals are safe, others have a toxic potential. For a large number of nutraceuticals, no toxicity/safety data are available due to a lack of pharmacological/toxicological studies. The safety of some nutraceuticals can be compromised via contamination with toxic plants, metals, mycotoxins, pesticides, fertilizers, drugs of abuse, etc. Knowledge of pharmacokinetic/toxicokinetic studies appears to play a pivotal role in safety and toxicity assessment of nutraceuticals. Interaction studies are essential to determine efficacy, safety, and toxicity when nutraceuticals and therapeutic drugs are used concomitantly. This chapter describes various aspects of nutraceuticals, particularly their toxic potential, and the factors influencing their safety.
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23
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Rao N, Spiller HA, Hodges NL, Chounthirath T, Casavant MJ, Kamboj AK, Smith GA. Author response to Kingston's comment on "An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers". J Med Toxicol 2017; 14:110-111. [PMID: 29185194 DOI: 10.1007/s13181-017-0640-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Nisha Rao
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
| | - Henry A Spiller
- The Ohio State University College of Medicine, Columbus, OH, USA.,Central Ohio Poison Center, Columbus, OH, USA
| | - Nichole L Hodges
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Thiphalak Chounthirath
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Marcel J Casavant
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA.,Central Ohio Poison Center, Columbus, OH, USA
| | - Amrit K Kamboj
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Gary A Smith
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. .,The Ohio State University College of Medicine, Columbus, OH, USA. .,Child Injury Prevention Alliance, Columbus, OH, USA.
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24
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Abstract
High-quality systematic reviews of use of herbal or homeopathic remedies in children often suffer from design flaws, such as not following PRISMA guidelines, inconsistent outcome measurements, and paucity of high-quality studies. Herbal remedies have modest demonstrated benefits with insufficient evidence to recommend any particular supplement. Homeopathic remedies have no role in treatment of pediatric conditions, and have been associated with great harm in infants given homeopathic teething products. Two types of herbal supplements are associated with high risk in adolescents, energy drinks and adulterated weight-loss products. Parents should be counseled about risks of these products.
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