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Analysis of the characteristics of geography study tour program development in China

Using 730 winning entries in the 2023 “Kyushu Cup” National Study Tour Program Design Competition as examples, this article analyzes characteristics of geography study tour program development in China via GIS and SPSS software. The study results show that the development of geography study tour programs in China is unbalanced in terms of spatial distribution, course content, main body of design, and field trip scope. The following manifestations were observed: first, there are large spatial and administrative differences in the development of Chinese geography study tour programs; second, although geography is a comprehensive discipline that emphasizes the holistic nature of regional studies, the proportion of comprehensive regional study tours is relatively low; third, colleges and universities are the primary developers of geography study tour programs, followed by secondary schools; and finally, the development of Chinese geography study tour programs is dominated by local study tours, which are mainly based on vernacular geography. This study provides new insight into the spatial and administrative disparities in geography study tour programs, highlights the lack of comprehensive regional study tours, and offers practical recommendations for promoting a more balanced and interdisciplinary approach to geography education in China.

Suicide rates in Germany in lockdown and non-lockdown phases during the COVID-19 pandemic in 2020/2021

Contrary to the cautions of many, suicide rates during the first COVID-19 pandemic lockdown in Germany did not rise, but declined. With the accessibility of the 2021 weekly suicide data, it was possible to analyze suicide rates and the proportion of suicide methods during the lockdown and non-lockdown phases and during the first 21 months of the pandemic compared to the previous ten years. An interrupted time-series analysis based on a linear regression was used. For the comparisons of predicted and observed suicide rates, excess suicide mortality rates (ESMR) were chosen among others. Changes in the choice of method were analyzed by comparing the rates of different methods in lockdown- and non-lockdown phases. Since the start of the COVID-19 pandemic, suicide mortality in 2020/2021 was significantly higher than expected (ESMR = 1.0161; 95% CI: 1.0005; 1.0317). Registered suicide mortality was lower than expected during the lockdown phases in these years (ESMR = 0.9477; 95% CI: 0.9128; 0.9825) and higher during non-lockdown phases (ESMR = 1.0353; 95% CI: 1.0178; 1.0528). A MANOVA revealed a significant difference of the absolute number of suicides between lockdown and non-lockdown periods (factor “lockdown”: F(1,100) = 9.47; p = 0.003). A shift of suicide methods in the comparison of these periods could not be detected. Our results are in line with the rise in yearly absolute numbers of suicides in 2022 in Germany and illustrate that even though suicide rates declined during lockdowns, there was a general rise since the beginning of the COVID-19 pandemic, especially during the non-lockdown periods. This hints towards a “postponement effect”, probably as loosening of the lockdown restrictions makes suicide methods more easily accessible and more suicides than expected are present in the following non-lockdown periods. More research is needed to better understand the mechanisms influencing suicidality during lockdowns and the COVID-19 pandemic in general.

Digital health technologies in Primary Health Care in rural territories: A protocol for scoping review

Aim To describe the protocol for a scoping review on digital health technologies in Primary Health Care in rural territories, with a view to evaluating their impact on the attributes of Primary Health Care and identifying barriers and facilitators for its implementation. Background Rural populations face significant barriers in accessing health care, and digital health emerges as a promising strategy to overcome challenges. Nonetheless, there is a gap in the literature regarding the systematic evaluation of the impact of these technologies on rural Primary Health Care, which justifies this scoping review. Method Scoping review protocol, conducted according to the guidelines of the JBI Manual for Evidence Synthesis. It was duly registered in the Open Science Framework platform, with information on the conduct of the study in nine stages, following the PRISMA-ScR. The search strategy includes relevant databases and gray literature to ensure a broad mapping of scientific production on the topic. The analysis of quantitative variables will be carried out by simple descriptive statistics, with absolute and relative frequencies, while qualitative data will undergo thematic content analysis, following the stages of preparation, organization and reporting. Expected results By evaluating the impact of digital technologies on rural Primary Health Care services, as well as identifying barriers and facilitators in their implementation, information is sought to improve access and quality of these services in rural territories through digital health. Conclusion This review will have great practical relevance for managers, public policy makers, health professionals and researchers, as it is intended to map scientific evidence that can support decision-making and the development of strategies for the implementation of digital health in the studied context.

AI-Driven quality assurance in mammography: Enhancing quality control efficiency through automated phantom image evaluation in South Korea

Purpose To develop and validate a deep learning-based model for automated evaluation of mammography phantom images, with the goal of improving inter-radiologist agreement and enhancing the efficiency of quality control within South Korea’s national accreditation system. Materials and methods A total of 5,917 mammography phantom images were collected from the Korea Institute for Accreditation of Medical Imaging (KIAMI). After preprocessing, 5,813 images (98.2%) met quality standards and were divided into training, test, and evaluation datasets. Each image included 16 artificial lesions (fibers, specks, masses) scored by certified radiologists. Images were preprocessed, standardized, and divided into 16 subimages. An EfficientNetV2_L-based model, selected for its balance of accuracy and computational efficiency, was used to predict both lesion existence and scoring adequacy (score of 0.0, 0.5, 1.0). Model performance was evaluated using accuracy, F1-score, area under the curve (AUC), and explainable AI techniques. Results The model achieved classification accuracy of 87.84%, 93.43%, and 86.63% for fibers (F1: 0.7292, 95% bootstrap CI: 0.711, 0.747), specks (F1: 0. 7702, 95% bootstrap CI: 0.750, 0.791), and masses (F1: 0.7594, 95% bootstrap CI: 0.736, 0.781), respectively. AUCs exceeded 0.97 for 0.0-score detection and above 0.94 for 0.5-score detection. Notably, the model demonstrated strong discriminative capability in 1.0-score detection across all lesion types. Model interpretation experiments confirmed adherence to guideline criteria: fiber scoring reflected the “longest visible segment” rule; speck detection showed score transitions at two and four visible points; and mass evaluation prioritized circularity but showed some size-related bias. Saliency maps confirmed alignment with guideline-defined lesion features while ignoring irrelevant artifacts. Conclusion The proposed deep learning model accurately assessed mammography phantom images according to guideline criteria and achieved expert-level performance. By automating the evaluation process, the model can improve scoring consistency and significantly enhance the efficiency and scalability of quality control workflows.

The impact of fires on mosquito populations in Eastern Siberian forests

Forest fires have a significant impact on forest fauna, killing not only mammals and birds, but also less noticeable representatives of forest fauna – insects. Existing research have mainly studied the effects on vertebrate taxa, but the data on the effects of fires on the number of insects living in forests is currently insufficient to cover all the groups. The research presented in this paper examines the immediate impact of forest fires on the number of adults in mosquito populations (Culicidae) in burned areas of the boreal forest. The data were collected in the boreal forests of Eastern Siberia, in the Republic of Sakha (Yakutia). Field survey was conducted in ten forest areas, including five recently burned and five unburned areas. Mosquitoes were caught in flight and counted during daylight hours within the time span of 7 days after the fire. We compared the data obtained from burned and unburned adjacent forest plots, which allowed us to establish the level of immediate impact of forest fires on the abundance of adult mosquito populations in the burned plots of the boreal forest. In all five pairs of forest plots, a decrease in the abundance of adult mosquitoes was noted, within the range of 86.6–93.9%. The data clearly show a lower number of adult mosquitoes for several days after the forest fire. The results obtained are of interest for further studying, regardless of the medical significance of mosquitoes, with consideration of their role in boreal ecosystems. This study is planned to be continued over the next few years in order to obtain new data on the impact of forest fires on mosquito populations in a medium and long term, which will allow us to form a broader vision of this problem.

Healthcare providers’ knowledge on sickle cell disease and its management: A pre- and post-training test evaluation outcome

In resource-limited settings in Africa, which harbour the greatest burden of Sickle Cell Disease (SCD) globally, poor care outcomes are driven in part, by a lack of trained healthcare providers (HCP) and an absence of context-specific treatment guidelines appropriate to the level of healthcare facility. The study aimed to evaluate the impact of a structured training program on HCP’s knowledge of SCD in Ghana. This was prospective cross-sectional study involving HCPs from 46 health facilities from 4 out of 16 regions in Ghana. A curriculum and standard slides were developed by SCD experts based on the Sickle Pan African Research Consortium (SPARCO)Standards of care for Sickle Cell Disease in sub-Saharan Africa clinical recommendations. A full-day workshop highlighting the general overview of SCD, diagnosis, health maintenance, acute and chronic complications was then organized. A pre-training test and a post-training test immediately after the workshop were administered and analyzed. A total of 543 HCPs were trained, mostly from primary level facilities (77.7%). The average number of years working with SCD patients was 5 years (Range: < 1–20 years). Most (93%) HCPs had experience with SCD patients but only 43% reported using a form of guideline for the care of SCD patients. The average score in the pre-training test was 8.4/20 (SD:3.3) increasing to 13.1/20(SD:3.6) in the post-training test, (p-value <0.01). The average proportion of persons indicating a correct answer for a question was 50% at the pre-training test increasing to approximately 69% in the post-test, (p-value <0.01). The knowledge of HCPs about SCD and its management was generally low but improved significantly after the standardized training. Further studies are required to assess the impact of HCP training on health outcomes of SCD in resource limited settings.

Fostering culture of care for early career researchers—Building a trustful environment: Insights from a German perspective

Early-career researchers (ECRs) play a key role in conducting animal experiments in academic research. However, they face considerable challenges, including poor working conditions, and inadequate strategies for managing distress. These difficulties are often amplified in animal research, where a lack of consensus on the 3Rs (replacement, reduction, and refinement), challenges to navigate complex regulations and ethical dilemmas can further complicate the situation. These challenges not only jeopardize the well-being of both animals and researchers, but also undermine the quality of scientific work, potentially driving ECRs out of academia. This paper explores the relationship between 3Rs training, communication, and stress-coping mechanisms used by ECRs in Germany and provides recommendations to address the challenges. To that end, we employed a dual-method approach: surveying ECRs to gather their perspectives on working with laboratory animals, communication challenges, and stress management, while also conducting a workshop to exchange insights with experienced professionals who engage with ECRs in their daily roles. Our results highlight the many difficulties faced by ECRs working on animal experiments, which range from organizational challenges to the practical implementation of the experiments. These insights emphasize the need for a holistic strategy that includes direct engagement with ECRs and the development of policies focused on their overall well-being. Our recommendations advocate for improved communication strategies, recognition of cultural differences, implementation of peer coaching and mentoring programs, and strengthening institutional support systems particularly with regard to the conduct of animal experiments. To conclude, this research calls for a transformative shift towards a more supportive and inclusive environment for ECRs, harmonizing scientific progress with ethical standards.

Sex as a moderator of the relationship between hip abduction strength and muscle activation during single-leg stance

Background Single-leg stance requires pelvic stability, largely supported by the hip abductors. Differences in hip abductor activation between sexes and individuals with or without musculoskeletal conditions may relate to abductor weakness. However, the relationship between hip abduction strength and muscle activation during stance, and whether this is moderated by sex, remains unclear. Objective To investigate whether maximal hip abduction strength is associated with hip abductor EMG amplitude during single-leg stance, considering sex as a moderator. Methods Thirty-six adults (18 males, 18 females) performed an estimated 1RM side-lying hip abduction test and two 10-second single-leg stance trials. EMG amplitude of the gluteus medius (GMed) and tensor fasciae latae (TFL) was analyzed. A moderation analysis (PROCESS Model 1) was used to test the interaction between strength and sex. Results Hip abduction strength, sex, and their interaction explained 51% of the variance in GMed EMG amplitude (R2 = 0.51; p < 0.001). A significant strength × sex interaction were observed (p = 0.002). Females with lower strength showed greater GMed activation (p < 0.001); this was not seen in males (p = 0.24). No significant effects were found for TFL activation (R2 = 0.02; p = 0.89). Conclusion Females with lower hip abduction strength demonstrate greater GMed activation during single-leg stance, suggesting a sex-specific compensatory strategy. No similar effect was observed for TFL. These findings highlight the importance of considering sex in neuromuscular assessments of pelvic stability.

Resting vagal tone, alpha amylase and cortisol levels in women with eating disorders before and after psychotherapy

Background Eating disorders such as Anorexia Nervosa (AN) and Bulimia Nervosa (BN) were previously found to partly entail alterations in stress physiology including salivary cortisol (sC), and salivary alpha amylase (sAA) at rest and basal vagal tone (HF-HRV), compared to individuals without mental disorders or with mixed mental disorders (anxiety and depressive disorders), but corresponding data remain scarce and are not entirely consistent. Method HF-HRV, sC and sAA at rest were assessed in a female sample of 58 individuals with AN and 54 individuals with BN before and after psychotherapy and contrasted against measurements from 59 female individuals suffering from mixed disorders and 101female healthy controls. Results Values for sC were elevated in AN compared to all other groups, those for HF-HRV were highest in both AN and BN and lowest in mixed mental disorders and no differences were found at rest for sAA. During psychotherapy, HF-HRV changed more in AN and BN groups than in HC or mixed samples. sC and sAA remained unchanged. There was no association between BMI and stress physiology. Conclusion Alterations in stress physiology present differently across EDs and mixed mental disorders. Correlates of physiological functioning remained mostly stable throughout 3 months of psychotherapy. Only basal vagal tone was normalized in AN/BN in comparison to HC. This might indicate that physiological changes can occur early, but mostly take longer to change during treatment. Trial registration: Data were assessed during a multi-site cross- and longitudinal experimental trial registered at the German Clinical Trials Registry (trial number: DRKS00005709; see [1] for details).

Reducing emergency department length of stay for hematology patients of tikur anbessa specialized hospital: An improvement initiative

Introduction Prolonged Emergency Department (ED) stays, a global issue driving overcrowding, were exacerbated at our hospital by lab delays and extended waits, increasing patient stress. This study aimed to reduce hematology patients’ length of stay (LOS). Using the fishbone method to identify care barriers, three interventions were implemented: redesigned lab referral systems, an online specialist communication platform, and patient navigation floor maps. Methods At Tikur Anbessa Specialized Hospital (Ethiopia), a quality improvement initiative targeted hematology patients (n = 203 baseline; n = 63 post-intervention) with prolonged emergency department (ED) stays. Using two PDSA cycles, interventions included an online consultation platform, floor markings for navigation, and digitizing peripheral smear workflows via the I-Care system. Weekly data on consultation time, lab turnaround time (TAT), navigation errors, and length of stay (LOS) were analyzed with run charts and Interrupted Time Series (ITS) regression. Results Median LOS decreased by 62.5% (144–54 hours; p < 0.001), remaining stable during a 5-week pause. Consultation time fell 80% (12 to 2.4 hours; 95% CI: 1.8–3.0), and lab TAT improved by 70% (78 to 23.25 hours). Navigation errors dropped from 53% to ≤7%, with minor fluctuations. Clinical outcomes (e.g., mortality) were not assessed, and long-term sustainability requires further study. Conclusions Targeted interventions improved care and efficiency at Tikur Anbessa Hospital, but sustained reductions in ED LOS were limited by data gaps and discontinued initiatives. Future efforts in resource-limited settings should prioritize continuous monitoring, stakeholder collaboration, and staff well-being.

Causal associations between psoriasis and atopic dermatitis: A bidirectional Mendelian randomization study

Background Although previous studies suggested associations between psoriasis and atopic dermatitis (AD), the directionality and causality of these relationships remain controversial. This study employed bidirectional Mendelian randomization to investigate the potential causal relationships between these two inflammatory skin conditions. Methods Genome-wide association statistics were obtained for psoriasis and AD from large-scale consortia and meta-analyses of genome-wide association studies. Inverse-variance weighting, as the primary analysis, was combined with five complementary sensitivity analyses to evaluate the robustness and potential pleiotropy of the data. Additionally, we performed gene mapping of psoriasis-associated single-nucleotide polymorphisms and subsequent pathway analysis to further elucidate the potential relationships. Results Genetic predisposition to psoriasis was significantly associated with a decreased risk of AD (odds ratio = 0.876; 95% confidence interval = 0.834–0.921; p = 1.6 × 10−7). Conversely, genetic predisposition to AD did not affect the risk of psoriasis. The associations remained consistent across multiple sensitivity analyses, and no evidence of horizontal pleiotropy was observed. Gene mapping identified eight key genes (ENSG00000249738, ENSG00000291336, ENSG00000291338, ENSG00000285703, OR2W1-AS1, HLA-DQA1, FBXL18, and nitric oxide synthase 2 (NOS2) located on chromosomes 5, 6, 7 and 17. Notably, NOS2 emerged as a core gene involved in key biological processes, including the TCR signaling pathway and protein metabolism. Conclusions This comprehensive MR study provided evidence of the protective causal effect of psoriasis on the risk of AD, whereas no reverse causal relationship was noted. These findings enhanced our understanding of the relationship between psoriasis and Ad and identified potential implications for their clinical management.

Targeting the Exon2 splice cis-element in PD-1 and its effects on lymphocyte function

T-cell therapies have proven to be a promising treatment option for cancer patients in recent years, especially in the case of chimeric antigen receptor (CAR)-T cell therapy. However, the therapy is associated with insufficient activation of T cells or poor persistence in the patient’s body, which leads to incomplete elimination of cancer cells, recurrence, and genotoxicity. By extracting the splice element of PD-1 pre-mRNA using biology based on CRISPR/dCas13 in this study, our ultimate goal is to overcome the above-mentioned challenges in the future. PD-1 plays an important role in controlling T cell responses and is expressed at the cell surface of T cells following activation. The receptor PD-1 interferes with T cell receptor (TCR) signaling following interaction with PD-L1. The outcome of stimulation via PD-1 leads to decreases in cytokine secretion and cell proliferation. We extracted the RNA region of PD-1 pre-mRNA using CD8+T cell lines and examined the effect of targeting the Exon2 splice cis-element on the production of cytokines in the present study. In particular, the production of IFN-γ, TNF-α, GM-CSF was lower in RNA-targeted cells than in non-targeted cells, but the cytokine secretion capacity and cell proliferation were maintained in RNA-targeted cells. These results suggested that the use of the RNA editing technology, CRISPR/dCas13 strategy offers a novel approach to mitigate genotoxicity in lymphocytes with cytokine production and cell proliferation.

Correction: The effects of probabilistic context inference on motor adaptation

Biomechanical characteristics of swing techniques using different clubs in college male golfers

Background Golf is a sophisticated sport that integrates precision, skillfulness, and strategic thinking, with swing techniques of different clubs exhibiting distinct biomechanical characteristics. This study aims to investigate the biomechanical characteristics of golfers’ full swings with different clubs from kinematic and dynamics perspectives, thereby providing insights for optimizing full swing techniques. Methods Ten low-handicap right-handed college male golfers were recruited, and their full swing parameters with the driver, 5-iron, and 7-iron (each club was successfully collected 10 times) were synchronously collected using a 250 Hz infrared motion capture system and a 1000 Hz three-dimensional force platform. A one-way ANOVA was conducted to compare biomechanical indicators during the swing motion across different clubs. Results There were significant kinematic differences between the driver and irons, yet smaller differences between 5-iron and 7-iron. As a whole, irons showed a faster peak time and a smaller angular velocity. The GRF of different clubs exhibited different dynamic characteristics at various swing moments, yet the dynamic regularity remained consistent throughout the full swing. During the downswing, the horizontal angular impulse of the driver was greater than irons, and the frontal angular impulse of the 5-iron was greater than that of both driver and 7-iron. Conclusions The characteristics of the driver are slow – paced energy accumulation, delayed acceleration, and horizontal sweeping shots; the characteristics of the 5-iron are that the leading arm coordinates with the frontal angular impulse to optimize the shot trajectory; the characteristics of the 7-iron are compact transition and precise shots driven by the torso.

Propofol emulsification in Intralipid and SMOFlipid: A promising alternative in response to future shortages

Introduction The Covid-19 pandemic has intensified shortages in various pharmaceutical products, notably injectable propofol in lipid emulsion form. Its demand surged sharply due to its critical role in intubating patients with respiratory distress during the pandemic, exposing vulnerabilities in the supply chain for this essential product. Objectives This project aims to develop an alternative formulation to commercially available propofol products and to evaluate its stability through a detailed study. Methods Two lipid emulsions commonly used for intravenous nutrition, Intralipid 20% and SMOFlipid 20%, were selected as diluents for pure propofol due to their composition’s similarity to DIPRIVAN, the standard propofol product. We developed and validated an HPLC method for quantifying propofol and employed an optimized laser diffraction technique to measure particle size. Additionally, we assessed the pH of the formulations. Results The preparation method demonstrated repeatability and homogeneity. Stability studies revealed that the propofol concentrations remained close to the target of 10 mg/mL (1%). Although particle sizes were larger compared to DIPRIVAN, they were consistent with those of the lipid emulsions before propofol addition. The pH of the formulations remained stable throughout the study period. Conclusions The developed propofol emulsion formulations met USP standards for all tested parameters over a period of at least 7 days, indicating that these alternatives are a viable and stable substitute for commercial propofol products.

Short-term costs and cost-efficiency of HPV triage strategies in a high HIV-prevalence setting: Evidence from Botswana

Cervical cancer remains the leading cause of cancer death among women in sub-Saharan Africa and is more severe in high HIV-burdened countries due to persistent high-risk human papillomavirus (hrHPV). In 2021, the World Health Organization recommended primary hrHPV testing for cervical cancer screening; however, optimal triage strategies following positive hrHPV tests remain unclear. We conducted a prospective cost analysis of triage methods for positive hrHPV results among women living with and without HIV in Gaborone, Botswana. We used a micro-costing approach from the perspective of the healthcare provider. The main outcomes were the implementation costs associated with three triage strategies following hrHPV testing: 8-type HPV genotype restriction, visual inspection with acetic acid (VIA), and colposcopy. We also compared the strategies by measuring the change in costs divided by the change in number of true cases of cervical intraepithelial neoplasia (CIN) 2 or worse (CIN2+) identified, based on the results of a prospective cohort study. Results indicated that the 8-type HPV genotype restriction strategy was the most cost-efficient, requiring no additional costs beyond hrHPV testing and identifying the highest number of true CIN2 + cases. VIA and colposcopy triage identified fewer true cases of CIN2+ and incurred additional costs, with colposcopy being the most expensive. Results were consistent in women with and without HIV. Sensitivity analysis highlighted personnel and hrHPV test kit cartridge costs as significant drivers of overall costs. Post-hoc analysis incorporating average treatment costs for precancer demonstrated that genotyping remained dominant at lower treatment costs but became less favorable as treatment costs increased. We found that 8-type genotype restriction was optimal compared to hrHPV screening combined with VIA or colposcopy. Cost estimates can inform future studies that examine the long-term costs and health outcomes of HPV-based two-stage screening algorithms.

Evaluation of mechanical ventilation modes in the laparoscopic perioperative period with electrical impedance tomography

Purpose Uncertainty persists regarding the optimal mode of mechanical ventilation for laparoscopic perioperative periods. Electrical impedance tomography (EIT) is an effective tool for monitoring and guiding lung-protective ventilation. This study aimed to compare the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume-controlled ventilation (VCV) on pulmonary ventilation during laparoscopic surgery. Method This trial was a randomized crossover study, with the laparoscopic perioperative period divided into five phases: pre-anesthesia induction (AWAKE), post-anesthesia induction (BEGIN), the first phase of surgery (MIDDLE-1), the second phase of surgery (MIDDLE-2), and pre-wakefulness (END). EIT data were recorded at each phase, and EIT parameters were calculated to quantify pulmonary ventilation performance in both spatial and temporal dimensions. Results During the surgical period, plateau pressure (Pplat) and driving pressure (ΔP) under PCV-VG were lower, while the oxygenation index (PaO2/FiO2) was higher compared to VCV. Furthermore, PCV-VG was associated with an increased center of ventilation (45.1 ± 3.7 vs. 41.7 ± 3.5, P < 0.05), a decrease in global inhomogeneity (GI) (0.85 ± 0.16 vs. 1.06 ± 0.30, P < 0.05), and a reduction in regional ventilation delay index (RVDI) (10.5 ± 4.5 vs. 15.9 ± 5.3, P < 0.05), when compared to VCV. The improvements in pulmonary ventilation were more pronounced with PCV-VG compared to VCV during the surgical period, compared to the non-surgical period. Conclusion EIT parameters reveal significant differences in ventilation between VCV and PCV-VG during the laparoscopic perioperative period. PCV-VG improves ventilation inhomogeneity and mitigates ventilation delay caused by the Trendelenburg position and pneumoperitoneum during surgery. PCV-VG is more effective than VCV in optimizing intraoperative lung ventilation. Trial registration ClinicalTrials.gov ChiCTR2400089365

Drug-induced vitiligo: a real-world pharmacovigilance analysis of the FAERS database

Background In recent years, with the expanding use of novel therapeutics such as immune checkpoint inhibitors and monoclonal antibodies, reports of drug-induced vitiligo have been increasing. This study aimed to identify drugs associated with vitiligo using the FDA Adverse Event Reporting System (FAERS). Methods A retrospective disproportionality analysis was performed on FAERS reports from the first quarter of 2004 to the fourth quarter of 2024. Disproportionality signals were assessed using the Reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN). Results The present study identified 1,910 cases of vitiligo, with a median age of 54 years (interquartile range [IQR]: 40.0–66.0). The gender distribution among these cases was 45.9% female, 35.9% male, and 18.3% with undetermined gender. The three most frequently reported drugs were nivolumab (152 cases), pembrolizumab (132 cases), and dupilumab (77 cases). Forty-six drugs showed significant positive vitiligo signals. The three strongest signals (based on ROR) were mogamulizumab (ROR 73.93, 95% confidence interval [CI] 39.62–137.94; the lower 95% CI for the information component [IC025] 2.40), imiquimod (ROR 72.00, 95% CI 43.24–119.89; IC025 3.00) and chloroquine (ROR 53.33, 95% CI 17.13–166.02; IC025 0.47). Notably, 80.4% (37/46) of these drugs lacked vitiligo warnings in their FDA-approved labels. Conclusion This study has uncovered an extensive catalog of drugs with the potential to induce vitiligo. While these findings are based on pharmacovigilance signals and require further validation, patients receiving these medications should be closely monitored for the development of vitiligo.

Exploring educational hypogamy among women in urban and rural China: Insights from random forest machine learning

Background Educational hypogamy, where women marry men with lower educational attainment, reflects evolving gender roles and societal norms. In China, the rapid expansion of education, coupled with persistent traditional values, provides a unique context to study this phenomenon. Methods Using data from the 2013, 2015, 2017, 2018, and 2021 waves of the China General Social Survey (CGSS), this study applies logistic regression models and Random Forest machine learning techniques to analyze the impact of education on women’s selection of hypogamy. Key control variables include age, income, parental education, and household registration, with a focus on urban-rural differences. Results Between 2013 and 2021, the proportion of women choosing hypogamy increased from 17.42% to 20.06%. As education levels rose, so did the likelihood of choosing hypogamy, particularly among women with higher educational attainment. Other factors such as income and parental education displayed complex interactions with hypogamy, with urban women experiencing more nuanced influences compared to rural women, who showed a clearer education-driven pattern. The random forest analysis further confirmed education as the most significant predictor of hypogamy. Discussion/conclusion The rise in educational hypogamy highlights women’s increasing autonomy and challenges to traditional gender norms, especially in rural areas where education’s impact is more pronounced. Urban-rural disparities suggest the need for targeted policies to promote gender equality. Future research should examine the long-term implications of educational hypogamy on household and child-rearing dynamics.

Analysis of flavor formation and metabolite changes during production of Double-Layer Steamed Milk Custard made from buffalo milk

Double-Layer Steamed Milk Custard (DLSMC) is a famous traditional Chinese dessert. This study aimed to analyze the flavor and the changes in metabolites during different stages of DLSMC preparation, including raw buffalo milk, thermo-processing, first and second-layer milk skin formation. Electronic nose and electronic tongue were employed to preliminarily assess the overall flavor characteristics between these stages. The results indicated that DLSMC demonstrated increased sweetness, saltiness, and umami compared to raw buffalo milk, along with heightened levels of nitrogen oxides, methane, alcohols, aldehydes, ketones, and sulfur-containing compounds. Thus, the thermo-processing and second-layer milk skin formation were pinpointed as critical for flavor alterations. Additionally, headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) detected a total of 46 volatile organic compounds (VOCs), with 8 compounds identified as key flavor components. Untargeted metabolomics revealed 98 differential metabolites, including amino acids, lipids, and nucleotides, that were significantly linked to changes in key flavor compounds. Indeed, the fluctuations in the levels of amino acids, lipids, and nucleotides play a crucial role in influencing flavor changes during the production of DLSMC made from buffalo milk.