Face Area Research Articles

Exploring the Human Response to Anger: Uncovering Insights through Infrared Thermography and Experimental psychology

This study examines how exposure to angry versus neutral facial expressions affects facial temperature, aiming to validate thermograms as reliable measures of emotional responses. We focus on Saudi youth and explore the impact of different stimuli categories (young vs. old, male vs. female) on subjective feelings recorded by thermal cameras.The research involved a sample of 40 male participants selected from King Fahd University of Petroleum and Minerals (KFUPM) in Saudi Arabia, with an average age of 21.8 years (SD = 1.3). All participants had normal or corrected-to-normal visual acuity. The study comprised two experiments to examine the impact of exposure to angry versus neutral faces on physiological responses. Thermal data were collected using infrared thermography, focusing on variations in facial temperature as a key indicator of physiological reactions. Participants were exposed to stimuli consisting of angry and neutral faces from various demographic categories, including males, females, young individuals, and elderly adults. This comprehensive methodology combined behavioral analysis and infrared thermography techniqueThe behavioral findings indicated that individuals exhibited increased response times (RTs) when classifying angry stimuli compared to neutral face stimuli. Infrared thermography revealed a notable impact of anger, particularly in Region of Interest 5 (the area around the upper jaw). This effect was especially pronounced in individuals exposed to angry facial expressions, but not in those analyzing angry expressions of younger individuals.These findings provide insight into the unique physiological responses triggered by angry facial expressions, specifically identifying temperature rises in specific facial areas. The results contribute to our understanding of the physiological mechanisms involved in the processing of facial expression recognition.

Linking energy efficiency and waste recovery to improve housing insulation and tackle energy poverty in south-central Chile

Given the environmental impact of the construction industry, sustainable solutions are increasingly needed to minimize the life cycle impacts of buildings by means of reusing renewable industrial waste. Abundant forest and farm waste exist in center-south Chile, with great potential to be used as thermal insulation and, thus, improve the livability of houses located in an area facing air pollution and energy poverty issues. This paper discusses two types of insulation produced and tested jointly with Germany-based Fraunhofer Institute for Wood Research (WKI)– using Chilean agroforestry waste: First, a flakeboard made of wood veneer chips; and second, a flexible substrate and a pressure resistant board made of wheat and oat straw. The main goal of this research is to assess, by means of digital modeling and experimental tests, the thermal characteristics and the resistance to humidity of these new insulation materials and their performance within construction solutions usually used in Chile. The benchmarks used were the most demanding national residential energy efficiency standard implemented to address air pollution and energy poverty, and the most demanding international standard, both for walls and roofing. The results of both insulation materials was promising, as they met the thermal performance and resistance to humidity requirements and show technical feasibility for the insulation market; in addition, they share the potential to be used in different types of buildings and construction solutions both in Chile and abroad, promoting a sustainable approach starting from the raw materials and the manufacturing process, through the buildings’ operations.

Island-wide characterization of agricultural production challenges the demographic collapse hypothesis for Rapa Nui (Easter Island).

Communities in resource-poor areas face health, food production, sustainability, and overall survival challenges. Consequently, they are commonly featured in global debates surrounding societal collapse. Rapa Nui (Easter Island) is often used as an example of how overexploitation of limited resources resulted in a catastrophic population collapse. A vital component of this narrative is that the rapid rise and fall of pre-contact Rapanui population growth rates was driven by the construction and overexploitation of once extensive rock gardens. However, the extent of island-wide rock gardening, while key for understanding food systems and demography, must be better understood. Here, we use shortwave infrared (SWIR) satellite imagery and machine learning to generate an island-wide estimate of rock gardening and reevaluate previous population size models for Rapa Nui. We show that the extent of this agricultural infrastructure is substantially less than previously claimed and likely could not have supported the large population sizes that have been assumed.

Comprehensive Systematic Review of Poly-L-lactic Acid in Facial Clinical Application.

With the increasing global clinical application of regenerative injection materials, there is a growing recognition of the crucial role played by poly-L-lactic acid (PLLA). The aim of this study is to conduct a systematic review on the therapeutic efficacy and safety of PLLA in clinical applications for facial treatments. We conducted a search of the PubMed, EMBASE, Web of Science, and Wanfang databases, followed by screening of the retrieved articles based on predefined inclusion and exclusion criteria. We then performed an analysis on the final set of included articles that met our inclusion criteria. Within these included articles, quality assessment for randomized controlled trials (RCTs) was carried out using the Jadad scale, while non-randomized controlled trials (non-RCTs) were evaluated using the MINORS scale. Our search of above database, using the relevant search terms, yielded a total of 1300 PLLA-related articles. After applying the inclusion and exclusion criteria, 1280 articles were excluded. Only 20 articles, 16 in English and 4 in Chinese, were included in our final analysis, among them 16 NRCTs and 4 RCTs. According to the different clinical evaluation standards, the treatment of PLLA has achieved good outcomes. Most PLLA injection-related adverse events are mild and self-limited, without any additional treatment requirement. PLLA is a reasonably safe and effective facial injection material that can be applied in different facial injection areas and depth using various reconstitute and injection methods. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effects of spironolactone on skin biophysical properties in women with acne treated with oral spironolactone.

Spironolactone (SPL) is an effective treatment for women acne, but other effects on skin biophysical properties remain to be investigated. The aim of the current study was to explore the effects of oral SPL used to treat women acne on skin biophysical properties, including hydration, transepidermal water loss (TEWL), skin surface lipid (SSL) levels, mechanical properties, color, pH, and pore size. Twenty-five Thai women with acne treated with oral SPL were followed for 6 months. Skin hydration, TEWL, SSL levels, mechanical properties, color, pH, and pore size of the forehead, chest, and inner arm were evaluated at baseline and 2, 4, and 6 months after treatment with oral SPL. Facial and upper back pore size were also assessed. Clinical outcomes were changes in these skin biophysical properties at each visit compared with baseline. Skin hydration, TEWL, SSL levels, color, pH, and pore size remained stable throughout the study. Facial skin parameters at 6 months demonstrated the following changes: hydration levels, 7.60 (95% confidence interval [CI], -59.74 to 74.94); TEWL, -2.36 (95% CI, -5.77 to 1.06); L* value, 0.51 (95% CI, -0.70 to 1.72); individual typology angle, 1.65 (95% CI -2.27 to 5.57); pH, 0.01 (95% CI -0.43 to 0.46); pore size, -0.24 (95% CI, -1.21 to 0.73); and SSL levels, 7.60 (95% CI -59.74 to 74.94). Improvement of facial mechanical properties was observed. R0 (indicating skin tightness) and R1 (indicating elasticity) showed significant decreases (-0.076 [95% CI, -0.141 to -0.010] and -0.016 [95% CI, -0.033 to -0.001]). R3 and R4 (representing tiring effects) were also improved (-0.091 [95% CI, -0.158 to -0.025] and -0.022 [95% CI, -0.044 to -0.001]). Parameters in the truncal and inner arm areas remained stable, except for skin elasticity and tiring effects, which exhibited a similar trend of improvement as the facial area. The changes were notable as early as 4 months. Oral SPL used for acne did not impair the skin barrier. Moreover, the skin mechanical properties were improved at 4 to 6 months.

Up to 80% of threatened and commercial species across European marine protected areas face novel climates under high emission scenario

Marine protected areas (MPAs) are a critical tool for safeguarding marine species and habitats for the future, though the effects of projected climate change raise concerns about their long-term success. Assessing the degree to which MPAs may be exposed to future novel climatic conditions is, therefore, crucial for informing conservation and management actions aimed at ensuring a resilient and thriving ocean in the years to come. Here, we evaluate the future exposure of 398 threatened and commercially important species to novel and extremely novel climatic conditions within European MPAs. We estimated climate novelty through multivariate analyses considering biologically meaningful distribution drivers of temperature, oxygen, pH, and primary productivity from present-day to the end of the 21st-century conditions under contrasting shared socioeconomic pathways (SSP) scenarios—low emission scenario (SSP1–1.9) and high emission scenario (SSP5–8.5). Our findings suggest that, under SSP1–1.9, ~6.5% of species and 0.5% of European MPAs will be at risk due to future novel conditions. In contrast, under SSP5–8.5, 87% of MPAs and 80% of species are projected to be at risk. Notably, up to 100% of species currently located in the MPAs of enclosed and semi-enclosed seas like the Baltic Sea and the Black Sea are projected to be exposed to novel or even extremely novel conditions. Virtually all species in most of those regions will be at risk, suggesting that even new MPAs might not be able to adequately protect them. Comparatively, the Norwegian Sea, North-East Atlantic, and western parts of the Mediterranean and North Seas are expected to be less impacted even under the high emission scenario. Overall, our study advances the understanding of the potential impacts of future climate change scenarios on threatened and commercially important marine species in European MPAs and reinforces the urgent need to meet the Paris Agreement. Our results suggest that existing approaches to marine governance in Europe may be insufficient for ensuring the success of MPAs in light of future impacts and that novel anticipatory forms of governance are needed.

Research on the early warning indicator system for public safety risks in county areas of the Yangtze River Delta region during urbanization process

China’s intense urbanization has profoundly impacted county-level societies, leading to increased diversity and contradictions, and pushing these communities towards a risk society. This is especially pronounced in the Yangtze River Delta, a region of peak urbanization. The stability and progress of these local societies are vital for the region’s overall high-quality development. Yet, with ongoing urbanization, these areas face numerous challenges. To effectively tackle these issues, a robust system encompassing pre-evaluation, early warning, and emergency preparedness is essential. This study explores the relationships and structures among various risk factors using grounded theory analysis. Furthermore, it applies the Analytic Hierarchy Process (AHP) to develop a comprehensive risk early warning index system, significantly enhancing the response capabilities to public security challenges in the Yangtze River Delta’s county-level societies.

Performance of dual-row condenser using microplate and conventional folded multiport extruded tube: A prospective pilot study

Microchannel heat exchangers (MCHXs) are typically manufactured using multiport extruded tubes and serpentine louvered fins, which exhibit deficiencies in corrosion resistance. Tubes made of multilayered aluminum have been shown to improve the corrosion performance. This study explored the thermal–hydraulic performance of a novel microplate heat exchanger (MPHX) with a dual-row design that utilizes advanced materials such as multilayer aluminum through comparison with conventional folded MCHXs. The results indicate that the heat transfer rate of the dual-row MPHX was at most 30 % higher compared to that of conventional folded MCHX for the same frame size. However, heat transfer of the MPHX was approximately 10 % lower than that of the conventional folded MCHX for the same effective face area. Additionally, the conventional folded MCHX is highly sensitive to the installation orientation and flow configuration; it fails to function when installed vertically and in co-current flows owing to issues such as liquid blockage. Such phenomena were not observed in the dual-row MPHXs. On the refrigerant side, the MPHXs exhibited pressure drops that were three to four times higher than that of a conventional folded MCHX.

Land tenure conflicts in forest areas: obstacles to rejuvenation of small-scale oil palm plantations in Indonesia

Purpose This study aims to investigate the problems small-scale oil palm plantations in Indonesia’s forest areas face and the government policies addressing them. Design/methodology/approach Survey and data collection were used to determine the socioeconomic, environmental, legal and governance problems related to the development of smallholder plantations. Information was obtained from the respondents via a rapid rural appraisal approach. Findings The potential land for potential participants in the community oil palm rejuvenation programme is a forest area of 1,628,749.60 ha. Owing to its legal dimensions and unsustainable land management, the rejuvenation regulatory programme has not reached independent farmers. Research limitations/implications The use of plantation space beyond its designation hinders the government’s goal of accelerating the rejuvenation programme. The problems regarding the accumulation of forest area result in low achievement of the annual rejuvenation target in Riau Province (21%–25%). The authors present solutions to resolve land ownership conflicts and implement strategic policies to ensure the sustainable development of such plantations. Originality/value The authors introduce a conflict–resolution model for small-scale smallholder oil palm plantations to resolve the problems of forest area claims unaddressed in the Indonesian Job Creation Law. Land conflict resolution is categorised into five typologies: oil palm plantations with business permits; those without a forestry permit and subject to administrative sanctions; business activities in forest areas without forestry permits; resolving non-conformities in the progress of land or management controlled and used in forest areas prior to their designation by removing land parcels through modifying the forest area boundaries; and the settlement for farmers without cultivation registration certificates but have established plantations and whose land tenure can be proven.

The Impact of Rural Environments on Reproductive Autonomy Among Women in Appalachia: A Qualitative Analysis

Reproductive autonomy encompasses one’s ability to make decisions around contraceptive use, pregnancy, and childbirth. An individual’s geographic location affects access to a wide range of information and care related to reproductive choice. Individuals in rural areas face additional barriers to reproductive health and decision-making than those in urban areas. This phenomenological qualitative study examined the experiences with and perceptions of reproductive decision-making among women in rural Appalachian communities in the United States. Four themes emerged from the data: autonomy tied to choice, role of religion and church on autonomy and decision-making, navigating limited access to care, and shame. Women should be supported in making reproductive health decisions, and efforts are needed to increase autonomy within reproductive health care and decisions. Sexual health programming within school and other community settings should address shame that often occurs around reproductive health topics, particularly among religious communities.

Management of Unilateral Buccal Necrotizing Fasciitis Superimposed with Submandibular Abscess At Colli Dextra in a Type 2 Diabetes Mellitus patient : A Case Report

Background: Necrotizing fasciitis (NF) is a relatively rare infectious disease of soft tissues that is characterized by necrosis of subcutaneous tissue and fascia and can even extend to involve the skin and muscles, with the main spread through odontogenic infections. One of the main comorbidities of necrotizing fasciitis is diabetes mellitus. Proper case management is needed because NF can result in severe morbidity and mortality if not treated at an early stage. Study Objective: This case report aims to report the management of patients with buccal necrotizing fasciitis complicated by submandibular abscesses with comorbid type 2 diabetes mellitus. Case Presentation: A 60-year-old woman came to RSHS complaining of swelling on her right cheek 20 days before hospital admission, which further extended to the jaw and neck area. Swelling on the patient's face did not improve after antibiotic treatment, and continued to enlarge to a size of 10x8x7 cm and 8x6x5 cm. The patient has a history of type 2 diabetes mellitus and controlled hypertension. The patient is diagnosed as necrotizing fasciitis and submandibular abscess. Patients are given antibiotic treatment and performed pus-tapping, necrotomy debridement, and tooth extraction. Conclusion : Necrotizing fasciitis involving the facial (especially buccal) area is rare, with the main cause being odontogenic, peritonsillar, or sinugenic. The main management includes debridement, reconstructive measures, and administration of antibiotics. Extensive tissue involvement, and poly-comorbid conditions can worsen the prognosis of necrotizing fasciitis. Keywords : Abscess, Buccal, Colli dextra, Necrotizing fasciitis, Submandibular

Prediction of land surface temperature using spectral indices, air pollutants, and urbanization parameters for Hyderabad city of India using six machine learning approaches

Urban areas face rising land surface temperatures (LST) and increased air pollution due to urbanization and industrialization. The consistent rise in LST impacts lives of the residents. Thus, LST forecasts can help manage activities more comfortably. The present study aims to predict LST for Hyderabad city, India using five-year (2018–2022) data on air pollution and meteorological parameters (from ambient air quality monitoring stations) and MODIS LST data. Six machine learning models i.e., Multiple Linear Regression (MLR), Support Vector Regression (SVR), Random Forest (RF), Artificial Neural Networks (ANN), XGBoost, and Long Short-Term Memory (LSTM), were used for LST prediction. Considerable influence of PM2.5 and CO (during summer) and SO2 (during winter) on LST was observed which demonstrated high sensitivity of these parameters on LST. LST exhibited a weak correlation with individual air pollutants while strong relationship of LST with all the study variables, when considered simultaneously, was observed. ANN method demonstrated better accuracy with lower error metrics, comprising of Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), and Mean Squared Error (MSE), compared to the other approaches with ranking in the order ANN > RF > SVR > XGBoost > LSTM > MLR. ANN model for Hyderabad city was validated by using it for prediction of LST of another geographical area i.e. Bengaluru city, India. The result of this study can provide insights for policymakers, urban planners, and environmental agencies for targeted interventions for temperature regulations and to mitigate urbanization's impact.

Development and validation of point-of-care mobile solution to guide the diagnosis of malnutrition: A multicenter, prospective cohort study.

11042 Background: Malnutrition has negative effects on patients with chronic diseases, leading to reduced treatment tolerance, increased risk of clinical complications, and even death. This research was aimed to develop a point-of-care program based on facial features to screen malnourished inpatient patients. Methods: In this prospective, multicenter, cohort study, we retrieved facial photograph and malnutrition screening scales from 4 different hospitals. We utilized a variety of machine learning models to explore whether the ocular area could serve as an enhanced region for facial recognition nutrition. Last, we utilized a facial area segmentation and weighted approach to retain the information of full-face features using a BP neural network and validated using Delong-test, IDI-test, and NRI-test. Overall, 619 inpatients’ facial photographs and their corresponding nutrition screening questionnaires were used to train, validate and test the machine learning model. Results: The Pearson correlation analysis showed a significant correlation (p<0.05) between the two questionnaires in all groups. The average AUC obtained from the five-fold cross-validation set was 0.886 (CI 0.843-0.930), 0.834 (CI 0.764-0.904), and 0.927 (CI 0.899-0.955) for the Cancer Inpatient Group, Other Inpatient Group, and All Inpatient Group, respectively, with the corresponding AUC obtained from the external validation set being 0.860 (CI 0.817-0.904), 0.843 (CI 0.796-0.889), and 0.887 (CI 0.829-0.944). Conclusions: The facial photograph-based point of-care mobile solution can screen malnutrition with good accuracy, showing its potential for screening malnutrition in inpatients in the hospital in different types of diseases.

Poly‐d,l‐lactic acid‐enhanced atrophic scar treatment via transdermal microjet drug delivery in Asians

Acne vulgaris often results in permanent scars, with atrophic scars being the most common type and posing a significant therapeutic challenge due to their prevalence and impact on patients' quality of life. Various treatment options exist, including the use of poly-d,l-lactic acid delivered via different methods. This study aimed to assess the efficacy and safety of poly-d,l-lactic acid delivered via laser-assisted needle-free microjet injection for treating atrophic scars. Five Korean participants with atrophic facial scars were recruited. Poly-d,l-lactic acid solution was administered via the Mirajet system in five sessions, with clinical assessments conducted at baseline, before each session, and at 12-week and 22-week follow-ups. Outcome measures included the Global Aesthetic Improvement Scale and patient satisfaction scores. Positive results were observed at the 12-week and 22-week follow-ups, with high patient satisfaction and improvements in atrophic scars and skin texture. Mild discomfort and transient side effects were reported, with no adverse events observed during the follow-up period. Poly-d,l-lactic acid delivered by a laser-assisted needle-free microjet injector was judged to be effective for improving atrophic the facial area. Further research, particularly through randomized controlled trials, is needed to validate these findings and assess the longer-term safety and sustainability of outcomes.

Robust memory of face moral values is encoded in the human caudate tail: a simultaneous EEG-fMRI study

Moral judgements about people based on their actions is a key component that guides social decision making. It is currently unknown how positive or negative moral judgments associated with a person’s face are processed and stored in the brain for a long time. Here, we investigate the long-term memory of moral values associated with human faces using simultaneous EEG-fMRI data acquisition. Results show that only a few exposures to morally charged stories of people are enough to form long-term memories a day later for a relatively large number of new faces. Event related potentials (ERPs) showed a significant differentiation of remembered good vs bad faces over centerofrontal electrode sites (value ERP). EEG-informed fMRI analysis revealed a subcortical cluster centered on the left caudate tail (CDt) as a correlate of the face value ERP. Importantly neither this analysis nor a conventional whole-brain analysis revealed any significant coding of face values in cortical areas, in particular the fusiform face area (FFA). Conversely an fMRI-informed EEG source localization using accurate subject-specific EEG head models also revealed activation in the left caudate tail. Nevertheless, the detected caudate tail region was found to be functionally connected to the FFA, suggesting FFA to be the source of face-specific information to CDt. A further psycho-physiological interaction analysis also revealed task-dependent coupling between CDt and dorsomedial prefrontal cortex (dmPFC), a region previously identified as retaining emotional working memories. These results identify CDt as a main site for encoding the long-term value memories of faces in humans suggesting that moral value of faces activates the same subcortical basal ganglia circuitry involved in processing reward value memory for objects in primates.

Queensland Trauma Education (QTE): an innovative simulation program that addresses the needs and barriers of interprofessional trauma care education across a complex landscape.

Effective trauma care requires the rapid management of injuries. Rural and remote areas face inequity in trauma care due to time, distance and resource constraints, and experience higher morbidity and mortality rates than urban settings. A training needs analysis (TNA) conducted with stakeholders across Queensland, Australia, revealed a lack of contextual, accessible and interprofessional trauma education for clinicians. The Clinical Skills Development Service and Jamieson Trauma Institute developed the Queensland Trauma Education (QTE) program to address these concerns. QTE comprises a face-to-face training course and open access to online training resources created and reviewed by trauma experts. QTE also supports local training through a statewide simulation network and free access to simulation training equipment. The aim of this article is to review the QTE program and assess the benefits to clinicians in both the delivery of education and the provision of trauma care. To evaluate the QTE program, a desktop review was conducted. This included analyses of website data, course and website content, and facilitator, stakeholder, participant and user feedback. The data were evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, and the program's alignment with the original TNA outcomes was assessed. The results showed that QTE aligns with the identified training needs. Specifically, QTE provides trauma education that is relevant, sustainable, employs best practice, is locally delivered, provides continuous support, is multidisciplinary, multi-platformed, physically accessible and accredited by the Australasian College for Emergency Medicine. The review also highlights how QTE has effectively been reaching its target population, improves knowledge and skills, has become widely adopted, and been implemented and maintained with relative success. The innovative QTE program addresses the previous deficits in trauma education and meets the needs identified in the TNA. The review also reveals further opportunities for continuous improvement and program sustainability.

Education Policy In Border Areas: A Narrative Literature Review

This study explores the challenges and solutions of education policy in border areas through a narrative literature review approach. Based on an analysis of 14 previous research articles, it was found that border areas face significant constraints in the education sector, including limited infrastructure, lack of qualified teaching staff and low community participation. Existing education policies are often inappropriate for the specific conditions of border areas, requiring adjustments that take into account local characteristics and the active involvement of all stakeholders. Proposed solutions include collaborative approaches, strengthening locally-based character education and improving educational infrastructure and resources. In addition, the government is expected to improve the quality and welfare of educators through special incentives and professional training. Effective education policies that are responsive to local needs are expected to improve the equity and quality of education in border areas, providing equal opportunities for all children to get a quality education. The results of this study emphasize the importance of regular policy monitoring and evaluation to ensure successful implementation.

Groundwater health risk assessment of North China Plain based on Monte Carlo model sensitivity analysis and morphological analysis: A case study of Shijiazhuang City.

The rapid development of the social economy and the influence of human activities can lead to aggravated groundwater pollution. Groundwater safety is the premise of residents' health. Therefore, studying the sustainable utilization and health risks of groundwater quality is important. The groundwater quality and potential health risks were evaluated in the Shijiazhuang area, which is located in the North China Plain in this paper. Based on 159 groundwater samples collected in the study area, the potential health risks of As, Cr6+, Ni, Pb, F-, and NO3 - to humans were evaluated from oral and skin contact. Results of the human health risk assessment showed that the average carcinogenic risk and non-carcinogenic risk of children are higher than those of adults. According to the spatial distribution of the total risk value, adults and children in the southwest of the study area face higher risks. Because of the uncertainty of USEPA, Monte Carlo simulation was used to calculate the probability of health risk assessment and prioritization of contaminant treatment. The results of the Monte Carlo simulation showed that the acceptable range for children is 6.82%, and the acceptable range for adults is 18.07%. According to the HRWM model, carcinogenic pollutants mainly include As, Cr6+, and Ni. The most important chemical species of As is HAsO4 2-, followed by H2AsO4 -. Similarly, CrO4 2- and Ni2+ are the main forms of Cr6+ and Ni. The results of this study can provide data support for the protection and management of groundwater quality in the North China Plain. PRACTITIONER POINTS: Children are more susceptible to carcinogenic risk than adults. After calculation, the main influencing elements are Ni and Cr. Metal morphology analysis was carried out, and the results showed that HAsO4 2-, CrO4 2-, and Ni2+ were the main types.

Once-daily upadacitinib versus placebo in adults with extensive non-segmental vitiligo: a phase 2, multicentre, randomised, double-blind, placebo-controlled, dose-ranging study

Janus kinase (JAK) inhibition is a promising approach for treating vitiligo. We aimed to assess the efficacy and safety of upadacitinib, an oral selective JAK inhibitor, in adults with non-segmental vitiligo. This was a phase 2, multicentre, randomised, double-blind, placebo-controlled, dose-ranging study completed at 33 clinical centres in the United States, Canada, France, and Japan. Eligible patients were aged 18-65 years with non-segmental vitiligo and had a Facial Vitiligo Area Scoring Index (F-VASI) ≥0.5 and a Total Vitiligo Area Scoring Index (T-VASI) ≥5. Patients were randomly assigned (2:2:2:1:1) using an interactive response technology to receive upadacitinib 6mg (UPA6), upadacitinib 11mg (UPA11), upadacitinib 22mg (UPA22), or placebo (PBO; preassigned to switch to either UPA11 or UPA22 in period 2) once daily for 24 weeks (period 1). For weeks 24-52 (period 2), patients randomly assigned to upadacitinib continued their treatment, and patients receiving PBO switched to their preassigned upadacitinib dose in a blinded fashion. The primary endpoint was the percent change from baseline in F-VASI at week 24. Efficacy was analysed in the intention-to-treat population, and safety was examined in all randomly assigned patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT04927975. Between June 16, 2021, and June 27, 2022, 185 patients (including 115 [62%] who were female and 70 [38%] who were male) were randomly assigned to UPA6 (n=49), UPA11 (n=47), UPA22 (n=43), or PBO (n=46). At week 24, the LS mean difference versus PBO in the percent change from baseline in F-VASI was-7.60 (95% CI-22.18 to 6.97; p=0.3037) for UPA6,-21.27 (95% CI-36.02 to-6.52; p=0.0051) for UPA11, and-19.60 (95% CI-35.04 to-4.16; p=0.0132) for UPA22. The LS mean difference versus PBO in the percent change from baseline in T-VASI was-7.45 (95% CI-16.86 to 1.96; p=0.1198) for UPA6,-10.84 (95% CI-20.37 to-1.32; p=0.0259) for UPA11 and-14.27 (95% CI-24.24 to-4.30; p=0.0053) for UPA22. Ongoing treatment with upadacitinib induced continuous skin repigmentation over time without reaching a plateau through week 52. The rates for study drug discontinuation and serious treatment-emergent adverse events (TEAEs) were higher in the UPA22 group than in the UPA11 and UPA6 groups. Eight serious TEAEs, including one death of unknown cause and one case of infiltrating lobular breast carcinoma, were reported through 52 weeks; only two serious TEAEs (coronary artery arteriosclerosis [UPA6 (n=1)] and non-fatal ischemic stroke [UPA11 (n=1)]) were deemed by the investigator to have a reasonable possibility of being related to study drug. The one case of breast cancer in the UPA11 group was deemed unrelated to study drug, and the one death of unknown cause in the UPA22 group was reviewed and adjudicated and was deemed to be unrelated to study drug. The most common TEAEs were COVID-19, headache, acne, and fatigue. No new safety signals were observed. Upadacitinib monotherapy led to substantial repigmentation of both facial and total body vitiligo lesions and may offer an effective treatment option for adults with extensive non-segmental vitiligo. Based on these findings, upadacitinib 15mg is being investigated in adults and adolescents with non-segmental vitiligo in an ongoing phase 3 randomised controlled trial. AbbVie Inc.

SHIKSHA-CHAKRA: Ideate & Implement a System to Enhance Quality of Education in Rural Areas

Abstract: Access to quality education is a fundamental right, yet many rural areas face significant challenges in providing effective learning experiences to their students. To bridge this educational divide, this project introduces an innovative Androidbased system, known as the Rural Education Enhancement System (REES), designed to transform the landscape of education in rural regions. REES comprises a multifaceted approach, with key features including an interactive learning app offering subject-specific content, localized curriculum, and an array of interactive modules. The system facilitates teacher-student communication and provides tools for personalized progress tracking. Moreover, it prioritizes local languages and offers community forums for collaboration. Assessments, both online and offline, support student evaluation, while offline resource centers and parental involvement portals enrich the learning ecosystem. To ensure the system's longevity, sustainability planning is at the forefront, emphasizing funding, maintenance, and ongoing improvements. The project implementation involves thorough needs assessments, pilot programs, and community engagement. By addressing the unique needs of rural communities and leveraging the power of mobile technology, REES aspires to enhance the quality of education in rural areas, empower students, and strengthen the connections between teachers, parents, and the community, ultimately contributing to a brighter and more equitable educational future for all.