High Sun Exposure Research Articles

The role of vitamin D in multiple sclerosis and its mechanisms of action

Introduction and Purpose: Multiple sclerosis (MS) is a prevalent autoimmune disease affecting the central nervous system, particularly in young people. Characterized by neurodegenerative and demyelinating processes, MS is influenced by genetic and environmental factors. Research indicates that sufficient levels of vitamin D can reduce the risk of developing MS. Studies show that higher sun exposure and dietary vitamin D intake are associated with a lower incidence of MS. Moreover, vitamin D supplementation may benefit those already diagnosed by alleviating symptoms and improving their quality of life. This review explores the potential benefits of vitamin D and its neuroprotective mechanisms in MS. State of Knowledge: MS research and treatments have focused on immunomodulation, with less emphasis on neuroprotection, including the role of vitamin D. It is well-established that vitamin D has anti-inflammatory effects on the immune system in MS. It influences the proliferation and differentiation of neural stem cells and oligodendrocytes, enhances neurotrophin expression, reduces reactive astrogliosis, decreases oxidative stress, and stabilizes the blood-brain barrier. Research suggests that adequate vitamin D levels and supplementation might improve MS outcomes. Conclusion: New diagnostic tools and therapeutic strategies are urgently needed to address the complex nature of MS, which includes inflammation, neuronal death, demyelination, and oxidative stress. Promoting vitamin D sufficiency and supplementation, alongside developing new neuroprotective agents, remains a valuable approach in combating MS. Understanding the mechanisms of MS and the effects of vitamin D could lead to better management strategies and enhanced quality of life for patients.

Assessing geographical variation in economic disadvantage and dermatological care access in Florida

This study aims to quantify the relationship between economic disadvantage and access to dermatological care in Florida in order to advocate for tailored healthcare policies. Identifying underserved geographic communities can guide policymakers in implementing strategies to enhance accessibility to care in these areas. Using data from the Centers for Medicare & Medicaid Services (CMS) and the US Census, this study analyzed dermatologist density across 920 Florida zip codes. Economic disadvantage was assessed using the distressed community index (DCI), a metric that stratifies zip codes into 5 levels of economic well-being. Statistical analyses, including the Kruskal-Wallis test, were conducted to assess disparities. Findings revealed significant differences in the number of providers by DCI quintile (p<.001) and urban/rural designation (p<.001). Lower deprivation areas were more likely to have providers, with 33.2% of the least deprived quintile having at least one provider compared to 11.8% in the most deprived quintile. Urban areas were more likely to have at least one provider (p<.001), with 36.6% of urban zip codes having providers versus 1.1% of rural ones. Zip codes with at least one provider had significantly higher total population (p<.001). These findings highlight the need for targeted interventions to address geographic disparities in the provision of dermatologic care, particularly in economically disadvantaged and rural areas of Florida. Considering the state’s high sun exposure rates and associated skin cancer risks, ensuring accessible dermatology services across all zip codes, regardless of socioeconomic status, is imperative for public health.

Recruitment responses of shade‐tolerant and heliophilous trees in degraded areas: The necessity of knowing the recruitment autecology of species for effective reforestation decisions

AbstractDirect seeding is a reforestation technique that allows introducing a great variety of tree species in degraded areas with less logistics, but tree establishment rates are usually low because developing plants do not tolerate the high sun exposure, extreme temperatures, and low soil moisture that prevail in these habitats. This leads to the proposal that seeds should be planted beneath shrubs or herbaceous plants that ameliorate harsh abiotic conditions, although this can also trigger interspecific competition and impair the performance of developing trees. This study aimed to test these proposals in dry forests in northwest Argentina. For this, seeds of two shade‐tolerant trees and a heliophilous tree, native to this region, were sowed beneath the canopy of pioneer shrubs and in open spaces with and without herbaceous plants. After 2 years, our findings indicated that shade‐tolerant trees performed better beneath shrub canopies, while the heliophilous tree achieved higher establishment rates in the open spaces. Nevertheless, it seems that herbaceous plants compete with the tree seedlings and, therefore, they should be removed before conducting reforestation programs. Thus, we propose that direct seeding could be an efficient reforestation strategy, but the regeneration autecology of the tree species selected for this task, as well as their competitive ability in the face of the pioneer vegetation, must be carefully evaluated before seeding.

Medical, Environmental, and Social Determinants Associated With Periocular Cutaneous Malignancies in the United States Using the All of Us National Database.

To identify common factors associated with periocular cutaneous malignancies using the National Institutes of Health (NIH) All of Us database. In this case-control study, we extracted electronic health records and sociodemographic data for 385 cases of periocular cutaneous malignancies from the All of Us nationwide database. Controls (N = 1540) were matched to the demographic characteristics of the 2020 United States Census. Bivariate analyses and multivariable logistic regression determined variables significantly associated with increased odds of periocular cutaneous malignancies. We analyzed medical, environmental, and social determinants to evaluate which factors were associated with increased odds of periocular cutaneous malignancies. Among the cases, the mean (standard deviation) age was 66.8 (11.2) years at the time of diagnosis. The majority were male (207, 54%) and white (361, 94%). Periocular cutaneous malignancy was significantly more likely among individuals with high sun exposure (odds ratio [OR] 14.79, 95% confidence interval [CI] 3.35-85.73, P= 0.001), those identifying as white race (OR 3.88, 95% CI 1.06-25.33, P= 0.079), and those with higher socioeconomic status, including higher annual income (OR 1.35, 95% CI 1.25-1.46, P< 0.001). This study demonstrates similar risk factors for periocular cutaneous malignancies, echoing prior research that showed increased associations with lighter-pigmented skin and higher socioeconomic status. It also sheds light on the positive impact of physician surveillance and health utilization factors in the early detection and treatment of these malignancies, aspects less explored in prior analyses.

Effect of zeolite and irrigation treatments on grapevine leaves, an interdisciplinary approach

Abstract Aims Global warming depicts a real challenge for viticulture. As found by PubMed results, a 90% increase in the abiotic stress publications number from 2015 onwards is registered. Soil and grapevine response interaction to abiotic stress is arbitrated by an intricate signal transduction network that determines adaptive changes and modifications in gene expression mediated by the transcription factors (WRKY proteins). Briefly, (i) Does zeolite application affect canopy and biochemical leaf components? (ii) Is it possible to start a gene expression approach in an open-field vineyard, without fixed and stable external parameters obtaining an interconnected net of interdisciplinary data? (iii) Could the zeolite application be a corroborant tool to maintain a state of homeostasis in grapevine? Methods After a soil clinoptilolite treatment (the "Roca magica" well known as water moderator) and/or irrigation utilizing vines presented to drought and high sun exposure, we investigated leaf biochemical variations (proline, chlorophyll, and quercetins) and we analyzed with rt-PCR approach the expression of selected genes (VvWRKY47 and VvWRKY39). Results Lower water potential and leaf temperature were recorded in plants subjected to treatments against abiotic stress together with greater chlorophyll a, b, and less quercetin-3-O-glucoside. A down-regulation in VvWRKY47 gene and an up-regulation in VvWRKY39 gene were found. The VvWRKY47 showed interactions from the beginning with the zeolitic treatment. Conclusion The zeolite in our experiment acted as a water flywheel, mitigating the effects of climate change; plant-soil interactions were positively emphasized by clinoptilolite. Finally, results suggest that VvWRKY47 could be a valid candidate in the evaluation of drought and temperature stress in the open-field.

Occupational skin cancer screening: Results of a cross‐sectional study at the city drainage company Munich

AbstractBackgroundSince skin cancer incidence and prevalence are rising steadily, the prevention of skin cancer has gained importance. People with high sun exposure at work are at special risk, and prevention measures by the employer may lower the risk, especially for keratinocyte carcinoma.ObjectivesThe aim of the study was to evaluate the results of a large‐scale skin cancer screening campaign at the city drainage company Munich where the cohort consisted mainly of outdoor workers.MethodsIn 2023, a skin cancer screening campaign was conducted at the city drainage company Munich. Sun exposure and protection measures of each participant were assessed using a questionnaire. Dermatologists identified clinical signs for sun damage and skin cancer by whole‐body skin examination.ResultsA total of 290 participants (72.8% male; mean age 43.7 ± 11.5 years) were enroled. 36.6% showed clinical signs of sun damage correlating with male gender, higher age, and more hours spent outdoors per day. Clinical examination revealed a suspect finding of skin cancer, a preliminary stage, or a lesion requiring clinical control to avoid skin cancer development in 19.3% of participants. Participants with atypical melanocytic lesions were mostly female and showed a high skin cancer awareness. This was concluded from the fewer signs of sun damage, a higher percentage of previous screening participation, and more regular self‐examination.ConclusionsWhole‐body examination for skin cancer screening at work is a valuable tool to encourage participation in this preventive measure. It may help identify people at risk either by clinical signs for sun damage or risk exposure which can be assessed with a simple questionnaire. Based on this result, the screening interval may be adopted individually.

Correlation Among Serum Calcidiol, Sun Index, and Vitamin D Intake in Individuals With Seborrheic Keratoses Living in Coastal Area.

Seborrheic keratoses (SK) are benign epidermal tumors with high sun exposure as a major risk factor. Vitamin D deficiency is also thought to play a role in its pathogenesis. There has been no data regarding SK, calcidiol level, vitamin D intake, and sun index (SI) among people living in coastal areas in Indonesia. To assess the correlation between 1) serum calcidiol levels with SI and vitamin D intake and 2) lesion size with SI and serum calcidiol level among SK patients living in a coastal area. This is a cross-sectional study. We performed interviews using the sun index questionnaire and semiquantitative food frequency questionnaire for vitamin D; physical examination; dermoscopy to determine the largest SK lesion size; and measurement of serum calcidiol levels in participants with SK living in Cilincing District, North Jakarta. Spearman correlation test was used to assess the relationship between variables. Thirty-nine participants with SK aged 19-59 years were analyzed. The median of the SK largest diameter, SI, serum calcidiol, and vitamin D intake was 2 (1-10) mm, 3.95 (1.1-23.52), 14.3 (5.25-35.30) ng/ml, and 4.3 (0.1-30.1) mcg/day, respectively. SI and vitamin D intake were not significantly correlated with calcidiol levels. Similarly, SI and calcidiol levels were not significantly correlated with the largest SK lesion size. We found low calcidiol levels and vitamin D intake in this coastal population. The SI and vitamin D intake had no correlations with calcidiol levels. Furthermore, calcidiol levels and SI had no correlations with the lesion largest diameter.

The Immune Response of Cutaneous Basosquamous- and Squamous-Cell Carcinoma Associated with Sun Exposure.

In recent years, there has been an observed increase in the frequency of cutaneous carcinoma, which correlates with sun exposure. This study aims to explore the variances of tumor characteristics and immune response markers among patients diagnosed with cutaneous squamous-cell carcinoma (SCC) and basosquamous-cell carcinoma (BSC) with varying levels of sun exposure. The objective is to elucidate the potential influence of sun exposure on tumor progression and immune response in these types of carcinomas. We conducted a retrospective observational study that included 132 patients diagnosed with SCC and BSC. Participants were separated into high- and low-sun exposure groups. Tumor characteristics and immune response markers, including lymphocyte percentage (LY%), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), were assessed using the Mann-Whitney U test. Our findings revealed the interplay between sun exposure, inflammation, aging, and immune response. In 80% of cases, it was found that individuals had high sun exposure throughout their lifetime. Patients in the high sun exposure category had a significantly higher LY% than those with low sun exposure (24.22 ± 7.64 vs. 20.71 ± 8.10, p = 0.041). Also, the NLR was lower in patients with high sun exposure (3.08 ± 1.47 vs. 3.94 ± 2.43, p = 0.023). Regarding inflammatory markers, the erythrocyte sedimentation rate (ESR), LY%, NLR, and LMR showed significant differences between the two groups. Patients who were diagnosed with SCC had higher ESR values (p = 0.041), higher LY% (p = 0.037), higher NLR (p = 0.041), and lower LMR (p = 0.025). This study provides evidence supporting distinct tumor characteristics and immune response patterns in patients diagnosed with SCC and BSC with a high sun exposure history. These findings imply that sun exposure may contribute to tumor progression and influence the immune response in individuals with SCC and BSC.

Clinical and genetic determinants of vitamin D receptor expression in cutaneous melanoma patients.

Decrease of vitamin D receptor (VDR) expression is observed in melanocytic naevi and melanoma compared to normal skin. Little is known about factors influencing VDR expression in cutaneous melanoma (CM). We investigated the correlation of VDR expression in CM with 25-hydroxy vitamin D (25OHD) levels, demographic/clinical parameters, genetic variants of VDR and pathology of the primary tumor. Demographic/clinical parameters were recorded in 407 prospectively recruited CM patients of a multi-center controlled study (ViDMe trial). We determined VDR expression both in the nucleus and in the cytoplasm by semi-quantitative assessment in CM tissue using histochemistry in 279 patients, expressed in percentages and histoscore (H-score). Genomic DNA from 332 patients was extracted to genotype thirteen VDR single nucleotide polymorphisms (SNPs) using TaqMan. VDR expression in CM tissue from 279 patients was correlated with clinical/demographic parameters and 25OHD levels (univariable and multivariable analysis), VDR SNPs (univariable analysis) and pathology parameters of primary CM tissue (univariable analysis). Cytoplasmic VDR expression was increased in patients who stated to have a high sun exposure during their life compared to patients with low sun exposure (p H-score,univariable : 0.001, p H-score,multivariable : 0.004). The A allele of the genetic VDR polymorphism Fok1 was associated with a higher expression of the VDR in the cytoplasm (p cytoplasmic, univariable : 0.001 and p H-score, univariable : 0.02). In the primary tumor, presence of mitosis (p nucleus,%, univariable : 0.002) and perineural invasion (p nucleus,%,univariable : 0.03) were significantly associated with low nuclear VDR expression. ClinicalTrials.gov Identifier: NCT01748448.

The relationship between the level of vitamin D and ruptured intracranial aneurysms among patients with high sun exposure

Non-traumatic subarachnoid hemorrhage (SAH) accounts for 3–5% of acute strokes. Intracranial aneurysm is the most common cause of non-traumatic SAH. Vitamin D influences the cardiovascular system, including the formation and rupture of cerebral aneurysms. To evaluate the serum vitamin D level in patients living in the tropical zone who suffered aneurysmal subarachnoid hemorrhage and its correlation with demographic and neurological characteristics. This is an analytical cross-sectional study to assess the serum level of vitamin D in a study population of 99 patients treated and diagnosed with aSAH in a public hospital in Recife-PE over a period of 12 months. In the study sample, composed of individuals with high sun exposure due to the lifestyle they lead in a tropical region, we observed hypovitaminosis D (85.9%), with a median of 19.9 ng/ml, although the majority of individuals are skin with high concentration of melanin (Fitzpatrick skin type IV and V). In addition, rates of sun exposure are high to all patients (Solar Index 9.03 P50). Most individuals were female (79.8%); there was no statistical difference in solar exposure/solar index between genders. As for the neurological repercussions, there was no statistical relevance in the clinical prognostic scales evaluated. As the sample was composed mainly of individuals whose economic activity is agriculture, the values of solar index found are vastly higher than those of other studies conducted in high latitude regions. In line with the literature review, some aspects were raised with the objective of justifying such findings that go from the base of the poor diet of these individuals, the increase of melanin in the skin and genetic alterations that directs us to possible mechanisms of natural photoprotection to high sun exposure. Thus, we had a vast majority (85%) of hypovitaminosis D, which in fact makes us wonder if there is any influence of calcitriol on vitamin D receptors in vascular walls and in the cardiovascular system as a whole, which influence bleeding events of this nature. As for the neurological repercussions, measured using assessment scales (Glasgow coma scale, WFNS scale, Hunt–Hess and Fisher's tomographic scale) there was no significant difference in the results. As it is only a descriptive study, the causal relationship of the facts cannot be established. However, in a population exposed to high sun exposure and affected by aneurysmal SAH, there is a significant rate of hypovitaminosis D, which supports the hypothesis that vitamin D plays a role in vascular pathologies, such as cerebral aneurysms and SAH.

Positive Impact of UV Photography on Individual Sun Protection: A Swiss Feasibility Study.

This study evaluates the feasibility and impact of conveying personalized sun protection message supported by a UV photograph of the face in Switzerland. 440 adults from 14 private and public sites associated with high sun exposure received a skin cancer prevention intervention composed of a facial UV-filtered photograph and individual counselling by a trained registered nurse. Pre-/post intervention surveys assessed sun protection of participants, their skin cancer risk and reasons for behavioural change. The range of facial UV spots' count per individual was very broad (0-590) and mainly determined by phototype, followed by age. Three months after the intervention, 61% of participants positively changed their sun protection habit both during leisure and at work. Use of all sun protection means increased. No factor could be specifically associated to that propension for change. The individualized message was perceived as the main motivation for change. Personalized sun protection messages supported by a facial UV photograph led to significant favourable behavioural change in a highly sun-exposed population of adults.

COMPARATIVE ANALYSIS BETWEEN AHP MOORA AND AHP-ELECTRE METHOD FOR OPTIMAL ELECTRIC AND SOLAR-POWERED SHIPYARD SITE SELECTION

Transportation is the second largest emitter of CO2 in the world, accounting for 25% of total CO2 emissions. To achieve a zero-carbon shipping industry, Indonesia can use its high sun exposure to generate electrical energy by using solar cell technology, which converts solar energy into electrical power. To answer the challenge, this research will start with the site selection of electric and solar-powered shipyards. This research tries to solve the problem of selecting the best location for electric and solar-powered shipyards by using the Multi-Criteria Decision Making (MCDM) method. The purpose of this research is to get the optimal location of electric and solar shipyards using AHP-MOORA and AHP-ELECTRE methods. There are three alternative locations in the location selection. Alternatives 1 and 3 are in Paciran District, Lamongan Regency, East Java Province, and alternative 2 is in Serang Regency, Banten Province. Alternative site 1 has an area of 38 ha and is located in Sidokelar Village, Paciran Sub-district. Decision-makers determine the parameters that will be evaluated from each alternative location, such as slope, soil type, rainfall, and 18 other criteria. In determining the weighting of parameters, a method that has a consistency test is needed so that the weight results obtained are consistent and objective. The study result shows that alternative location 1 is the best location for the electric and solar-powered shipbuilding industry, the same conclusion using the AHP-MOORA Integration approach and the AHP weighting ELECTRE Integration approach.

Increased Risk of Local Recurrence in Cutaneous Squamous Cell Carcinoma Arising in Sun-Exposed Skin: A Retrospective Cohort Study.

The incidence of cutaneous squamous cell carcinoma (cSCC) is increasing over the years. Risk factors for local recurrence and metastasis have been widely studied in highly sun-exposed areas of the body but less data exist about less sun-exposed ones. The main objective of this study is to compare the risk of local recurrence and metastases in patients with cSCC in highly sun-exposed areas compared to cSCC in less sun-exposed areas. A retrospective observational study was carried out, including 558 patients with histopathologically confirmed cSCC at the Reina Sofía University Hospital (HURS), Córdoba, during the period from 1 January 2017 to 31 December 2020. Demographic, clinical and anatomopathological data were collected. Local recurrence occurs more often in highly sun-exposed areas (15.8%) compared to less sun-exposed ones (7.4%) (p < 0.05). However, no differences in the rate of metastases in both groups were found. The presence of affected surgical margins and tumor thickness were identified as independent risk factors for cSCC in low sun-exposure areas. cSCC located in anatomical areas of high sun exposure presented a greater risk of developing local recurrence in our population, which could suggest that these tumors have worse prognosis than those that lie in areas that do not receive chronic sun exposure.

A Population-Based Family Case-Control Study of Sun Exposure and Follicular Lymphoma Risk.

Epidemiologic evidence suggests an inverse association between sun exposure and follicular lymphoma risk. We conducted an Australian population-based family case-control study based on 666 cases and 459 controls (288 related, 171 unrelated). Participants completed a lifetime residence and work calendar and recalled outdoor hours on weekdays, weekends, and holidays in the warmer and cooler months at ages 10, 20, 30, and 40 years, and clothing types worn in the warmer months. We used a group-based trajectory modeling approach to identify outdoor hour trajectories over time and examined associations with follicular lymphoma risk using logistic regression. We observed an inverse association between follicular lymphoma risk and several measures of high lifetime sun exposure, particularly intermittent exposure (weekends, holidays). Associations included reduced risk with increasing time outdoors on holidays in the warmer months [highest category OR = 0.56; 95% confidence interval (CI), 0.42-0.76; Ptrend < 0.01], high outdoor hours on weekends in the warmer months (highest category OR = 0.71; 95% CI, 0.52-0.96), and increasing time outdoors in the warmer and cooler months combined (highest category OR = 0.66; 95% CI, 0.50-0.91; Ptrend 0.01). Risk was reduced for high outdoor hour maintainers in the warmer months across the decade years (OR = 0.71; 95% CI, 0.53-0.96). High total and intermittent sun exposure, particularly in the warmer months, may be protective against the development of follicular lymphoma. Although sun exposure is not recommended as a cancer control policy, confirming this association may provide insights regarding the future control of this intractable malignancy.

Evaluasi Mutu Fisik dan Penentuan Nilai Sun Protecting Factor (SPF) Sediaan Lotion Ekstrak Etanol Daun Matoa (Pometia pinnata)

Indonesia has high sun exposure, and most people work outdoors, so they need skin protection. One plant with the potential as a sunscreen is matoa leaf (Pometia pinnata). This study aimed to determine the physical quality and the Sun Protecting Factor (SPF) value of matoa leaf ethanol extract lotion, which were analyzed in vitro. Physical quality evaluation included organoleptic tests, homogeneity, pH, adhesion and spreadability, and SPF values obtained by the UV-Vis spectrophotometry method. Mansur Formula was used to calculate the SPF value. The results of the study showed FI (0.5%), FII (1%), and FIII (1.5%) obtained an average SPF value of 13.99 ± 1.45 (maximum protection), 22.27 ± 2.06 (ultra protection), 27.42 ± 0.54 (ultra protection). All formulas had good physical quality and had potential as sunscreens. Key words: lotion; matoa leaves; SPF; sunscreen

Komparasi Metode Maut dan Moora dalam Pemilihan Sunscreen untuk Kulit Menggunakan Pembobotan ROC

The skin is the outer layer of the human body that has various important functions. However, high sun exposure in Indonesia can cause damage to the skin due to ultraviolet rays. The use of sunscreen becomes important in preventing sunburn and skin cancer. Women with combination skin types often have difficulty choosing the right sunscreen. This study applies the Multi Attribute Utility Theory (MAUT) and Multi-Objective Optimization on The Basis of Ratio Analysis (MOORA) methods with the weighting of the Centroid Rank Order (ROC) method and the level of accuracy of MSE aims to produce decisions in choosing the right sunscreen for combination skin. At the methodology stage, data on criteria, sub-criteria, and alternatives are collected through observation and interviews. The criteria consist of 6 namely Benefit, Composition, Price, Vitamins, Side Effects, and Size. The ROC is used for weighting, while the MAUT and MOORA methods are used in the assessment and comparison of alternatives and MSE is used for the level of accuracy. The discoveries from this study hold the possibility to offer recommendations for choosing the best sunscreen for combination skin, namely A7 with the brand sunscreen Somethinc Comfort Correct for the MAUT method is 0.7134 and the MOORA method is 0.102. The results of the MSE calculation obtained a deviation value, namely the MOORA method with a value of 215.0091 better than the MAUT method of 207.4922. So that the MOORA method is the best method in choosing sunscreen for combination skin and aims to help people who are still having difficulty choosing the right sunscreen, so as to avoid mistakes in choosing inappropriate sunscreens that can have a negative impact on the skin

Dopamine Transporter Availability in Early Parkinson's Disease is Dependent on Sunlight Exposure.

Preliminary studies suggested seasonality of dopaminergic functioning, but it is unknown whether dopamine transporter (DAT) expression in humans is also dependent on the seasons. We, therefore, investigated seasonal and sunlight-dependent effects on DAT availability in early Parkinson's disease (PD) patients and healthy controls. DAT single-photon emission computed tomography scans (n = 730) were gathered from the Parkinson's Progression Marker Initiative (PPMI) database. We used global horizontal irradiance (GHI) as proxy for sun exposure/month and assessed associations between striatal DAT availability and season (autumn/winter versus spring/summer), GHI and latitude of the PPMI site. In PD patients, DAT availability in the left caudate nucleus was higher in spring/summer (B [standard error (SE)] = 0.05 [0.02], P = 0.03) and positively associated with higher sun exposure (B [SE] = 0.59 [0.22] × 10-3 , P = 0.007). Latitude (in degrees north) of the PPMI site was negatively associated with DAT availability in both PD and healthy controls. Striatal DAT availability may be influenced by daylight exposure. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Relationship of vitamin D with the anthropometric indicators and lifestyle of adults. Medellín. Colombia

Introduction: Serum vitamin D levels depend on sunlight, diet, and other factors. Objective: We aimed to determine serum vitamin D levels and evaluate their relationship with anthropometric indicators and lifestyle habits in apparently healthy volunteers. Materials and Methods: In this cross-sectional study (n=75), socio-demographic, anthropometric, and lifestyle habit-related data were collected. Serum vitamin D levels were determined with high performance liquid chromatography, food intake was measured by semiquantitative frequency and nutritional status was assessed by anthropometry. Chi-square test and also principal component analysis were used to analyze the relationship between some variables and vitamin D status. Spearman’s test was used to determine correlations between quantitative variables. Results: 73% were women and 61% belonged to medium socio-economic level. Median vitamin D intake was 137 (83.1–227.3) IU/day. Based on body mass index (BMI), 44% individuals had overweight/obesity. The 68% exhibited deficient/insufficient vitamin D levels (Hypovitaminosis D). BMI classification and waist circumference (CW) were not related with vitamin D status; however, activities with higher sun exposure were highly related (p = 0.013). Sun exposure time explained variation in component 2 (16.60%), where most of the individuals with normal level were grouped. Sun exposure time was positively correlated with vitamin D status (r = 0.263; p = 0.023). Discussion: Excess weight and abdominal obesity are not always associated with hypovitaminosis D. Conclusions: The majority of individuals showed hypovitaminosis D but their status was not related with anthropometric indicators. A Sun exposure time was the only factor positively correlated with vitamin D status.

Can active sun exposure decrease the risk of giant cell arteritis and polymyalgia rheumatica in women?

To study if active sun exposure among women affects the risk of developing GCA or PMR in a prospective cohort study with restricted latitudinal variability. We linked the response to questions relating to sun exposure from the Melanoma Inquiry in Southern Sweden (MISS) prospective cohort study in women to the risk of developing GCA or PMR. Healthcare data were gathered from the Skåne Healthcare Register (SHR), covering all public healthcare consultations. The direct effect of active sun exposure on the risk of developing GCA or PMR was assessed using Cox proportional hazards models adjusted for covariates based on a directed acyclic graph. A total of 14 574 women were included in the study; 601 women were diagnosed with GCA or PMR (144 and 457, respectively) during the follow-up time. Women with moderate or high sun exposure were not less likely to develop GCA or PMR compared with women that indicated they avoided sun exposure [hazard ratio (HR) 1.2 (CI 0.9, 1.6) and 1.3 (0.9, 1.9), respectively] when adjusted for diabetes, hyperlipidaemia, hypertension, smoking, obesity and stratified by age. Similar patterns were observed when studying only GCA [HR 1.2 (CI 0.7, 2.3) and 1.3 (0.7, 2.6)] and only PMR [HR 1.3 (CI 0.9, 1.8) and 1.4 (0.9, 2.0)]. Active sun exposure did not affect the risk of developing GCA or PMR in women in a cohort with restricted latitudinal variability.

The Effect of Climate on the Dose Requirements of Botulinum Toxin A in Cosmetic Interventions.

Botulinum toxin A to the glabella is a popular cosmetic intervention. Functional musculature differences may arise from chronic behavioral adjustment to high sun exposure levels, requiring greater doses. This could affect clinical practice globally. This study investigated the effect of climate on real-world doses. The authors conducted a comparative cohort study using data from a registry from a single provider practicing across two centers: the United Kingdom and Malta. They classified one center as low sun exposure (United Kingdom winter month treatment) and the other as high sun exposure (Malta summer months). Patients were followed up once every 3 weeks and received top-up doses until full clinical paralysis was achieved. To standardize the comparison, the study included only women aged 35 to 60 years undergoing glabellar botulinum toxin treatment by experienced clinicians following standard procedures from 2012 to 2019. Smokers, those not seeking maximal paralysis, those documented as not compliant with posttreatment advice, those with colds or fevers, and those with broken cold supply chains were excluded. Univariable and multivariable analyses were undertaken. A total of 523 patients were included: 292 "high-sun" patients and 231 "low-sun" patients. Mean total doses were significantly higher in the high-sun group (29.2 units versus 27.3 units; P = 0.0031). When correcting for age in multivariable analysis, the low-sun group still had lower total dose requirements ( P = 0.00574). Patients injected with glabellar botulinum toxin in high-sun climates may have significantly increased dose requirements to achieve maximal paralysis. Therapeutic, III.