Low Sun Exposure Research Articles

Relationship between sun exposure and seasonal affective disorder symptoms in rural older people with different personalities: a cross-sectional study

ObjectivesEvidence suggests that environmental support, personality traits, and psychological factors can influence seasonal changes in human mood and behavior, particularly in rural middle-aged women and older people. This study aimed to quantify the associations between personality traits, seasonal affective disorder symptoms, and sun exposure in rural older people.MethodsThis study is a cross-sectional analytical study, the participants were 300 rural older persons from 12 natural villages and 5 geriatric service centers in 4 different cities in Jiangxi Province, China. The Eysenck Personality Questionnaire (EPQ), the Personal Inventory of Depression and Seasonal Affective Disorder (PIDS-SA-SimpChi), and the Sunlight Exposure Scale were used to conduct follow-up interviews throughout the year. Spatial analysis was performed using ArcGIS and Geodetic Probes. The data were analyzed using SPSS 21 and Amos 23.0 mediated models.ResultsRural older people with low sun exposure exhibited higher personality trait scores (p < 0.001). Personality traits were directly associated with seasonal affective disorder symptoms(p < 0.01); Sun exposure mediated this effect in rural older people (p < 0.05).ConclusionHigh-scoring personalities are more typical of rural older people with low sun exposure, and there is a greater risk of emotional and behavioral instability. Latitudinal differences are not a determinant of SAD. Increased sun exposure is associated with symptom relief. The promotion of light therapy devices in rural areas with low sunlight is warranted.

Low Sun Exposure Is Associated with Both Progressive-Onset and Relapse-Onset Multiple Sclerosis Risk: A Case-Control Study

Background: Sun exposure has consistently been associated with multiple sclerosis (MS) onset, but case samples are predominantly relapse-onset MS (ROMS), and risk estimates have rarely been reported separately for ROMS and progressive-onset MS (POMS). We aimed to determine whether sun exposure prior to disease onset was associated with POMS and whether the effect differed between POMS and ROMS. Methods: This nationwide case-control study included 153 POMS cases, 204 incident ROMS cases, and 558 community controls with data from two separate datasets: the PPMS Study (2015–2021) and the Ausimmune Study (2003–2006). Information on time spent in the sun before the first MS symptom, skin phenotype, and sun protection behavior was collected. Satellite data on ambient ultraviolet radiation (UVR) were used to calculate cumulative UVR dose. Unconditional logistic regression was used with adjustment for covariates. Results: There were consistent dose-response associations, with higher levels of UVR exposure associated with a reduced risk of POMS, both for leisure-time and occupational UVR from age 6 to symptom onset. Associations were overall stronger for POMS than ROMS. For example, cumulative leisure-time UVR dose (per 100 kJ/m2 increment) was associated with POMS (aOR 0.93, 95% CI: 0.91–0.95) and the association was slightly weaker for ROMS (aOR 0.96, 95% CI: 0.94–0.99) for age 6 to symptom onset (test for interaction p < 0.001). Conclusions: Low levels of sun exposure, throughout the whole lifespan, are associated with an increased risk of POMS and ROMS onset. The sun effects are usually stronger for POMS than ROMS.

A prospective cohort study exploring the joint influence of sunlight exposure and tanning bed use on basal cell carcinoma, squamous cell carcinoma, and melanoma risk.

Exposure to solar ultraviolet (UV) radiation and use of UV-emitting tanning devices are known risk factors for skin cancer. Few studies have explored the interaction between these risk factors, namely how the risk of skin cancer increases among those who both have been exposed to high levels of natural sunlight and regularly use tanning beds. Nurses' Health Study II followed 116,430 women, aged 25-42, from 1991 to 2011. Cumulative average UV exposure was based on participants' residences at follow-up periods. History of severe sunburn during ages 15-20 was used as a proxy for early-life sunlight exposure. Tanning bed use in early life data was collected. Participants reported melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) diagnoses. We built multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of skin cancer associated with joint effects of sunlight exposure and tanning bed use. Participants with high sunlight exposure and tanning bed use during high school/college had an increased risk of BCC (HR = 1.53, 95%CI 1.37-1.71, Pinteraction=0.01; vs. low sun exposure and no tanning bed use). Participants with a history of severe sunburns and tanning bed use during high school/college were at increased risk of BCC (HR = 1.62, 95%CI 1.47-1.79, Pinteraction=0.02; vs. no sunburns and no tanning bed use). No significant interactions were found between sunlight exposure and tanning bed use on SCC and melanoma risk. We found significant interactions between sunlight exposure and tanning bed use on the risk of BCC.

Niveles de vitamina D en un área de baja radiación solar del norte de la península ibérica

Introduction: vitamin D deficiency is a cause of concern in Europe, especially in latitudes above the 40° N parallel, and several clinical factors are involved. Most prevalence studies in the paediatric population in Spain have been carried out in latitudes with high sunlight exposure. Materials and Methods: cross-sectional descriptive study in two periods (summer and winter seasons) in healthy children aged 2 to 14 years between July 15, 2013 and April 15, 2016, through data collection and blood analysis (calcifediol, calcium, phosphorus) in a total of 603 children residing in La Garrotxa (Girona) (latitude 42° N), an area in Catalonia with low sun exposure. We calculated prevalences and performed a multivariable regression analysis to determine the impact of different clinical variables. Results: 31.86% of children had levels of vitamin D below 20 ng/mL that increased to 52.87% in winter. Ethnicity, phototype and season of the year accounted for 53.2% of the observed variation. Conclusions: children in an area of low solar radiation of Spain had a high prevalence of hypovitaminosis D, especially in the winter, in those with dark skin phototypes and in certain ethnic groups.

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.

Vitamin D Deficiency as a Risk Factor of Tinnitus: An Epidemiological Study.

Vitamin D deficiency as a risk factor of tinnitus has not been well known. We tried to evaluate the association between the serum 25-(OH) vitamin D levels and tinnitus among the Korean population to propose the possible role of serum vitamin D in patients with tinnitus. This cross-sectional study investigated the potential risk factors of tinnitus in relation to serum 25(OH)D levels within the Korean population. It encompassed a health interview, nutrition assessment, and a health examination. Data was sourced from the KNHANES V (2010-2012), conducted by the Division of Health and Nutritional Survey under the Korean Centers for Disease Control and Prevention (KCDCP). Participants were chosen from various sampling units categorized by geography, gender, and age group. The selection was facilitated through household registries using a stratified, multistage, clustered probability sampling approach. Data of 16 408 subjects were collected in this study. There were significant differences in gender, economic status, educational level, and sun exposure duration between the tinnitus and non-tinnitus groups. Serum 25(OH) vitamin D level between hearing loss and normal hearing was also significantly different. The logistic regression models with serum 25(OH) vitamin D quartile and tinnitus as the dependent variable, which were controlled for age, sex, smoking status, BMI, diabetes, hypertension, sun exposure, regular exercise, income, and education, eventually demonstrated that serum vitamin D deficiency and low sun exposure duration significantly increased the risk of tinnitus development. This study demonstrated a significant association between serum vitamin D levels and tinnitus, driven by large epidemiological data. The results of our study provide baseline data for further research to investigate the role of vitamin D in the pathogenesis and management of tinnitus.

Comparative transcriptomic analysis reveals differences in gene expression and regulatory pathways between nonacral and acral melanoma in Asian individuals.

Melanoma predominantly occurs in White individuals, which is associated with factors such as exposure to UV radiation and skin pigmentation. Despite its low incidence, melanoma is the primary cause of skin cancer-related death in Asia, typically in areas with low sun exposure. In our previous whole-exome sequencing study, we identified mutational signature 12 as the most prevalent variant in Asian patients, differing from the common UV-associated mutational signature 7 observed in White individuals. We also observed major differences between acral melanoma (AM) and nonacral melanoma (NAM) in terms of signatures 7, 21, and 22. Notably, few studies have investigated the genomic differences between AM and NAM in Asian individuals. Therefore, in this study, we conducted transcriptomic sequencing to examine the disparities in RNA expression between AM and NAM. Ribosomal RNA depletion was performed to enhance the detection of functionally relevant coding and noncoding transcripts. Ingenuity pathway analysis revealed significant differences in gene expression and regulatory pathways between AM and NAM. The results also indicate that the genes involved in cell cycle signaling or immune modulation and programmed cell death protein 1/programmed cell death 1 ligand 1 signaling were differentially expressed in NAM and AM. In addition, high CDK4 expression and cell cycle variability were observed in AM, with high immunogenicity in NAM. Overall, these findings provide further insights into the pathogenesis of melanoma and serve as a reference for future research on this major malignant disease.

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.

Cognitive status and low sun exposure as frailty major risk factor among older people in a rural area of East Java, Indonesia: A cross-sectional study.

To reveal the prevalence of frailty and factors that strongly affected the frailty condition among older adults in East Java, Indonesia. We conducted a cross-sectional study carried out among 400 older adults aged ≥60 years without any acute illness. Data were collected from rural area in two locations in Malang and Pasuruan, East Java, Indonesia, in 2019-2020. For data collection, we used the sociodemographic profile assessment, Fried frailty phenotype, Geriatric Depression Scale, Mini Mental State assessment, sun exposure, handgrip strength, International Physical Activity Questionnaire, walk score, and body mass index. We used logistic regression statistics for data analysis. The result showed that 2.5% were robust, 83% were prefrail, and 14.5% were frail. A higher proportion of subjects were aged 60-74 years (83.3%), women (70.3%), with lower educational status (84.5%). Multivariate analysis showed that the intrinsic factors low cognitive status (odds ratio [OR], 3.052 [95% confidence interval (CI), 1.691-5.508]) and older age (OR, 3.073 [95% CI, 1.637-5.767]) were associated with frailty among the older adults in a rural area. Depression was also associated with frailty (OR, 2.458 [95% CI, 0.465-12.985]). From extrinsic factors, we also found that low sun exposure (OR, 2.931 [95% CI, 1.650-5.204]) and unemployment (OR, 1.997 [95% CI, 1.112-3.588]) were associated with frailty. For the Indonesian elderly in this study, low cognitive status, older age, depression, low sun exposure, and unemployment were associated with frailty. Understanding the modifiable risk factors of frailty can provide a valuable reference for future prevention and intervention. Geriatr Gerontol Int 2024; 24: 170-175.

Hand grip strength, vitamin D status, and diets as predictors of bone health in 6–12 years old school children

BackgroundVitamin D and calcium-rich foods, exposure to sunlight, and physical activities (PA) play a pivotal role in promoting the production of sufficient vitamin D and improving grip strength needed for better bone health among school children.PurposeThis study aimed to determine the effects of hand grip muscle strength (HGS), vitamin D in addition to diets, and PA on bone health status among 6–12 years old schoolchildren.MethodsThis study was based on a cross-sectional observational design, which was descriptive in nature. A diverse sample of 560 elementary school children aged 6–12 years old were invited to participate in this descriptive cross-sectional study. The Dual-Energy X-Ray Absorptiometry (DXA), QUS technique, and ACTi graph GT1M accelerometer were used respectively as a valid tools to identify BMD, BMC, and other parameters of bone health like c-BUA values and bone stiffness (SI), and physical activity (PA) of all individuals participated in this study. In addition, a hydraulic dynamometer was used to measure hand grip strength among the participants. Moreover, an immunoassay technique was used to measure the serum levels of vitamin 25(OH)D level, and bone metabolism markers; NTX, DPD, Ca, and sBAP in all participants. Bone loss (osteoporosis) was cross-sectionally predicted in 19.64% of the total population, most of whom were girls (14.3% vs. 5.4% for boys; P = 0.01). Compared to boys, the incidence of osteoporosis was higher and significantly correlated in girls with lower HGS, deficient vitamin D, inadequate vitamin D and Ca intake, greater adiposity, poor PA, and lower sun exposure. Also, in girls, lower vitamin 25(OH)D levels, and poor HGS were shown to be significantly associated with lower values of BMD, BMC, SI, and higher values of bone resorption markers; NTX, DPD, and sBAP and lower serum Ca than do in boys. The findings suggested that deficient vitamin D, lower HGS, adiposity, PA, and sun exposure as related risk factors to the pravelence of bone loss among school children, particularly in girls. In addition, these parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts; however, more studies are required.

Low Sun Exposure as a Dominant Risk Factor of Hypertension Among Adolescents in SMPN 21 South Tangerang

Hypertension is a global health problem that can occur in adolescents. According to Riskesdas 2018, the national prevalence of hypertension is 34.1%. In Banten Province, it stands at 29.4%, and in South Tangerang City, it’s 27.5%. This study was aimed to determine the association between age, sex, vitamin D intake, fat intake, and sun exposure with the incidence of hypertension among adolescents at SMPN 21 South Tangerang and the dominant factor among these variables that is a risk factor of hypertension. This study used a cross-sectional design with a sample of 102 respondents taken using a stratified random sampling technique. Data were collected through blood pressure measurements, the Sun Exposure Questionnaire (SEQ), and the Semi Quantitative Food Frequency Questionnaire (SQ-FFQ). Association analysis was conducted using the chi-square test and Fisher's exact test, showing that there was an association between sun exposure (&lt;0.05; OR = 7.902) with the incidence of hypertension, and there were no association between age (p = 0.556), sex (p = 0.386), vitamin D intake (p = 0.760), and fat intake (p = 1.000) with the incidence of hypertension among adolescents at SMPN 21 South Tangerang. The result of multivariate analysis using the regression logistic test showed that sun exposure was the most correlated factor of hypertension among adolescents at SMPN 21 South Tangerang (p = &lt;0.05; OR = 7.949). Respondents should have more sun exposure to prevent hypertension.

Prospective effects of cholecalciferol supplementation on irisin levels in sedentary postmenopausal women: A pilot study

IntroductionIn postmenopausal women, vitamin D deficiency has been associated with disability, low muscle mass and fractures. Irisin is an important myokine that may contribute to the maintenance of muscle and bone density. Vitamin D is associated with the growth and function of muscle tissue through interactions between the vitamin D receptor and PGC-1α and activation of p38/MAPK (mitogen-activated protein kinase) in muscle, a mechanism similar to irisin action. The aim of this pilot study was to evaluate the effects of cholecalciferol supplementation on serum irisin levels in sedentary postmenopausal women with hypovitaminosis D (25(OH)D < 20 ng/mL). Material and methods80 sedentary postmenopausal women with hypovitaminosis D and low sun exposure were supplemented with cholecalciferol (30,000 IU/month) for 12 months. Calcium, parathyroid hormone, alkaline phosphatase (AP) and irisin levels were measured before and after supplementation. Results25(OH) vitamin D increased in all participants. Serum levels of irisin increased (from 0.52 ± 0.27 to 0.80 ± 0.53; p < 0.003), accompanied by a decrease in AP (from 80 ± 24 to 66 ± 23; p < 0.001). ConclusionsRestoration of vitamin D status increased serum irisin levels in sedentary postmenopausal women. Whether increased serum irisin levels may have an impact on clinical outcomes deserves further evaluation.

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.

Influence of environmental factors on facial pigmented spots: Epidemiological survey of women living in the northern and southern regions of Japan.

Several epidemiological studies have been conducted to understand the relationship between environmental factors (including chronic sun exposure) and clinical signs of pigmented spots. However, no quantitative analysis has focused on the adverse effects of the detailed features of pigmented spots, including their color intensity, size, and number on the cheek. This study was performed to elucidate the adverse effects of environmental factors on clinical signs of pigmented spots. We conducted an epidemiological survey of 102 Japanese women in 2 regions of high and low sun exposure (southern and northern regions, respectively). Using image analysis of high-resolution digital facial photographs, individual pigmented spots were quantified according to color, size, and total number on the cheek. Each indicator was then compared between the groups. For the number of pigmented spots on the cheek, the age-related increase curve showed a large slope in the southern group. For the size of pigmented spots, no significant difference was found between the two groups, and large pigmented spots were observed on the cheek even in the northern group. For the color intensity of the spots, the southern group showed a marked age-related change; among older subjects, the pigmented spots were significantly darker in the southern than northern group. Our results may indicate that environmental factors, including chronic exposure to sunlight, mainly increase the number of pigmented spots and darkening of these spots. However, the occurrence of large pigmented spots may be related to intrinsic factors represented by heredity rather than environmental factors.

Vitamin D Fortification and Its Effect on Athletes' Physical Improvement: A Mini Review.

Poor vitamin D status is a widespread problem regardless of age and sex, emphasizing the necessity of new food sources to improve vitamin D levels. Currently, approximately 60% of dietary vitamin D consumption occurs via fortified foods. Vitamin D insufficiency (50-90%) is widespread according to age and region, despite different levels of sunlight exposure. The food industry must identify more effective strategies to increase normal dietary vitamin D intake and improve overall health. Strategies for vitamin D fortification include bioaddition, wherein a vitamin D-rich food source is added to staple foods during processes. These bioadditive strategies expand the range of vitamin D-containing foods and appeal to different preferences, cultures, and economic statuses. In several countries, vitamin D deficiency places athletes at a high risk of disease susceptibility. Due to low sun exposure, athletes in countries with higher and lower levels of sunlight have similar risks of vitamin D deficiency. In this review, we summarize recent technical advances to promote vitamin D utilization by humans during sports activities and in relation to the normal practices of athletes.

Determinants of sun exposure time among Sri Lankan pregnant women.

Introduction: Sun exposure becomes extremely important for primary prevention of vitamin D deficiency (VDD) for high-risk populations who do not receive supplemental vitamin D. The present study investigated the determinants of sun exposure time and its association to vitamin D among Sri Lankan pregnant women in a primary health care population from the Colombo District.Methods: This is part of a cross-sectional study of 383 third trimester pregnant mothers from primary healthcare (PHC) units in the Colombo District in Western Sri Lanka. A newly developed interviewer-administrated questionnaire was used as the main study instrument. In addition, a venous blood sample was collected for 25(OH)D levels. The univariate and multivariate analysis examined the determinants of sun exposure time. One-way ANOVA and Tukey post hoc test described the association between sun exposure time and vitamin D level.Results: Most (56.9%) had &lt;30 minutes of sun exposure per day. Low sun exposure time observed with Moor ethnicity (OR:7.45, 95% CI: 3.764, 14.741, p&lt;0.001), lower parity (OR:0.53, 95%CI: 0.369, 0.753, p&lt;0.001) and higher educational level (OR: 3.10, 95% CI: 1.606, 5.976, p=0.001). Women who spent ≥30 minutes exposed to sun between 9am to 3pm [F(3,373)=10.1, p&lt;0.001] had higher vitamin D levels.Conclusions: Educational level, parity, and ethnicity are important determinants of sun exposure time. A significantly lower serum vitamin D is demonstrated in pregnant women with exposure time &lt;30 minutes. This evidence will allow health personnel to individualize the advice to improve vitamin D-related sun exposure behaviour in this population who are not routinely supplemented with vitamin D.

Osteoporosis — Are we aware?

The number of women with osteoporosis, a condition characterized with reduced bone mass and the disruption of bone architecture is on the rise in India. Deficiency of calcium and low vitamin D levels are important risk factors for the development of osteoporosis. Low sun exposure, inadequate dietary vitamin D intake, lack of food fortification with vitamin D, pigmented skin, environmental pollution, and traditional dress code further aggravate the condition. Age, gender (female), Asian origin, low BMI also act as a threat for the disorder. It is estimated that maximum bone loss occurs in women during perimenopause and menopause, indicating the prevalence of osteoporosis to increase with advancing age, resulting in a geriatric female population prone to fractures and related morbidities. For the proper management of any disorder, it is imperative that the patient should have an understanding of the disease, which begins with awareness. However, owing to societal pressures the elderly Indian female population rarely prioritizes osteoporosis as a major health issue. In the last few decades the life expectancy has increased giving rise to a larger geriatric population. It is necessary to ensure proper health status for this populace, in order to improve their quality of life which will uplift the national health benchmark. The key to effective and compliant therapy is adequate knowledge of the disorder among the target subjects. The current review highlights the prevalence, etiology and awareness of osteoporosis among Indian women. Keywords: Osteoporosis, Indian women, Awareness

Hydration status assessment and impinging factors among university students in the UAE.

Insufficient water intake has been a global health concern as it is linked to numerous adverse health consequences. Risk factors for dehydration include low fluid intake, sun and heat exposure which is a key element especially in the Gulf region. The aim of this study was to identify the prevalence and the impinging factors of hypohydration among college students in UAE. Bioelectrical Analysis Impedance (BIA), attained using BodyStat 1,500 MDD, was used to assess participants' body water levels. Adequate hydration level was defined as body water level of 50-60% for females and 55-65% for males. Alongside this, a scale and a stadiometer were used to measure the participants' weight and height in order to calculate their BMI. A self-administered questionnaire was also used to assess and correlate the test findings with the risk factors, signs and symptoms, and the level of knowledge awareness of the participants. Of the 201 university students that participated in the study, 41.3% were hypohydrated, 55.7% were well hydrated and 3% were hyper-hydrated. Among hypohydrated participants, 56.6% were females and 43.4% were males, highlighting that females were at higher risk of becoming dehydrated than males. A major factor that negatively affected hydration status was BMI; as BMI increased, water percentage and therefore hydration status decreased. We checked for numerous signs and symptoms that could indicate hypohydration levels, and the following were the top five most prevalent among our participants: dry lips (51.90%), thirst (46.90%), tiredness (46.80%), dry skin (39.70%) and headache (36.90%). According to The Urine Color Chart (Human Kinetics, Champaign, IL, USA), 3.5% were classified as dehydrated, 46% were in danger of getting hypohydration levels while 19.5% were classified as having good hydration levels. There was no significant correlation between water intake and urine colour chart (p = 0.334). Among the study participants, 64.2% acquired their knowledge from internet, 30.80% from TV and radio and 26.90% from books and courses. The behavior aspect of the participants when feeling thirsty, was that 79% of them would resort to water, while 11% resorted to soft drinks and 10% to juices. The prevalence of hypohydration levels was 41.3% among the study participants of young university students. The main risk factors affecting hydration levels were BMI and gender. This signifies the importance of good hydration habits which were not commonly practiced among students even though they had adequate knowledge regarding the topic. Regular check-ups held intermittently can aid in recognizing those at risk of dehydration and help in educating about the importance of such topic especially regionally.

Hydrochlorothiazide use, sun exposure, and risk of keratinocyte cancer

BackgroundKeratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties, and high sun exposure are two known NMSC risk factors, but their synergistic effects are undetermined. The purpose of this study was to examine the development of NMSC between adults who did and did not use HCTZ, as well as those with high and low sun exposure.MethodsA retrospective case–control sample was assembled from adult patients in north-central Wisconsin (USA). Duration of HCTZ use and occupational sun exposure were extracted from electronic health records, along with a linked survey of lifetime sun exposure.ResultsThere were 333 cases and 666 controls in the analytical sample. A significant main effect was observed for HCTZ duration in the full sample. Under low sun exposure, the odds of NMSC was 14% greater for each additional year of HCTZ use (aOR = 1.14 [1.11, 1.18], p < 0.001). In a sensitivity analysis of participants age 70 years and over, there was a borderline significant (p = 0.086) HCTZ use by high sun exposure interaction, suggesting modestly increased HCTZ risk in older, high sun exposure adults.ConclusionsConsistent with prior studies, longer duration of HCTZ use was a predictor of NMSC in north-central Wisconsin adults. NMSC may be accelerated in HCTZ users with outdoor lifestyles, but future studies should attempt to further disaggregate specific effects of sun exposure time, HCTZ duration, and age on NMSC development.

Growth response of Echinacea purpurea (L) Moench to biochar types and hormone doses

Purple Cone Flower (Echinacea purpurea) is one of the introduced medicinal plants originating from America which has its native habitat growing in subtropical countries with optimal growth conditions of low temperature and full sun exposure. Problems that occur in climate change between subtropics and tropics, especially in Indonesia will have an impact on the less than optimal growth and development of plants so that it will reduce the production and quality of ekinase yields. One way to improve ekinase can suitable in Indonesia (especially in the lowlands) is by adding biochar as a soil enhancer and hormones. The aims to study the interaction between the addition of biochar and the level of hormone dose on the growth rate of ekinase. The research method used a Split-Plot Completely Randomized Block Design. The results show the interaction between the type of biochar and hormone dose. The best results were shown in the treatment of giving husk charcoal and 6 ml/L hormones of 27.67 cm for plant height and 89.67 cm2 for leaf area. The formation of the highest number of leaves was 26 in the treatment of husk charcoal and hormone 2 ml/L. The best results were wood charcoal and hormone treatment 6 ml/L of 0.1467 for the rate of photosynthesis and 0.02937 for the rate of transpiration. Treatment with a dose of 6 ml/L hormone can optimize the growth rate of ekinase.