Skin Color Research Articles

Innovative hybrid approach: digital and analog fabrication of orbital prosthesis for post-COVID-19 mucormycosis defects using photogrammetry technique

In addition to anatomical loss, removal of the full or portion of the orbit results in a facial deformity and psychological distress for the patient. This article details a practical case of prosthetic rehabilitation using digital workflow for an orbital deformity caused by post-COVID-19 Mucor mycosis. The main goal of this case study was to create a maxillofacial orbital prosthesis that is well-retained, simple to use, and accurate in terms of appearance. The study addresses the problems involved in fabricating the orbital prosthesis, particularly the unique dimensions and form of the defect, replicating the natural skin tone, and accomplishing retention by the most prudent and patient-friendly approach. Through this article, a digitised algorithm, using photogrammetry technique for facial scan, is suggested for fabricating the prosthesis.

The causal effects of lifestyle, circulating, pigment, and metabolic factors on early age-related macular degeneration: a comprehensive Mendelian randomization study

PurposeEarly detection of lifestyle factors, skin and hair color, circulating parameters, and metabolic comorbidities is crucial for personalized prevention and treatment of early age-related macular degeneration (AMD). This study aimed to assess the relationships between genetically predicted comprehensive risk factors and early AMD.Methods and resultsPublicly available genome-wide association study (GWAS) data were utilized to identify genetic variants significantly associated with each trait. We applied a Bonferroni-corrected significance level of P < 0.0017. P values between 0.0017 and 0.05 were considered suggestive associations. Univariable Mendelian randomization (MR) analyses revealed that elevated serum HDL-C, lower serum TG, and decreased three circulating fatty acids levels were robust indicators of an increased risk of early AMD (all P < 0.0017), with odds ratios (ORs) and 95% confidence intervals (CIs) of 1.218 (1.140–1.303), 0.784 (0.734–0.837), 0.772 (0.698–0.855), 0.776 (0.706–0.852), and 0.877 (0.798–0.963), respectively. Additionally, the “never eat wheat products”, “age started wearing glasses”, and “skin color” were significantly associated with the risk of early AMD (both P < 0.0017), with ORs (95% CIs) of 23.853 (2.731–208.323), 1.605 (1.269–2.030) and 1.190 (1.076–1.317), respectively. Multivariable MR analysis confirmed that elevated serum HDL-C (OR = 1.187, 1.064–1.324) increased the risk of early AMD, while higher serum TG (OR = 0.838, 0.738–0.950) was associated with a significantly lower risk. Furthermore, validation results indicated that serum HDL-C 1.201 (1.101–1.310) and TG 0.795 (0.732–0.864) were significantly associated with the risk of early AMD. There were suggestive associations of smoothies, chronotype, and hair color (0.0017 < P < 0.05), but sun/UV protection, smoking, BMI, diabetes, high blood pressure, cardiovascular diseases, fresh fruit intake, fish oil/cod liver oil supplement, sleeplessness, serum C-reactive protein level, and iron level were not associated with the risk of early AMD.ConclusionsOur comprehensive MR analysis demonstrated that elevated circulating HDL-C levels increase the risk of early AMD, while TG and fatty acid levels are associated with a decreased risk. These findings provide robust evidence for improved diagnosis and personalized prevention and treatment of early AMD.

Representation of diverse skin tones in Nelson's Textbook of Pediatrics.

Physicians are trained to visually recognize disease using images. Many pediatric dermatologic conditions are initially identified and treated by pediatricians, who need to diagnose on varied skin tones. The objective was to evaluate if figures depicting cutaneous disease in the preeminent pediatrics textbook reflect diverse skin tones. Figures depicting dermatologic findings in Nelson's Textbook of Pediatrics were assessed using the Fitzpatrick, Massey-Martin, and Color Bar scales. The distribution was compared to the US population using American National Election Survey 2012 data. The three scales were compared for concordance. Statistical analysis included chi square with P < 0.05 significant. Of 515 figures, 484 were classifiable. Light skin tones were depicted in 453 (93.6%) by Fitzpatrick, 364 (75.2%) by Massey-Martin, and 406 (83.9%) by Color Bar, moderate tones in 92 (19.0%) by Massey-Martin and 53 (11.0%) by Color Bar, and dark tones in 31 (6.4%) by Fitzpatrick, 28 (5.8%) by Massey-Martin, and 25 (5.2%) by Color Bar. The textbook skin tone distribution did not reflect the US population: light 75.2% vs. 63.3%, moderate 19.0% vs. 25.8%, dark 5.8% vs. 11.0%, respectively (P < 0.00001). The three scales yielded consistent proportions for light/moderate vs. dark tones (P = 0.71). Certain conditions were mostly depicted on dark (burns, leprosy, urticaria pigmentosa) or light skin (psoriasis, acne, hemangioma, molluscum, herpes, keloid). Figures demonstrating dermatologic manifestations are predominantly depicted on light skin tones, and are not representative of the US population. Certain conditions were more commonly shown on dark or light skin tones, unrelated to epidemiology.

Analysis of vitamin D metabolism, thyroid and autoimmune markers in the vitiligo pathways and their possible interaction with sleep.

Vitiligo is an autoimmune skin disease that can be influenced by stress, including that resulting from sleep deprivation and sleep disturbances. Sleep is essential in the regulation of several hormonal, metabolic and autoimmune pathways that may have important roles in vitiligo. This study aimed to investigate the potential interplay between hormonal, metabolic, and autoimmune markers in vitiligo patients, and the possible influence of sleep quality in these vitiligo pathways. A cohort of 30 vitiligo patients and 26 healthy controls were assessed for various laboratory markers, including thyroid-stimulating hormone (TSH), parathyroid hormone (PTH), serum calcium, 1.25(OH)2D, 25(OH)D, anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and antinuclear antibodies (ANA). The study evaluated sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Positive anti-TPO were found in the vitiligo group, but did not in the control group. Vitamin D 25(OH)D mean levels were clinically insufficient in both groups (< 30mg/dL). Reactive ANA was analyzed with 2 variables related to vitiligo: phototherapy and skin activity. No statistical correlation was found in the chi-square test on this relationship. Descriptive findings have shown that the positivity to anti-TPO and anti-TG, associated or not with reactive ANA, was higher in vitiligo group. Great part (85.7%) of vitiligo group were "poor sleepers" (PSQI > 5), which has increased (88.2%) when considering only individuals with signs of vitiligo activity. Autoimmune hypothyroidism and positive anti-TPO are expected in vitiligo, although this marker is not usually measured in the first laboratory screening to this disease. Adequate vitamin D levels may be a key adjuvant in skin pigmentation, and be related to sleep quality and immune regulation, as this vitamin can be related to better sleep and immunomodulation in autoimmune diseases. Evaluating ANA before phototherapy can be controversial, but it should be considered in cases with a poor response to this treatment, or when there is a higher risk of other autoimmune diseases. Poor sleep predominated in the vitiligo group, based on PSQI scores that reported worse subjective sleep in these patients. Worse sleep predominated in individuals with signs of skin activity and reactive autoimmune markers. Screening these components could be important in the management of vitiligo, as maintaining body homeostasis can help to improve the disease course. Sleep should be considered as a potential modulator of several multidirectional vitiligo pathways.

Depression is associated with unintended pregnancy among fathers during the first 3 years after childbirth

BackgroundThe aim of the present study is to estimate the prevalence of unintended pregnancy in fathers with children aged less than or equal to 36 months and evaluate whether unintended pregnancy is associated with depression after controlling for covariates. MethodsWe used data from the Brazilian National Health Survey (PNS) of 2019, a cross-sectional study that comprised a representative sample of residents in private households in Brazil. For the analysis of this study, we selected 30,579 men (> 14 years old) who answered to the Selected Resident questionnaire of the PNS and reported having a biological child (son). Among these 4806 had a child with less than 4 years of age and were used in our analysis. ResultsThe prevalence of unintended pregnancy in this group of fathers with a child ≤ 3 years was 35.0 % (95 % CI 32.6–37.5). In the final adjusted model, the variables associated with depression were: PHQ-9 total score (OR: 1.07, 95 % CI 1.03–1.11, p ≤0.001), a higher father's age (OR 1.01, 95 % CI 1.01–1.02), a higher father's age at birth (OR: 0.92, 95 % CI 0.90–0.94), self-reported black (OR: 3.00, 95 % CI 1.94–4.66), brown (OR: 1.63, 95 % CI 1.25–2.13) or indigenous (OR: 0.22, 95 % CI 0.07–0.69) skin color, lower per capita family income >1 to 2 MW (OR: 1.54, 95 % CI 1.01–2.35), ½ to 1 MW (OR: 2.22, 95 % CI 1.46–3.38) and up to 1 MW (OR: 1.76, 95 % CI 1.19–2.59) and not participating in the partner's prenatal appointments (OR: 2.04, 95 % CI 1.55–2.68). DiscussionIn our study, the prevalence of unplanned pregnancy among fathers of child less than 4 years of age is high, and it is associated with depression. Black and brown self-reported skin color, lower family income and higher father's age are associated with increased risk of unintended pregnancy.

Halobacteria Formula Improvement of Skin Care-A Randomized, Double-Blind, Placebo-Controlled Clinical Study.

Halobacteria trueperi, an extremophilic microorganism thriving in high-salt environments, produces extracellular polysaccharides with potential anti-inflammatory and anti-aging properties. However, its clinical efficacy in skin improvement remains unclear. This study focuses on H. trueperi TCI66207, isolated from the Pacific Ocean at a depth of 662 m near Hualien, and its potential to enhance skin parameters, aiming to develop a novel functional formulation for pharmaceutical and cosmetic use. This sudy aims to evaluate the clinical efficacy of H. trueperi TCI66207 on various skin parameters and its potential for developing new functional cosmetic formulations. A total of 40 subjects were recruited and randomly divided into two groups: the test group applied a serum containing H. trueperi TCI66207, while the placebo group used a basic serum. Subjects were instructed to apply the serum twice daily for 4 weeks. Skin parameters, including moisture, brightness, elasticity, pigmentation (spots and UV spots), texture, wrinkles, pores, and collagen density, were assessed before and after the 4-week application period. After 4 weeks of using the H. trueperi TCI66207 serum, significant improvements were observed in all measured skin parameters compared to baseline, with notable enhancements in moisture, brightness, elasticity, texture, and collagen density, along with reductions in wrinkles, spots, and pore size. Halobacteria trueperi TCI66207 serum demonstrates a clear ability to improve skin conditions and delay signs of aging, making it a promising candidate for the development of new cosmetic formulations with potent anti-aging and skin-rejuvenating properties.

Frankenstein's Monster in the Metaverse: User Interaction With Customized Virtual Agents.

Enabled by the latest achievements in artificial intelligence (AI), computer graphics as well as virtual, augmented, and mixed reality (VR/AR/MR), virtual agents are increasingly resembling humans in both their appearance and intelligent behavior. This results in enormous potential for agents to support users in their daily lives, for example in customer service, healthcare, education or the envisioned all-encompassing metaverse. Today's technology would allow users to customize their conversation partners in the metaverse - as opposed to reality - according to their preferences, potentially improving the user experience. On the other hand, there is little research on how reshaping the head of a communication partner might affect the immediate interaction with them. In this paper, we investigate the user requirements for and the effects of agent customization. In a two-stage user study ($N=30$), we collected both self-reported evaluations (e.g., intrinsic motivation) and interaction metrics (e.g., interaction duration and number of tried out items) for the process of agent customization itself as well as data on how users perceived the subsequent human-agent interaction in VR. Our results indicate that users only wish to have full customization for agents in their personal social circle, while for general services, a selection or even a definite assignment of pre-configured agents is sufficient. When customization is offered, attributes such as gender, clothing or hair are subjectively more relevant to users than facial features such as skin or eye color. Although the customization of human interaction partners is beyond our control, customization of virtual agents significantly increases perceived social presence as well as rapport and trust. Further findings on user motivation and agent diversity are discussed in the paper.

Integrated deep learning approach for generating cross-polarized images and analyzing skin melanin and hemoglobin distributions.

Cross-polarized images are beneficial for skin pigment analysis due to the enhanced visualization of melanin and hemoglobin regions. However, the required imaging equipment can be bulky and optically complex. Additionally, preparing ground truths for training pigment analysis models is labor-intensive. This study aims to introduce an integrated approach for generating cross-polarized images and creating skin melanin and hemoglobin maps without the need for ground truth preparation for pigment distributions. We propose a two-component approach: a cross-polarized image generation module and a skin analysis module. Three generative adversarial networks (CycleGAN, pix2pix, and pix2pixHD) are compared for creating cross-polarized images. The regression analysis network for skin analysis is trained with theoretically reconstructed ground truths based on the optical properties of pigments. The methodology is evaluated using the VISIA VAESTRO clinical system. The cross-polarized image generation module achieved a peak signal-to-noise ratio of 35.514dB. The skin analysis module demonstrated correlation coefficients of 0.942 for hemoglobin and 0.922 for melanin. The integrated approach yielded correlation coefficients of 0.923 for hemoglobin and 0.897 for melanin, respectively. The proposed approach achieved a reasonable correlation with the professional system using actually captured images, offering a promising alternative to existing professional equipment without the need for additional optical instruments or extensive ground truth preparation.

Early developmental insights into the social construction of race.

The way that societies assign people to racial categories has far-reaching social, economic, and political consequences. One framework for establishing racial boundaries is based on ancestry, which historically has been leveraged to create rigid racial categories, particularly with respect to being categorized as white. A second framework is based on skin tone, which can vary within families and across the lifespan, and is thus more likely to blur racial boundaries. The persistence of these distinct cultural beliefs about race requires that they be transmitted to each new generation, but there have been few cross-cultural studies on their development during childhood. Participants (5- to 12-year-old children, N = 123) were from the United States, in which the ancestry model has been more prevalent, or from Brazil, in which the skin tone model has been more prevalent. In both countries, 5- to 7-year-olds endorsed the belief that skin tone determines race, for example, by assigning biological siblings with differing skin tones to different racial categories. However, racial concepts diverged among the 10- to 12-year-olds, with children from the United States shifting toward a classification based on ancestry and children in Brazil endorsing a classification based on skin tone even more strongly with age. These differing conceptions were especially evident with reference to white racial categorization: Older children from Brazil persisted in classifying lighter skinned people as white when they had African ancestry, unlike older children from the United States. These findings provide important insights into the developmental and cultural influences on racial classification systems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Genome-Wide Association Study of Sweet Potato Storage Root Traits Using GWASpoly, a Gene Dosage-Sensitive Model

Sweet potato (Ipomoea batatas) is an important food crop that plays a pivotal role in preserving worldwide food security. Due to its polyploid genome, high heterogeneity, and phenotypic plasticity, sweet potato genetic characterization and breeding is challenging. Genome-wide association studies (GWASs) can provide important resources for breeders to improve breeding efficiency and effectiveness. GWASpoly was used to identify 28 single nucleotide polymorphisms (SNPs), comprising 21 unique genetic loci, associated with sweet potato storage root traits including dry matter (4 loci), subjective flesh color (5 loci), flesh hue angle (3 loci), and subjective skin color and skin hue angle (9 loci), in 384 accessions from the USDA sweet potato germplasm collection. The I. batatas ‘Beauregard’ and I. trifida reference genomes were utilized to identify candidate genes located within 100 kb from the SNPs that may affect the storage traits of dry matter, flesh color, and skin color. These candidate genes include transcription factors (especially Myb, bHLH, and WRKY family members), metabolite transporters, and metabolic enzymes and associated proteins involved in starch, carotenoid, and anthocyanin synthesis. A greater understanding of the genetic loci underlying sweet potato storage root traits will enable marker-assisted breeding of new varieties with desired traits. This study not only reinforces previous research findings on genes associated with dry matter and β-carotene content but also introduces novel genetic loci linked to these traits as well as other root characteristics.

Ultrasonic Lifting and High Frequency Lifting Procedures a Study on the Effects of Moisture, Pigmentation, Sebum, and Wrinkle Improvement through

This study was intended to study the effects of improving skin moisture, pigmentation, sebum, and wrinkles using ultrasonic and high-frequency devices and to help develop the aesthetic industry. The study received final approval (YSUIRB-202304-HR-124-02) from the Research Ethics Committee (IRB) on July 20, 2023, taking into account the ethical issues of the study subjects. This study investigated the theoretical background through previous studies related to skin structure, ultrasound, and high-frequency devices, and SPSS 22.0 was used to verify homogeneity and to find out the difference in effectiveness. Women in their 30s to 50s living in Busan were selected as those with no skin history or skin disease, and those with less UV exposure in daily life, and 14 women in their 30s to 50s who met the criteria for selecting the study subjects were finally selected, and the following results were obtained. As a result of the study using ultrasonic waves, moisture and pigmentation were significant, but not in sebum and wrinkles. As a result of the study using high frequency, moisture and pigmentation were significant, but not in sebum and wrinkles. The interaction effect between ultrasonic waves and high frequency was not significant.

Objective and Perceived Skin Color: Consequences for the Use of Skintone Scales.

Objective and Perceived Skin Color: Consequences for the Use of Skintone Scales.

Celebrating Diversity: Unveiling the Characteristics of Nail Psoriasis and Nail Lichen Planus in 30 Patients With Skin Of Color

Introduction: Dermatological conditions affecting the nails can manifest differently in individuals with distinct skin tones. This often leads to difficulty in the recognition of nail diseases especially in people with skin of color (SoC), that result not well represented in the literature. Objectives: Our aim was to provide dermatologists with useful clues for prompt recognition and diagnosis of nail psoriasis (NPso) and nail lichen planus (NLP) in people with SoC. Methods: We described the ungual manifestations of NPso and NLP in a population of 30 patients with SoC. Diagnosis was primarily based on clinical examination; in cases of diagnostic uncertainty, a biopsy of the nail matrix was performed to obtain histological conclusive evidence. Results: Of the 30 people with SoC in the analysis, 24 patients had NPso with a median Fitzpatrick phototype of 4.77 and 6 patients had NLP with a median Fitzpatrick phototype of 5. Regarding the 24 patients with NPso, 10 presented with trachyonychia, 9 displayed nail pitting, 8 showed onycholysis, 12 had subungual hyperkeratosis, while splinter hemorrhages were visible in 2 patients and activation melanonychia was discernible on the nail plates of 8 patients. Over the 6 patients diagnosed with NLP, all of them had post-inflammatory pigmentation on the proximal nail, with 3 patients exhibiting trachyonychia and 3 others having longitudinal fissures; subungual hyperkeratosis was found in 5 patients, while 3 patients displayed activated melanonychia. Conclusion: People with SoC exhibit a peculiar clinical presentation of both NPso and NLP and a better understanding is essential for providing timely and effective care.

Phytochemicals and Functional Properties of Pitaya Juice Powders

Background: Crassulacean acid metabolism plants, such as Stenocereus spp., are climate warming-resilient crops used as food and for by-products elaboration in arid and semi-arid agroecosystems. A few studies on secondary metabolites have been conducted in pitayo fruit (PF), but there are no reports of these compounds in juice powders (JP) with (JPS) or without seeds (JPWS). This study was devoted to characterizing the juice powders (JPS and JPWS) of five pitayas with different flesh colors with regard to some phytochemical and functional attributes. Methods: The study was conducted with a completely random design with factorial arrangement in treatments (PF × JP). Results: Differences among pitayas were related to peel and flesh color attributes. Except for soluble dietary fiber, the remainder of the non-digestible carbohydrates were greater in JPS than in JPWS of all pitayas. Phenols and flavonoids were found to be the highest in the JPWS of all pitayas, whereas total saponins were the highest in JPS of the ‘Pink’ pitaya. The JPWS of the ‘Yellow’ and ‘Reddish-Purple’ pitayas had the highest content of betaxanthins and indicaxanthins, respectively. Antioxidant capacity was the highest in JPS of ‘Reddish-Purple’ and ‘Pink’ pitayas. Conclusions: Except for some phenolic compounds, the study suggests that pitayas’ JPS would benefit human health when freshly consumed or as elaborated by-products.

Humphry Davy, transatlantic slavery and his constructions of racial difference in an early notebook

Humphry Davy was the most celebrated chemist of his day in Britain, but he has been absent from discussions of Romantic-era constructions of race. It is well known that Davy was an experimental chemist, popular lecturer, and, as has been recently explored by the Davy Notebooks Project, a poet; this essay expands this narrative to include his connection to transatlantic slavery and writing about race, which are neglected aspects of his life and writing. In this essay, I examine Davy’s response to the slave-trade debates and for the first time his close family links to transatlantic slavery, focusing on his wife Jane’s stepfather, the major enslaver, Robert Farquhar. I discuss Davy’s writing on the chemical causes of Black skin colour and a draft essay on the climate in notebook 13F in which he constructed the racial difference of Black Africans. I argue that his essay can be understood by recognizing 13F as a school notebook used during his period of self-education and that it reflects the messy and unstable nature of writing about race in the Romantic period. Davy’s racial thinking was influential and he was recognized as an authority on skin colour by his contemporaries, Thomas Beddoes, Johann Friedrich Blumenbach, and Sir Everard Home.

Epidemiological characterization of rare diseases in Brazil: A retrospective study of the Brazilian Rare Diseases Network

BackgroundThe Brazilian Policy for Comprehensive Care for People with Rare Diseases was implemented in 2014; however, national epidemiological data on rare diseases (RDs) are scarce and mainly focused on specific disorders. To address this gap, University Hospitals, Reference Services for Neonatal Screening, and Reference Services for Rare Diseases, all of which are public health institutions, established the Brazilian Rare Diseases Network (RARAS) in 2020. The objective of this study was to perform a comprehensive nationwide epidemiological investigation of individuals with RDs in Brazil. This retrospective survey collected data from patients receiving care in 34 healthcare facilities affiliated with RARAS in 2018 and 2019.ResultsThe survey included 12,530 participants with a median age of 15.0 years, with women representing 50.5% of the cohort. Classification according to skin color demonstrated that 5044 (47.4%) participants were admixed. Most had a confirmed diagnosis (63.2%), with a predominance of phenylketonuria (PKU), cystic fibrosis (CF), and acromegaly. Common clinical manifestations included global developmental delay and seizures. The average duration of the diagnostic odyssey was 5.4 years (± 7.9 years). Among the confirmed diagnoses, 52.2% were etiological (biochemical: 42.5%; molecular: 30.9%), while 47.8% were clinical. Prenatal diagnoses accounted for 1.2%. Familial recurrence and consanguinity rates were 21.6% and 6.4%, respectively. Mainstay treatments included drug therapy (55.0%) and rehabilitation (15.6%). The Public Health System funded most diagnoses (84.2%) and treatments (86.7%). Hospitalizations were reported in 44.5% of cases, and the mortality rate was 1.5%, primarily due to motor neuron disease and CF.ConclusionThis study marks a pioneering national-level data collection effort for rare diseases in Brazil, offering novel insights to advance the understanding, management, and resource allocation for RDs. It unveils an average diagnostic odyssey of 5.4 years and a higher prevalence of PKU and CF, possibly associated with the specialized services network, which included newborn screening services.

Combined Transcriptome and Metabolome Analyses Provide New Insights into the Changes in the Flesh Color of Anthocyanins in Strawberry (Fragaria × ananassa (Weston) Duchesne ex Rozier)

Background: Strawberries are bright in color, sweet and sour in taste, and rich in nutrients and flavonoid compounds such as anthocyanins and proanthocyanidins. The synthesis and accumulation of anthocyanins are the decisive factors that make strawberries appear bright red. From the perspective of plant breeding, a change in flesh color is an important goal. Methods: In this study, two strawberry plants with different flesh colors were selected, and transcriptome and metabolome analyses were performed during the color change period (S1) and ripening period (S2). Results: RNA-seq revealed a total of 13,341 differentially expressed genes (DEGs) between and within materials, which were clustered into 5 clusters. A total of 695 metabolites were detected via metabolome analysis, and 243 differentially regulated metabolites (DRMs) were identified. The anthocyanin biosynthesis, starch and sucrose metabolism and glycolysis/gluconeogenesis pathways were determined to be important regulatory pathways for changes in strawberry flesh color through a joint analysis of RNA-seq data and the metabolome. The leucoanthocyanidin reductase (LAR) and chalcone synthase (CHS) gene is a key gene related to anthocyanins, cinnamic acid, and phenylalanine. In addition, through joint RNA-seq and metabolome analyses combined with weighted gene co-expression network analysis (WGCNA), we identified 9 candidate genes related to strawberry flesh color. Conclusions: Our research findings have laid the groundwork for a more comprehensive understanding of the molecular mechanisms governing the color transformation in strawberry flesh. Additionally, we have identified novel genetic resources that can be instrumental in advancing research related to strawberry color change.

Total resection via right mini-thoracotomy for left atrial myxoma in juvenile Carney complex: a case report

BackgroundCarney complex is a rare syndrome characterized by skin pigmentation, endocrine disorders, and myxomas. It is particularly notorious for its tendency to exhibit aggressive cardiac myxomas. Herein, we present a case of a juvenile female patient diagnosed with Carney complex who underwent a right lateral mini-thoracotomy.Case presentationA 13-year-old girl presented with sudden-onset left hemiplegia and dysarthria. Magnetic resonance imaging revealed multiple areas of restricted diffusion. Echocardiography identified a tumor in the left atrium, suspected to be related to Carney complex based on her medical history and physical examination findings. Surgery was performed via right lateral mini-thoracotomy, which minimized the risk of embolism and ensured a cosmetically favorable outcome. The left atrial wall defect was repaired with autologous pericardium. At 3 years postoperatively, follow-up echocardiography indicated no tumor recurrence and normal cardiac function.ConclusionsOngoing follow-ups are essential due to the aggressive nature of the Carney complex and its high recurrence rates. Right lateral mini-thoracotomy offers the advantage of avoiding re-sternotomy and minimizing adhesion dissection, making it the optimal choice for this case.

Automated cardiac arrest detection using a photoplethysmography wristband: algorithm performance in relation to sex, skin color type and arm hair density

Abstract Background While survival from witnessed out-of-hospital cardiac arrest (OHCA) has improved, this is not the case for unwitnessed cardiac arrest as the event goes unnoticed. Automated cardiac arrest detection and alerting through a wristband is considered a promising technique also facilitating early assistance for this large group. In the DETECT-1 study, a photoplethysmography(PPG) algorithm for circulatory arrest detection was developed in patients with induced circulatory arrest. However, patient characteristics, such as skin color and arm hair density, can influence the accuracy of the PPG signal. Thus, we performed further analyses to study the effect of patient characteristics on the algorithm’s performance. Purpose To assess the performance of the developed PPG algorithm for cardiac arrest detection in relation to sex, skin color type and arm hair density. Methods Patients who underwent short-lasting circulatory arrest induction during transcatheter aortic valve implantation, ventricular tachycardia ablation or subcutaneous ICD implantation wore a PPG wristband during the procedure. Continuous ECG and invasive blood pressure recordings served as reference standards. A PPG algorithm for circulatory arrest detection was developed. The algorithm’s performance was assessed in subgroups based on sex, skin color type (according to the Fitzpatrick scale), and arm hair density. The sensitivity for the detection of circulatory arrest and false positive alarms were compared between the different subgroups. Results In total, 151 patients were included in the current analysis. Analyzed data consisted of 159 hours of PPG data including 176 induced circulatory arrest events. The population consisted of 57 (38%) females and 94 (62%) males. The sensitivity for circulatory arrest detection was 100% in the female group vs. 98% in the male group (p=ns); false positive alarms occurred in 4 females and 9 males, resulting in a positive predictive value (PPV) of 94% and 92% (p=ns), respectively. Within the skin color subgroup analysis, 114 (75%) patients had skin color type I or II, and 37 (25%) patients had a skin color type III, IV, V or VI. There were no differences in sensitivity (p=ns) and PPV (p=ns) in the skin color subgroup (table 1). The population consisted of 106 (71%) patients with nil or sparse arm hair density, 43 (29%) patients with moderate or dense arm hair density, and 2 not reported. There were no differences in sensitivity (p=ns) and PPV (p=ns) within the arm hair density subgroup (table 1). Conclusions Automated cardiac arrest detection using a smartwatch is feasible and its accuracy is not affected by sex, skin color type or arm hair density in this study. Further study is needed to assess performance of the algorithm in a larger sample size and a more diverse study population. If proven to be effective, automated cardiac arrest detection has the potential to improve survival from OHCA.Sensitivity/PPV for arrest detection

Poly-D,L-Lactic Acid Filler Attenuates Ultraviolet B-Induced Skin Pigmentation by Reducing Destruction of the Basement Membrane

Poly-D,L-lactic acid (PDLLA) filler, which increases volume and collagen synthesis, is used for skin rejuvenation. PDLLA filler also increases M2 macrophages and IL-10. Ultraviolet (UV) radiation induces dermal hyperpigmentation by disrupting the basement membrane (BM), allowing melanin to move into the dermis. Therefore, using UV-irradiated macrophages and animal skin, we determined whether PDLLA filler decreased M1 macrophages and skin inflammation, thereby reducing BM destruction and dermal hyperpigmentation. UV radiation increased the M1 macrophage marker CD86 and TNF-α expression, which was inhibited by the treatment of macrophages with PDLLA. In fibroblasts treated with conditioned medium from UV-irradiated macrophages, NF-κB activity, NLRP3 inflammasome components (NLRP3, ASC, and pro-caspase-1), IL-18, MMP2, and MMP9 increased, but all decreased after PDLLA treatment. Similar to the in vitro study, UV-irradiated mouse skin showed increased CD86, NLRP3, ASC, pro-caspase-1, MMP2, and MMP9, which decreased after PDLLA injection. Disruption of the lamina densa of the BM and dermal pigmentation increased after UV irradiation and decreased after PDLLA injection. In conclusion, PDLLA reduced dermal pigmentation by decreasing BM destruction in UV-irradiated skin. PDLLA has the potential to reduce dermal pigmentation by regenerating the BM.