Skin Color Research Articles

Impact of skin of color specialty dermatologic clinics on diagnoses and management.

Dedicated care of Skin of Color (SOC) individuals is crucial for increasing access and culturally-sensitive management of this population [1]. Although SOC specialty clinics (SOCSC) are becoming increasingly popular, data on these is limited. We seek to describe the first detailed experience from a SOCSC. Demographic and clinical data of the University of Nebraska Medical Center Department of Dermatology's Ethnic Skin/SOC Clinic were collected. Of 252 patients, 82% were female; mean age was 45.1 years. Self-reported race consisted of Black/African-Americans (86.9%), Other (6.0%), and Asians (3.6%). Hispanics/Latinos constituted 4.8%. The top chief complaints (CC) included acne, itch/rash, and hair loss. Among patients previously seen by a dermatologist, 20.3% had a diagnosis change, 24.3% received a new diagnosis unrelated to CC, and 48.6% had a treatment change. Patients with a prior dermatology visit showed a higher rate of change in diagnosis (20.3% vs. 2.8%) and change in treatment (48.6% vs. 28.0%) than those without. The most common diagnosis changes were itch/rash (29.3%) and hair loss (19%). Changes in treatment were mostly seen in patients with acne (20.8%), and the most common were discontinuation (50%) and switch in antibiotics (11%). In patients with previous dermatologic contact, one out of five patients (20.3%) previously seen by a non-SOC dermatologist had a diagnosis change, one out of four (24.3%) had a new diagnosis, half (48.6%) had a change in treatment, and 17.6% were being diagnosed and treated for the first time after being seen in SOCSC, highlighting the importance of SOC-specialized dermatologists in patient care.

An Analysis of the Diversity of Skin Colour Representation in Paediatric Nursing Practitioner Textbooks.

Our study aims to analyse 8 commonly used textbooks to determine how diverse skin tones are represented in paediatric nursing practitioner education. Literature reviewed from 2016 to 2024 demonstrated that the lack of darkly pigmented skin colour representation in health science education leads to diminished patient outcomes for these populations. Our study sought to study representation teaching images and eight commonly referenced nursing textbooks were chosen for this study, given their use in paediatric nurse practitioner education. Of the eight textbooks selected, five were analysed based on inclusion criteria. Two investigators trained in skin prototyping coded each textbook for skin colour representation and coded during 2023-2024. Coders used the widely accepted prototyping scale, the Fitzpatrick Scale (range I-VI, with I being the lightest colour skin and VI the darkest). Teaching photographs were defined as all photos used to provide insight into a disease or diagnostic technique that included human skin. Two individual coders coded and documented data, ensuring each coder was blinded to the overall results. Our analysis of 5 textbooks revealed that 2112 images met the criteria as teaching images. Of the 2112 teaching images, 593.5 included images of type IV-VI skin (darkly pigmented skin), resulting in a 28% representation of dark skin tone images. Additionally, 2 of the 82 total illustrations included patients with dark skin tones, indicating a representation of 2.5%. However, chapters addressing conditions of child abuse/neglect (55.95%) and stigmatised social issues (infectious disease, 54.88%) displayed a disproportionate representation of patients from these demographics. Our results highlight the importance of enhancing equitable representation in educational resources for nursing practitioners. There is room to collaborate with other health science institutions to establish clear guidelines for future improvement in expanding teaching images to include diversity representation in education. No patient or public contribution.

A greener approach to assess bioactive compounds in tropical pumpkin (Cucurbita moschata) using colorimetry

Bioactive compounds have been shown to promote healthy human development and protect against certain diseases including some cancers. Tropical pumpkins bred for consumption, such as calabaza (Cucurbita moschata), possess these compounds, though concentrations vary considerably between varieties. Bioactive compound quantification methods can be expensive, complex, and generate considerable hazardous waste. A predictive tool utilizing the relationship between extrinsic properties and tristimulus colorimetry values of calabaza would allow for significantly higher throughput with lower requirements for equipment, training, and laboratory consumables. Therefore, this study examined correlations between flesh color and bioactive compound quantities of several calabaza germplasm lines to assess the utility of a sustainable and portable predictive tool. CIEL* a* b* values of pumpkin flesh were assessed using a colorimeter and compared to bioactive compound concentrations determined analytically. Redness was found to correlate with increased ascorbic acid and total soluble solids content. Yellowness correlated with β-carotene equivalent carotenoids and ascorbic acid content. These results suggest that colorimetry may be a viable pre-screening technique for quantifying bioactive compounds in C. moschata.

Equitable Skin Disease Prediction Using Transfer Learning and Domain Adaptation

In the realm of dermatology, the complexity of diagnosing skin conditions manually necessitates the expertise of dermatologists. Accurate identification of various skin ailments, ranging from cancer to inflammatory diseases, is paramount. However, existing artificial intelligence (AI) models in dermatology face challenges, particularly in accurately diagnosing diseases across diverse skin tones, with a notable performance gap in darker skin. Additionally, the scarcity of publicly available, unbiased datasets hampers the development of inclusive AI diagnostic tools. To tackle the challenges in accurately predicting skin conditions across diverse skin tones, we employ a transfer-learning approach that capitalizes on the rich, transferable knowledge from various image domains. Our method integrates multiple pre-trained models from a wide range of sources, including general and specific medical images, to improve the robustness and inclusiveness of the skin condition predictions. We rigorously evaluated the effectiveness of these models using the Diverse Dermatology Images (DDI) dataset, which uniquely encompasses both underrepresented and common skin tones, making it an ideal benchmark for assessing our approach. Among all methods, Med-ViT emerged as the top performer due to its comprehensive feature representation learned from diverse image sources. To further enhance performance, we conducted domain adaptation using additional skin image datasets such as HAM10000. This adaptation significantly improved model performance across all models.

Pathological changes on the skin due to the combined effects of polycyclic aromatic hydrocarbons and ultraviolet radiation

Introduction. In the National Healthcare Project, one of the key areas is the federal project "Fight against oncological diseases for 2019-2024". The influence of the nature of work activities of workers in contact with industrial carcinogens — polycyclic aromatic hydrocarbons (PAHs) significantly increases the risk of skin neoplasms, as evidenced by differences in the frequency of their occurrence among representatives of different labor categories. The leading factor in the development of skin neoplasms is ultraviolet radiation (UV) of the A and B spectrum. There is literature evidence of a possible mutual enhancement of the combined effects of PAHs and UV in the occurrence of skin neoplasms and their malignancy. The study aims to evaluate the role of the combined effects of polycyclic aromatic hydrocarbons (PAHs) and ultraviolet radiation (UV) in the occurrence of pigmented skin tumors in workers engaged in the construction of highways and highways and in housing and communal services. Materials and methods. During periodic medical examinations (PMEs) in 2022–2024, specialists have examined 140 people who formed 4 study groups. The researchers have conducted a physical examination of skin tumors; examination in the rays of a Wood lamp; dermatoscopy of skin tumors using a Heine Delta 20 dermatoscope. Hyperpigmentation was assessed according to the hyperpigmentation area and severity index (NASI). Results. During the clinical examination, the authors assessed the presence of pigmentation and skin neoplasms (lentigo, ephelides, seborrheic keratomas). The most frequent localizations of pigmentation and skin neoplasms were open areas of the body: face, hands, upper third of the back. At the same time, in asphalt concrete workers — group I, working under the influence of PAHs and solar insolation (spectrum A and B, in the range of 320–400 nm and 280–320 nm), specialists revealed pigmented neoplasms in a larger number of individuals compared with the population control for all skin localizations. The HASI index (in the surveyed groups) showed that the highest rates (24–48) of HASI were observed in a larger number of individuals — 57.1% — from group I (UV+PAHs), compared with groups of individuals (II, III, IV) who do not work under conditions of exposure to solar insolation (spectra A and B, in the range of 320–400 nm and 280–320 nm). The authors noted that the intensity of pigmentation is higher and the lesion area is larger when assessing the foci of hyperpigmentation in the rays of the Wood lamp compared with the clinical examination in all the examined groups. Limitations. The study is limited by the number of subjects examined, corresponding to the design of the study and the time interval of the study. Conclusion. To obtain objective results of the study of the role of the combined effects of polycyclic aromatic hydrocarbons (PAHs) and ultraviolet irradiation (UV) in the occurrence of pigmented skin tumors, scientists used a method for determining the hyperpigmentation area index and severity index (HASI) in the rays of a Wood's lamp. When comparing the results obtained, experts revealed an increase in the area of hyperpigmentation and its intensity with localization in open areas of the body in workers engaged in the construction of highways and housing and communal services, in contact with the combined effects of carcinogens (PAHs) and ultraviolet irradiation (UV A and B). Further in-depth studies are needed to study the etiopathogenesis of photogenotoxicity depending on the dose-effect ratio. Ethics. The work was performed in accordance with the ethical standard set out in the Helsinki Declaration of the World Medical Association of 1964 (as amended and supplemented in 2013). The authors conducted all the studies after receiving informed consent and a decision of the Local Ethics Committee (extract from Protocol No. 7 dated 10/21/2020).

Study on the Characteristics of Fine Rice Flour by Micro-Crushing and Its Effects on the Quality Improvement of Rice Cakes

To investigate the impact of micro-crushing technology on rice flour characteristics and its enhancement of rice cake quality, resting angle, slip angle, solubility, water-holding capacity, emulsification, oil absorption, gelatinization, and baking quality, rice flour and rice cakes were analyzed using a texture analyzer and a gelatinization instrument. The results indicated that a decrease in particle size led to a significant increase in damaged starch from 18% to 26.5%. Both the resting angle and slip angle increased, indicating reduced fluidity. The gelatinization temperature decreased from 76.63 °C to 71.61 °C, the gelatinization time was reduced from 6.6 min to 6.4 min, and gelatinization viscosity initially increased and then decreased. Water-holding capacity increased 1.0-fold with decreased particle size, and solubility increased 11.6-fold together with the increase temperature. Emulsification and oil absorption were optimal when the particle size exceeded 120–140 mesh. The conductivity of the rice flour suspension rose with decreased particle size, while the conductivity of rice flour paste and cake batter decreased. Decreased particle size led to significantly reduced rice cake hardness and chewiness of 47.77% and 52.44%, while elasticity, restoration, specific volume, and porosity increased 18.75%, 15.15%, 31.16% and 25.10%, respectively. The skin and core color darkened with reduced luminosity, correlating with enhanced sensory scores. Correlation analysis revealed that physiochemical properties of rice flour influenced gelatinization properties, thereby affecting rice cake quality. This study provides a foundation for utilizing fine rice flour in rice cakes.

Plain language summary of the pivotal study of calcium hydroxylapatite with lidocaine for improvement of jawline contour

Summary What is this article about? A study (ClinicalTrials.gov identifier: NCT03583359) that tested whether an injectable filler treatment called calcium hydroxylapatite with lidocaine, or CaHA (+), could improve the shape of the jawline.How was the study in this summary conducted? Loss of jawline shape is a change to jawline appearance, like sagging or deflating, that occurs as people get older. A total of 123 participants received CaHA (+) injections on day 1 of the study (immediate treatment). Fifty-seven participants did not receive CaHA (+) until week 12 (delayed treatment). Jawline shape at week 12 was rated on a five-point scale (0 = no loss of shape or volume; 4 = extreme loss). Researchers also looked at participants’ satisfaction and self-reported improvement, ratings of how old participants thought they looked, and side effects.What were the results of the study? In the immediate treatment group, 76% of participants had improvement in jawline shape at week 12 (compared with 9% of participants in the delayed treatment group), which typically lasted approximately 8 months, and 94% self-reported improvement in jawline appearance. The participants were more satisfied with their jawlines and reported looking approximately 3 years younger at week 12 compared with before treatment. Regardless of sex or skin tone, side effects were categorized as mostly mild or moderate reactions, like lumps or bruising, at the site where CaHA (+) was injected.What do the results of this study mean? The results showed that CaHA (+) injections improved jawline shape in most participants and caused only mild or moderate side effects regardless of sex or skin tone, suggesting that CaHA (+) is safe and works well for diverse groups of patients.Who should read this article? This summary is for patients and others interested in learning about how CaHA (+) works, its safety, and its ability to improve jawline shape.Who sponsored this study? The study was sponsored by Merz North America, Inc.

A case of methotrexate toxicity in induced abortion

Background: Methotrexate is an anticancer drug from the antimetabolite class which is being used in cases of unruptured ectopic pregnancy and as an abortifacient as well. Giving correct dosage according to the body weight and body surface area is of utmost importance to avoid the complications.Case: A 29-year-old, G4P3L3 at 8+3 weeks of gestation with previous three cesarean sections, presented to our hospital with complaints of fever, abdominal pain, multiple episodes of diarrhea and vomiting and oral ulcers for two days. On enquiring, it was found that she received two doses of injection methotrexate (75 and 50 mg) as an abortifacient for an unwanted intrauterine pregnancy from a local doctor nearby. On presentation, her general condition was poor, she was dehydrated, temperature was 101.3°F, pulse rate was 130 beats/minute, blood pressure was 102/64mmHg, respiratory rate was 25/minute and SPO2 was 99% on room air. Her body weight was 55 kgs. Skin pigmentation and multiple oral ulcers were present. Per speculum and per vaginal examination was suggestive of minimal spotting and bulky uterus. Initial blood investigations revealed a hemoglobin level of 8.8 gm/dl, TLC of 1000/mm3, platelet count of 1.45L, INR of 1.37, and normal liver and renal function tests. A provisional diagnosis of methotrexate toxicity was made. Management of the patient was started in consultation with medical oncologist along with supportive treatment. She received IV fluids, antibiotics, and blood products (2-unit PCV and 12-RDP). She received oral leucoverin 15 mg QID and two doses of 300 mg granulocyte stimulating factor each. Gradually, her condition improved and thereafter tablet misoprostol was given for abortion. She was discharged after 13 days of hospital stay with contraceptive advice.Conclusion: The successful management of this case who presented with a constellation of symptoms and deteriorating hematological parameters exhibits the significance of a multidisciplinary approach and vigilant monitoring. Strategies to reduce the side effects and their early recognition include a safety checking procedure like SMART (safety of methotrexate therapy by assessing risks and toxicity) and determining plasma methotrexate concentrations.

Ethical implications of artificial intelligence in skin cancer diagnostics: use-case analyses.

Skin cancer is the most common cancer worldwide. Early diagnosis is crucial for improving patient survival and morbidity. Artificial intelligence (AI)-assisted smartphone applications (apps) for skin cancer potentially offer accessible, early risk assessment of suspicious skin lesions. However, the integration of novel technologies into dermatology pathways raises ethical concerns. Although ethical principles for AI governance are well known, how these principles should be applied to real-life AI apps readily available for public use is less well understood. We conducted an ethical use-case analysis of commercially available skin cancer apps to better understand the ethical issues arising from their development and use in a real-world context. Established methods for ethical analysis of clinical AI applications were applied to two popular skin cancer apps in the UK: SkinVision and Scanoma. Systematic searches of published literature, regulatory documents, and websites were conducted to review the evidence regarding app development, effectiveness, and use. Screening for inclusion was undertaken by two researchers independently. Ethical concerns were identified with reference to previously described ethical concerns and principles for AI-assisted healthcare. By conceptualising ethical principles within the use-context of skin cancer apps, we identified specific ethical issues arising throughout the AI lifecycle of both apps. One company provided extensive detail regarding algorithm development and decision-making, this information was insufficiently reported for the other app. Other concerns identified related to number, quality, and consistency of studies assessing algorithm efficacy. Limited efforts to address potential skin tone biases and exclusion of individuals with darker skin tones as target users by one app risks perpetuating existing inequalities. Inadequate regulatory oversight was identified. Findings from our ethical use-case analysis of two patient-facing AI-assisted skin cancer apps suggest inadequate incorporation of bioethical norms such as justice, responsibility and transparency into the development and deployment of both apps. Improved regulation should increase accountability. Ensuring ethics by design through integration between technology developers, dermatologists, ethicists, and the public is urgently needed to prevent the potential benefits of AI-assisted skin cancer apps being overshadowed by potential ethical harms.

Breeding of new kiwifruit (Actinidia chinensis) cultivars with yellow (golden) fleshed and superior characteristics

The most widely cultivated species globally is Actinidia deliciosa cv. ‘Hayward’. However, in recent years, consumers have shown greater demand for new varieties with novel flesh colour, flavour and appearance in international markets. To meet these expectations, one breeding study was started in 2016 at the University of Guilan in Iran to develop new kiwifruit cultivars with superior characteristics. In this breeding program, 201 female and 534 male hybrid genotypes were obtained from combinations of six different parents using the controlled cross-breeding technique. The evaluations were carried out over three consecutive stages. In the first stage, 201 female hybrid genotypes and control (‘Golden’) were evaluated based on 25 phenological and pomological traits. In the second stage, hybrids passed the desired threshold values in 7 key attributes were selected. Sensory testing in the next stage evaluated these selected hybrid genotypes more. As a result of the first stage, 30 hybrid genotypes with fruit weight (90 ≥ g) were selected. Then, in the second stage, 21 hybrids that showed acceptable dry matter, hue angle, flesh firmness, soluble solid content, acidity, and ascorbic acid were selected. Finally, 13 hybrid genotypes received high scores in sensory testing, and just two hybrid genotypes represented a 100% of novelty with positive texture. These genotypes were selected as potential cultivar candidates. In future studies, fruit yield, disease/pest resistance, and post-harvest performance trials of the 13 selected candidates will be evaluated at different sites. Thus, the ones that give the best results will be introduced to kiwifruit growers.

Beneficial Effects of Epigallocatechin Gallate in Preventing Skin Photoaging: A Review

Skin photoaging, primarily caused by ultraviolet (UV) radiation, leads to skin metabolic disorders, which have adverse psychological and physiological effects on individuals. However, traditional medications for repairing skin photoaging cause side effects. Natural bioactive compounds have been shown to prevent and treat skin photoaging with fewer side effects. Epigallocatechin gallate (EGCG), the main substance in tea polyphenols, is a natural bioactive compound with a range of properties. This review summarizes the beneficial effects and mechanisms of EGCG, as well as the application forms of EGCG in repairing photoaged skin. Results indicated that EGCG has repair effects, including improving elasticity, enhancing moisturization, inhibiting damage, and reducing pigmentation of photoaged skin. It has also been demonstrated that EGCG delivery systems, modified EGCG, and combinations with other bioactive substances could be used for repairing photoaged skin due to its poor stability and low bioavailability. EGCG effectively repairs various types of skin damage caused by UV radiation while maintaining normal skin structure and function. It is, therefore, an effective candidate for repairing photoaged skin. These results could provide references for the development and application of EGCG products for the treatment of photoaged skin.

Bioinspired Ultra‐Stretchable and Highly Sensitive Structural Color Electronic Skins

AbstractOrganisms possess remarkably adaptive ability to complex environments. For example, chameleons can alter their skin color to adapt to varying environments, which has inspired significant advances in bioinspired soft electronic skins (E‐skins), and their wide applications in wearable sensors, intelligent robots, and health monitoring. However, current bioinspired E‐skins face challenges in ultra‐stretchability, high sensitivity, and long‐term stability owing to the intrinsic limitations associated with their mismatched interface between soft matrix and hard conductive fillers, hindering their practical applications. Here, it is reported that bioinspired structural color electronic skins (SC E‐skins) that consist of liquid metal particles (LMPs), periodical ordered colloidal crystal arrays, and ultra‐stretchable hydrogel, imparting synergistic and durable electrical–optical sensing capabilities. Such SC E‐skins demonstrate outstanding performances including superior flexibility (elongation at break > 1100%), high sensitivity (gauge factor = 3.26), fast synergetic electric–optical response time (≈100 ms), outstanding durability (over 1500 cycles), and high accuracy (R2 > 99.5%). These bioinspired SC E‐skins with excellent capability of converting mechanical signals into synergetic electrical–optical outputs hold great promise for smart wearable devices, affording a new horizon in developing advanced health monitoring technologies.

A prospective, double‐blinded, randomized head‐to‐head clinical trial of topical adapinoid (oleyl adapalenate) versus retinol

AbstractBackgroundRetinoids, such as retinol, are widely investigated and utilized in skin care products as a treatment for photoaging but their use is limited by tolerability. Adapinoid (oleyl adapalenate, OA) is a novel third generation retinoid that is a pro‐drug of adapalene, but there is little research on its effects on photoaging or its tolerability.ObjectivesThe purpose of this study is to compare the effects and tolerability of OA 0.5% to retinol 0.5% cream regarding visible signs of facial photoaging including facial wrinkles, fine lines and pigmentation.MethodsIn this 12‐week, double‐blind, randomized clinical trial, 48 eligible participants were recruited and enroled from the Greater Sacramento region. The study consisted of a baseline and follow‐up visits at weeks 4, 8 and 12. Participants were randomized to receive either topical OA 0.5% or retinol 0.5% for 12 weeks. The primary outcome was changes in the appearance of wrinkle severity at 12 weeks. Secondary outcome measures include changes in erythema, skin pigmentation, skin hydration and transepidermal water loss (TEWL).ResultsOA improved wrinkle severity by 9.45% (p < 0.0001) at week 12, whereas retinol improved wrinkle severity by 4.11% (p < 0.001) compared to baseline. When comparing the two treatment groups at week 12, the OA group improved significantly more than the retinol group (p = 0.001). OA decreased pigment intensity at week 12 by 3.88% (p < 0.0001), whereas retinol decreased pigment intensity by 3.15% (p < 0.03) compared to baseline. OA‐based improvement in pigment intensity at week 12 was not significantly different from retinol (p = 0.62). OA reduced facial erythema by 13.39% (p < 0.05) at week 12, whereas the retinol group did not have a significant change. OA use led to a 14.92% decrease in TEWL by week 12 (p = 0.07), whereas the retinol group had no significant change. OA was better tolerated than retinol when assessed at all follow‐up visits.ConclusionsOA 0.5% is superior to retinol 0.5% in improving wrinkle severity and similar in improvement of pigment intensity. OA is better tolerated than retinol. Overall, the use of OA as a precursor to adapalene may be an effective method to improving the tolerability of retinoids while maintaining efficacy.Trial RegistrationThis study was registered on www.clinicaltrials.gov (NCT05778760).

083. Bilateral Mammae Reduction in Patients with Gestational Gigantomastia

Background: Gestational gigantomastia is a rare clinical condition characterized by rapid and disproportionate breast enlargement during pregnancy. This case report describes a 24-year-old female patient with bilateral gigantomastia. Case: A 24-year-old female patient presented with complaints of a lump in both breasts that had progressively enlarged since her first pregnancy. Physical examination revealed breast enlargement measuring 30x20 cm, with signs of skin stretching, redness, no lesions, and engorged veins around both the left and right breasts. On palpation, there was no tenderness, the tissue felt soft, no masses were detected, and there was retraction of the nipple. In the right and left axillary regions, masses measuring 4x5 cm and 4x3 cm, respectively, were noted, matching the skin color. Breast ultrasound showed diffuse edematous changes in bilateral mammary parenchyma accompanied by duct ectasia, with a differential diagnosis of mastitis. The patient was diagnosed with bilateral gigantomastia and underwent reduction mammoplasty. Conclusion: This case report describes a patient with gestational gigantomastia who underwent reduction mammoplasty and excision of aberrant breast tissue.

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.

Are you what you emoji? how skin tone emojis and profile pictures shape attention and social inference processing

Emojis can express emotions and some aspects of the sender’s identity; however, only limited research has explored how the choice of skin tone in emojis influences the perceptions of the users. We examined the interaction between emoji skin tones and profile pictures in instant messaging, using self-reported and eye tracking measures. White participants viewed 14 screenshots of conversations (9 target and 5 fillers) where the sender used an emoji in a Darker or Lighter skin tone, or the default Yellow; alongside profile pictures displaying a Black or White individual, or a landscape as a neutral condition. Results showed that Black senders using Darker emojis were seen as warmer and closer to the receiver, but less competent, suggesting a dimensional compensation effect. Conversely, Black senders using Lighter emojis appeared more competent, but less warm. In the Neutral condition, Lighter emojis improved warmth and relationship quality, but reduced competence inferences, unlike Yellow and Darker emojis, suggesting a black sheep effect (in-group strictness). Yellow emojis were assumed to be sent by White individuals. Eye-tracking measures revealed an implicit bias towards White senders using Darker emojis, although such an impact was not observed for Black senders using Lighter emojis. Overall, findings indicate that skin tone emojis and profile pictures influence sender perception and challenge the neutrality of Yellow emojis.

Prevalence of social jetlag and associated factors in Brazilian adolescents: Results from a country-wide cross-sectional study

ObjectivesSocial jetlag is a disturbance in the circadian rhythm caused by a desynchronization between an individual's biological rhythm and social commitments and responsibilities. It leads to sleep debt during the week and compensation on weekends. Social jetlag is associated with an increased risk of chronic diseases and cognitive dysfunction in adolescents. This study aims to assess the prevalence of social jetlag and associated factors in Brazilian adolescents. MethodsAdolescents of both sexes, aged between 12 and 17years, participating in the Study of Cardiovascular Risks in Adolescents (ERICA), were included. The sleep duration on a typical weekday and weekend day was collected through a self-reported questionnaire. The occurrence of social jetlag was defined as the difference between the midpoint of sleep on weekends and weekdays, with differences equal to or higher than 1hour considered as an indicator of positive social jetlag. Factors associated with the prevalence of social jetlag were investigated using Poisson regression models. ResultsThe sample included a total of 64,029 adolescents. Social jetlag affects more than 80% of Brazilian adolescents, with higher prevalence among girls in the age group of 16-17years, with white skin color, attending private schools, and those having morning classes. Additionally, unhealthy risk behaviors such as skipping breakfast, alcohol consumption, and increased screen time are associated with a higher prevalence of social jetlag. ConclusionThe prevalence of social jetlag was high in Brazilian adolescents, and, among its associated factors, studying in the morning shift and engaging in unhealthy risk behaviors stand out.

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.