Subjective Self-assessment Research Articles

P1332 Differences in gut microbiome regarding education level, occupation and income level during COVID-19

Abstract Background Psychological and physical stress can worsen symptoms and contribute to flare-ups in ulcerative colitis (UC) patients. The education level, occupation and income level may affect ulcerative colitis patients during stressful periods such as COVID-19 outbreak. Methods In 12 months time (June 2021 to June 2022) 79 ulcerative colitis (UC) outpatients from Riga East Clinical University Hospital and 78 healthy controls were included in a Cross-sectional study. All patients were divided into groups according to medically proven data about COVID-19 status (COVID-19pos vs. COVID-19neg) within the last 6 months. Information about education, occupation, income level, stress, and faecal samples was collected. For taxonomical classifying of the gut microbiome shotgun-metagenome data, MetaPhlAn v.2.6.0 tool was used. Stress levels were evaluated by subjective self-assessment reporting high stress in the last month. In further analysis gut microbiome (mostly bacteria phyla) and related data were analysed with SPSS 20.0. Results In the UC group were 35(44.3%) female and 44(55.7%) males, in controls 63 (80.8%) female and 15(19.2%) male,p<0.001. UC group had fewer COVID-19 cases (16(20.5%) vs. 48(61.5%),p<0.001) and were sick for a shorter time (M=2.85;SD=7.10 vs. M=5.68;SD=5.22,p=0.005). UC group with COVID-19 symptoms had less Verrucomicrobia (M=0.1; SD=0.3 vs.M=0.8; SD=2.0,p=0.012). In both groups was equally high stress in the last month; no statistically significant changes were found. UC group was more worried about contracting COVID-19 than controls 29(38.7%)vs.9(11.5%),p<0.001. Evaluating occupation, respondents were in service (56(70.9%)UC vs.72(92.3%) controls,p=0.001). Evaluating education level, 38(48.1%) UC patients had a high school education level vs. 6(7.69%) in the control group p<0.001. Less respondents had a university and above university education level (37(46.8%) in the UC colitis group vs. 72(92.3%) in the control group<0.001. Regarding income level, fewer participants in the UC group considered their income as high 12(15.2%) vs.38(48.7%),p<0.001. UC group respondents considered their income as average 56(70.9%) more often than control 32(41.0%),p<0.001. Conclusion UC patients had COVID-19 less frequently and suffered from COVID-19 shorter time than healthy controls. Both groups underwent high stress in the last month before the interview. UC patients were worried more about contracting COVID-19 than controls. UC group had a high school education and considered their income as average. There were no differences regarding stress levels and gut microbiota in UC and healthy controls. Those in the UC group who had COVID-19 symptoms had less Verrucomicrobia.

Instruments for Evaluating Undergraduate Medical Education in Complementary and Integrative Medicine: A Systematic Review.

Objectives: The provision of courses in complementary and integrative medicine (CIM) varies widely between medical schools. To effectively improve CIM education, it is essential to use robust evaluation instruments that measure the impact of different educational interventions. This review aimed to identify and critically appraise qualitative and quantitative instruments used to evaluate CIM courses in undergraduate medical education. Methods: A systematic review was conducted in PubMed/MEDLINE, LIVIVO, CINAHL/EBSCO, Scopus, Web of Science, and Ovid/Embase in January 2023. Eligible studies included complete evaluation instruments for medical students and reported learning outcomes. Data extraction included information on the study design, the educational intervention, the evaluation instrument, and the outcome measure (e.g., Kirkpatrick levels: 1 reaction, 2a attitudes, 2b knowledge/skills, 3 behavioral change, 4 results). Instruments were categorized as validated, nonvalidated, or qualitative and analyzed using descriptive statistics. Validated instruments were assessed for quality using standardized criteria. Results: Of the 1909 records identified, 263 were subjected to a full-text review and 100 studies met the inclusion criteria. Twenty-seven studies reported on 14 validated instruments, 7 studies reported on qualitative, and 66 reported on nonvalidated instruments. Most were conducted in the United States (31) and Europe (28), 51 were cross-sectional studies, and 42 were intervention studies. Most of the instruments were self-administered (50), addressed general aspects of CIM (53), and assessed student attitudes (74). None of the validated instruments covered Kirkpatrick level 1, one covered level 3. Measurement of levels 2b and 3 was usually based on subjective self-assessment. Qualitative instruments covered the widest range of outcomes overall. Validated instruments often had good content validity and internal consistency, but lacked reliability and responsiveness. Revalidation of translated or modified instruments was mostly inadequate. Discussion: This structured and comprehensive set of existing instruments provides a starting point for the further development of CIM course evaluation in undergraduate medical education. Future studies should prioritize the measurement of higher-level learning outcomes, such as behavioral change and impact on patient care. Comparative intervention studies between medical schools or with pre-post designs and follow-up evaluations are needed to assess the effectiveness of different teaching approaches. Regular revalidation of both existing and newly developed instruments is essential to ensure their applicability to different audiences and settings. Their structured and standardized use would promote evidence-based CIM training and understanding of its impact on student competencies and patient outcomes.

Ordered correlation forest

. Empirical studies in various social sciences often involve categorical outcomes with inherent ordering, such as self-evaluations of subjective well-being and self-assessments in health domains. While ordered choice models, such as the ordered logit and ordered probit, are popular tools for analyzing these outcomes, they may impose restrictive parametric and distributional assumptions. This article introduces a novel estimator, the ordered correlation forest, that can naturally handle non linearities in the data and does not assume a specific error term distribution. The proposed estimator modifies a standard random forest splitting criterion to build a collection of forests, each estimating the conditional probability of a single class. Under an “honesty” condition, predictions are consistent and asymptotically normal. The weights induced by each forest are used to obtain standard errors for the predicted probabilities and the covariates’ marginal effects. Evidence from synthetic data shows that the proposed estimator features a superior prediction performance than alternative forest-based estimators and demonstrates its ability to construct valid confidence intervals for the covariates’ marginal effects. Comparisons using various real-world data sets further highlight the advantages of forest-based estimators over parametric models in larger samples while showing that the ordered correlation forest remains competitive in smaller samples.

The Predictive Value of Burnout and Impostor Syndrome on Medical Students’ Self-Esteem and Academic Performance: A Cross-Sectional Study

Stress exposure can take a toll on the adjustment of young individuals, including students. The aim of this study was to investigate the impact of burnout and impostor syndrome (IS) on self-esteem and academic performance in medical students. The participants were 331 undergraduate medical students (102 men, 229 women; 89.7% native, 12,1% international; mean age = 21.18, SD = 2.338). The study instruments included the Copenhagen Burnout Inventory for Students (CBI-S), Clance Impostor Phenomenon Scale (CIPS), and Rosenberg’s Self-Esteem Scale, while academic performance (AP) was reported as received GPA (objective AP) and expected GPA (subjective AP). The statistical analysis comprised independent t-tests, MANOVA, ANOVA, and correlational and mediational analyses. The results showed that native students had lower self-esteem and higher scores of personal burnout and IS. Irrespective of cultural differences, women scored higher than men in IS and in personal burnout, while men had higher self-esteem than women. Burnout and IS were correlated with a decrease in self-esteem (adj. R2 = 0.531) in the overall sample, whereas in native students, IS was correlated with a difference between subjective and objective self-assessments of AP (adj. R2 = 0.027). Burnout and impostor syndrome, despite not directly impacting academic performance, may significantly influence self-esteem, making them a target for preventive or interventional measures.

A comparative evaluation of a commercially available kojic acid and arbutin-containing test product with a test regime in the treatment of hyperpigmentation

Background: The study compared the effectiveness of kojic acid and arbutin-containing lotion (alone) with arbutin-containing facewash and kojic acid and arbutin-containing lotion in the reduction of pigmentation. Methods: The study compared the test product (lotion) and the test regime (lotion + facewash) over a period of 45 days. In both test groups, a thin layer of advance body lotion was applied to the face, neck, and upper trunk. In the test regime group (TRG), these areas were washed with advance facewash before the lotion was applied. Both groups used sunscreen (with a sun protection factor of 50). The primary outcomes measured were (i) skin radiance and skin pigmentation, (ii) skin gloss, and (iii) skin hydration. The secondary outcomes measured were clinical evaluation and a subjective self-assessment for tolerance and perception of the product. Results: The study included 61 participants. The TRG showed a statistically significant increase in skin hydration (at 21 days) and skin gloss compared to the test product group (TPG) (at 21 and 45 days) (p<0.05). The majority of participants in both groups reported a visible reduction in pigmentation and improved facial glow and hydration as compared to baseline. No serious adverse effects were reported. Conclusions: The use of kojic acid and arbutin-containing lotion alone and arbutin-containing facewash with the lotion led to significant improvements in skin radiance, lightening, gloss, and hydration as compared to the baseline, with the TRG showing significantly better clinical results than the TPG in terms of skin hydration and gloss.

A Randomized, Single-Center, Double-Blind, Controlled Case Study Evaluating Procedure Pairing of a Neurocosmetic Postprocedure Cream With Radiofrequency Microneedling for Facial Rejuvenation.

Radiofrequency (RF) microneedling produces patient discomfort which deters patients from completing the recommended treatment series. The primary objective was to determine the tolerability, safety, and efficacy of a neurocosmetic postprocedure cream post-RF microneedling in reducing patient discomfort and enhancing recovery across the length of the study and, secondarily, to evaluate against a leading comparator. The third objective was to evaluate the efficacy of the neurocosmetic on self-perceived improvement and objective grading. An Institutional Review Board (IRB) approved, fourteen-day, randomized, single-center, double-blind, controlled clinical case study was conducted with 11 healthy female subjects, 6 randomized to the neurocosmetic and 5 to the comparator cell. Following a 7-day washout period, subjects received RF microneedling (face and neck) and applied the postprocedure cream twice daily for 7 days. Objective and subjective tolerability, self-assessments, and clinical photography were performed immediately postprocedure, 24 h, three and seven days following the procedure. The neurocosmetic was tolerable and safe. Erythema and stinging immediately decreased postprocedure, postneurocosmetic application. After 24 h, 83% favorably agreed the neurocosmetic "reduced irritation on the skin post-procedure," and after 7 days, 100% favorably agreed "experience with the product was positive and I would be interested in returning for a second treatment." The neurocosmetic reduced skin tone redness in the face and neck faster and to a greater degree when measured against a comparator. The neurocosmetic postprocedure cream improved patient discomfort and enhanced recovery when used immediately post-RF microneedling and after 7 days. Pro00064211.

Subjective Well-Being and Successful Ageing of Older Adults in Eastern Croatia—Slavonia: Exploring Individual and Contextual Predictors

The process of population ageing with socioeconomic and political implications necessitates the creation of sustainable social strategies aimed at societal inclusion, support of subjective well-being and successful ageing of older adults. Therefore, the aim of this cross-sectional study was to explore individual and contextual factors and predictors which impede the possibility of successful ageing. The study was conducted from January to June 2024 through a questionnaire involving 403 elderly participants who live in the Eastern region of Croatia—Slavonia. The Diener Scale of Subjective Well-being and Self-assessment of Successful Ageing Scale were used in this research. A separate and model contribution of predictors (gender, age, subjective age, residence, level of education, marital status, comorbidities, Satisfaction with Life Scale and Prosperity Scale) were examined using bivariate and multivariate regression. Multivariate regression differentiated a statistically significant model, which as a whole explains between 41% and 55% of the variance of the present negative assessment of successful ageing, correctly classifying 80% of cases. The significant predictors included subjective age, place of residence, level of education, comorbidities, Satisfaction with Life Scale, and Prosperity Scale. These findings underscore the importance of both individual and contextual factors in successful ageing within this specific regional context.

Assessment of the efficacy and safety of Indulekha svetakutaja hair oil in management of dandruff: a randomized, double-blind, and placebo-controlled study

Background: This study aimed to evaluate the efficacy and safety of Indulekha Svetakutaja Hair Oil in comparison with coconut oil in the management of dandruff through a randomized, double-blind, placebo controlled study. Methods: A total of 110 subjects with clinically diagnosed moderate dandruff were randomly assigned into two groups: Group A (The Indulekha Svetakutaja Hair Oil group, n=55) and Group B (Placebo coconut hair oil group, n=55), where 50 subjects in each group completed the study. The treatment phase was for 4 weeks, followed by a regression phase of 2 weeks. Subjects applied the allotted oil on their scalp, massaged and kept it for a minimum of 30 mins or overnight thrice a week, then washed it with the provided neutral shampoo for a duration of 4 weeks. Dermatological assessments, instrumental measurements and subject self-assessment questionnaire were evaluated in comparison to baseline at weekly intervals throughout the study period. Results: After 4 weeks of treatment, group A demonstrated a significantly greater reduction (p<0.05) in dandruff severity compared to group B. The Total Dandruff scores in Group A showed a significant reduction of 70.62 units while in Group B, it was noted to be 48.79 units. Nearly all participants (98%) in Group A reported a subjective perception improvement in dandruff symptoms compared to Group B. Conclusions: Indulekha Svetakutaja Hair Oil is safe and effective in controlling dandruff and improving scalp and hair health, making it a promising therapeutic option for individuals with dandruff.

Effectiveness of an ultrasound basic cancer training program through on-site training and virtual case discussions in rural Tanzania: a proof-of-concept study.

Cancer rates are rising in low- and middle-income countries. While point-of-care ultrasound is now available globally and could serve to mitigate against this rise, its use in diagnosing cancers is inconsistent in lower-resourced healthcare contexts. This proof-of-concept study investigates the feasibility of an ultrasound training concept in a low-resource setting. It evaluates whether this educational concept led to improved knowledge and application of ultrasound diagnostics, cancer screening and staging and patient care. The curriculum was developed through expert exchange and is based on the World Health Organisation's Manual of Diagnostic Ultrasound. It consisted of two didactic components: an on-site training phase across 5 days for a total of 24 hours, and a digital follow-up phase involving the meeting of a bi-weekly tumor board online. The learning objectives of the on-site training were normal imaging and recognition of common pathologies of the abdominal organs, vessels, lymph nodes, female breasts and lungs. The virtual tumour boards met to discuss cases and ultrasound findings, thus aiding continuing professional development after the training sessions had concluded. The face-to-face course component was accompanied by tests given before and after training as well as an evaluation sheet (Likert-scale with 1 = 'completely/very good' and 7 'not at all/very poor'). Of 20 participants from a rural hospital in Tanzania, a total of 16 were included in the analysis (clinical officers n = 6; medical officers n = 10). A significant increase in knowledge (p < 0.01) was measured both in the subjective self-assessment and in the theoretical competence tests. In multivariate linear regression, the status 'medical officers yes' (β = 5.4; p = 0.04) had a significant influence on theory test results at T2. During the 24 virtual tumour board meetings, 28 cases were discussed and a continuous improvement in image acquisition quality was observed. The ultrasound education concept comes with a sustainable increase in clinical competence and improved oncological ultrasound screening locally. There is potential for the transfer of the concept to other locations, which can be explored in the future.

A Composite Inter-Temporal Economic Insecurity Index

Interest in the study of economic insecurity has grown in recent years. However, the ongoing debate about how to measure it remains unresolved. On the assumption that economic insecurity is related both to the forward-looking perception of future outcomes based on past experience and to the perception of one’s own situation compared to others in the present, we propose a class of objective individual composite inter-temporal indices of economic insecurity. The indices are obtained by combining two components, one longitudinal and one cross-sectional. In order to combine the two components, we propose a novel method that takes advantage of the availability of subjective self-assessments of one’s own economic conditions. The composite inter-temporal index is applied to the European Union-Statistics on Income and Living Conditions (EU-SILC) Longitudinal Dataset, encompassing a selection of European countries. Our analysis shows that the proposed class provides new insights into individual perceptions of well-being that are not captured by poverty and inequality measures. It also provides individual measures that can be used to study the relationship between economic insecurity and other phenomena.

The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study.

The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty. We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes. The relationships between puberty, islet autoimmunity, and progression to type 1 diabetes were investigated prospectively in children followed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Onset of puberty was determined by subject self-assessment of Tanner stages. Associations between speed of pubertal progression, pubertal growth, weight gain, homeostasis model assessment of insulin resistance (HOMA-IR), islet autoimmunity, and progression to type 1 diabetes were assessed. The influence of individual factors was analyzed using Cox proportional hazard ratios. Out of 5677 children who were still in the study at age 8 years, 95% reported at least 1 Tanner Stage score and were included in the study. Children at puberty (Tanner Stage ≥2) had a lower risk (HR 0.65, 95% CI 0.45-0.93; P = .019) for incident autoimmunity than prepubertal children (Tanner Stage 1). An increase of body mass index Z-score was associated with a higher risk (HR 2.88, 95% CI 1.61-5.15; P < .001) of incident insulin autoantibodies. In children with multiple autoantibodies, neither HOMA-IR nor rate of progression to Tanner Stage 4 were associated with progression to type 1 diabetes. Rapid weight gain during puberty is associated with development of islet autoimmunity. Puberty itself had no significant influence on the appearance of autoantibodies or type 1 diabetes. Further studies are needed to better understand the underlying mechanisms.

Comparison of Facial Aesthetic Evaluation Given by Patients with Cleft Lip and/or Palate and Professionals: A Systematic Review.

To compare the differences of facial aesthetic evaluation between patients with Cleft Lip and/or Palate (CL/P) and professionals for the treatment outcome of CL/P. This systematic review was conducted on MedLine, Web of Science, Embase and Cochrane Library databases. The Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) tool was used to evaluate the included researches. Not applicable. Patients with CL/P and professionals. Not applicable. The facial aesthetic evaluation of patients with CL/P and professionals. Among the 1695 literatures retrieved, 22 articles were included, including 974 patients with CL/P and 251 professionals. The bias risk assessment on 21 articles was rated "Moderate" and only one article was rated "Serious". Due to the high heterogeneity of the included studies, meta-analysis was not possible, so descriptive analysis was conducted. Among the included studies, two articles indicated similar views from both groups, 19 noted differences between the two groups, of which three articles indicated more positive evaluation by professionals and nine articles indicated more positive evaluation by patients. The available data indicate that there is a difference between patients with CL/P and professionals in the aesthetic evaluation, but it is not clear which group is more positive. During the treatment of patients with CL/P, apart from the objective aesthetic evaluation, professionals should fully consider subjective ideas and self-assessment of patients, in order to improve the quality of life for patients.

Analysis of drug-related problems in the home medication review practice by the master of pharmacy students

Background: Master’s students are required to perform community service (CS), so a strategy is needed to merge CS into a course and make it a learning method that can be sustainably evaluated. Objective: This study aimed to analyse patients’ problems in using, storing, and disposing of drugs through home medication review (HMR) by master’s students of pharmacy. Subjective self-assessment assesses students’ performance in fulfilling the relevant competencies. Method: This cross-sectional study, conducted for four months, involved 225 patients living near the students’ residences. Semi-structured interviews collected data on subject characteristics and how the patients/family members managed drugs at home. Result: Nine master’s students practised HMR to achieve the learning outcomes of the pharmaceutical care course. The most commonly identified drug-related problems (DRPs) were inappropriate timing or dosing interval (41.2%) and medication nonadherence (25%). Some patients (31.6%) stored drugs without adherence to the provisions, and 70.2% disposed of drugs directly in the trash can. Meanwhile, 88.9% of students strongly agreed that HMR could improve their ability to gather patient data and information. Conclusion: HMR is an excellent patient-oriented practice for master’s students to strengthen and refine their awareness of community needs regarding drug use and management by patients at home.

ИЗУЧЕНИЕ ЗДОРОВЬЯ НАСЕЛЕНИЯ НА ОСНОВАНИИ САМООЦЕНКИ ЗДОРОВЬЯ

An analysis of the use of subjective self-assessment of health to study the health status of the popu-lation was carried out. Some results of our own empirical research using the EQ-5D questionnaire are shown

Safety, Efficacy and Attributes of 2.5% Selenium Sulfide Shampoo in the Treatment of Dandruff: A Single-Center Study.

Selenium sulfide, available as a shampoo or topical lotion at 1%, or 2.5% concentrations in India, is used as a topical antiseborrheic and antifungal for the treatment of dandruff, seborrheic dermatitis, psoriasis, and tinea versicolor. In the present study, the safety, efficacy, and attributes of 2.5% selenium sulfide shampoo were evaluated in Indian participants with dandruff. A single-center, single-arm, prospective, investigator-initiated, open-label, post-marketing interventional study was conducted on Indian subjects aged 18-70 years diagnosed with moderate dandruffwho were prescribed 2.5% selenium sulfide shampoo every three days for four weeks. The primary endpoints were 1) reduction in total dandruff score assessed using a clinical grading scale for adherent and loose dandruff from baselineto weeks 1, 2, and 4, and 2) incidence of adverse events up to the end of the study. The key secondary endpoints were 1) participants' perception of shampoo attributes (dandruff reduction, scalp itch, scalp oiliness/greasiness, or fragrance) as assessed by a subjective self-assessment questionnaire post-first wash and at weeks 1, 2, and/or 4; 2) satisfaction with treatment as assessed by investigators and participants using a subjective self-assessment questionnaire at week 4; and 3) reduction in scalp sebum as assessed with a meibometer at weeks 2 and 4.Statistical analysis was performed using the Wilcoxon signed-rank test for continuous variables and the Chi-square test for categorical variables. A p-value of 0.05 was considered to be statistically significant. Of 34 enrolled subjects, 30 completed the four-week study. The mean (standard deviation, SD) age of the study participants was 29.8 (7.87) years, with the majority being females (n=18; 60.0%). Mean (SD) total dandruff score significantly (p=0.001) reduced from a baseline score of 11.5 (2.15) to 7.17 (2.12) at week 1, 4.93 (1.72) at week 2, and 2.5 (1.17) at week 4. All the participants reported dandruff reduction and acceptable fragrance of the shampoo at four weeks. Absence of itching and reduction in oiliness was reported by 73.3% (n=22) of participants at week 4 and by 50.0% (n=15) of participants at week 2, respectively. All participants reported good, very good, or excellent satisfaction with the test shampoo at week 4, whereas the investigators rated the shampoo as very good or excellent in managing dandruff in all participants. At week 4, erythema was reported to be absent in all participants. No adverse events were reported during the study. The 2.5% selenium sulfide shampoo was found to be effective in the management of dandruff and related symptoms like itching, oiliness, and greasiness and had a good safety profile in Indian participants with dandruff.

Enhancing Human-in-the-Loop Ontology Curation Results through Task Design

The success of artificial intelligence (AI) applications is heavily dependent on the quality of data they rely on. Thus, data curation, dealing with cleaning, organising, and managing data, has become a significant research area to be addressed. Increasingly, semantic data structures such as ontologies and knowledge graphs empower the new generation of AI systems. In this article, we focus on ontologies as a special type of data. Ontologies are conceptual data structures representing a domain of interest and are often used as a backbone to knowledge-based intelligent systems or as an additional input for machine learning algorithms. Low-quality ontologies, containing incorrectly represented information or controversial concepts modelled from a single viewpoint, can lead to invalid application outputs and biased systems. Thus, we focus on the curation of ontologies as a crucial factor for ensuring trust in the enabled AI systems. While some ontology quality aspects can be automatically evaluated, others require a human-in-the-loop evaluation. Yet, despite the importance of the field, several ontology quality aspects have not yet been addressed and there is a lack of guidelines for optimal design of human computation tasks to perform such evaluations. In this article, we advance the state-of-the-art by making two novel contributions. First, we propose a human computation (HC)–based approach for the verification of ontology restrictions —an ontology evaluation aspect that has not yet been addressed with HC techniques. Second, by performing two controlled experiments with a junior expert crowd, we empirically derive task design guidelines for achieving high-quality evaluation results related to (i) the formalism for representing ontology axioms and (ii) crowd qualification testing . We find that the representation format of the ontology does not significantly influence the campaign results. Nevertheless, contributors expressed a preference in working with a graphical ontology representation. Additionally, we show that an objective qualification test is better fitted at assessing contributors’ prior knowledge rather than a subjective self-assessment and that prior modelling knowledge of the contributors had a positive effect on their judgements. We make all artefacts designed and used in the experimental campaign publicly available.

How Intuitive Is the Administration of Pediatric Emergency Medication Devices for Parents? Objective Observation and Subjective Self-Assessment.

to assess the intuitiveness of parents' administration of pediatric emergency devices (inhalation, rectal, buccal, nasal, and auto-injector). We invited parents without prior experience to administer the five devices to dummy dolls. We observed whether the parents chose the correct administration route and subsequently performed the correct administration procedures without clinically relevant errors. We interviewed parents for their self-assessment of their own administration performance and willingness to administer devices in actual emergencies. The correct administration route was best for the inhalation device (81/84, 96% of parents) and worst for the intranasal device (25/126, 20%). The correct administration procedures were best for the buccal device (63/98, 64%) and worst for the auto-injector device (0/93, 0%). Their own administration performance was rated to be best by parents for the inhalation device (59/84, 70%) and worst for the auto-injector device (17/93, 18%). The self-assessment of the correct administration overestimated the correct administration procedures for all the devices except the buccal one. Most parents were willing to administer the inhalation device in an emergency (67/94, 79%), while the fewest were willing to administration procedures the auto-injector device (28/93, 30%). Intuitiveness concerning the correct administration route and the subsequent correct administration procedures have to be improved for all the devices examined. The parents mostly overestimated their performance. Willingness to use a device in an actual emergency depended on the device.

Efficacy and tolerability of a novel cosmetic growth factor serum when used as part of biweekly diamond tip hydradermabrasion treatments on facial skin.

Growth factor preparations have demonstrated effectiveness in reversing age-related changes in facial skin. TNS® Advanced+ Serum (TNS A+ Serum; SkinMedica®, Allergan Aesthetics, an AbbVie Company) and TNS Advanced+ Pro-Infusion Serum for DiamondGlow® (DG-TNS A+; Allergan Aesthetics) combine growth factor technology with active botanical ingredients to target signs of skin aging. This prospective clinical study evaluated the effectiveness and tolerability of biweekly facial hydradermabrasion (DiamondGlow [DG]; Allergan Aesthetics) plus DG-TNS A+ combined with at-home topical TNS A+ Serum. Females aged 25-65 years with mild to severe facial photodamage received 6 biweekly DG plus DG-TNS A+ in-office treatments with at-home twice-daily TNS A+ Serum for 12 weeks. Investigator-assessed clinical grading of multiple skin attributes, subject self-assessments, instrumentation measurements, and clinical grading of irritation parameters (0-3, none to severe) were conducted at Visit 1, Day 3, and biweekly from Weeks 2-12. Twenty-nine women (Fitzpatrick skin types II-VI; 52% White, 41% African American) were enrolled. Immediate significant improvements after 1 DG plus DG-TNS A+ treatment were observed for fine lines/wrinkles, skin smoothness (visual and tactile), radiance, and hydration (all p ≤ 0.004). From Weeks 6-12, all investigator-assessed parameters showed significant improvements versus baseline (all p ≤ 0.002 at Week 12). Mean tolerability scores were <1 across parameters. All subjects (100%) were satisfied with results at Weeks 2-12. The combination of biweekly hydradermabrasion plus DG-TNS A+ with at-home TNS A+ Serum treatments was well tolerated and produced immediate, progressive improvement in multiple signs of photoaging in facial skin.

A Phase III Clinical Study of the Efficacy and Safety of Botulinum Toxin Type A (MASPORT) with DYSPORT for the Treatment of Glabellar Lines.

Botulinum toxin type A is a widely used treatment of facial wrinkles. The objective of this study was to compare the efficacy and safety of a new botulinum toxin type A (Masport [abobotulinum toxin A], MasoonDarou Co) with DYSPORT® for the treatment of glabellar lines. 262 subjects with moderate-to-severe glabellar lines received either a fixed dose of 50 units of MASPORT® or DYSPORT® (Ipsen Company, England). Subjects were followed up at 14, 30, 60, 90 and 120 days after injection. Efficacy was assessed by investigator at maximum frown and rest and also by Subject Global Assessment of Change (SGA). The responders were defined as persons with +2 grade improvement from baseline for both investigator and patient assessment. The occurrence and duration of adverse effects were recorded up throughout the study. According to the investigator evaluations, the responder rate at maximum frown were 94.5% for MASPORT and 95.6% for DYSPORT group on day 30 and at rest were 85.45% and 85.68% for MASPORT and DYSPORT group, respectively. According to the subject self-assessment, the proportion of responders in MASPORT group at day 30 was 95.28% versus 97.04% for DYSPORT group. No serious drug related adverse effect was recorded in either study groups, and the rates of adverse effects were similar for both groups. Abobotulinum toxin A [MASPORT] is equally safe and effective as commercial product [DYSPORT] for the treatment of glabellar lines with the dose of 50 units, up to 120 days. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Efficacy and tolerability of Profhilo® Structura intended to restore lateral cheek fat compartment: An observational pilot study.

Hyaluronic acid (HA)-based injections are used worldwide to improve skin defects associated with aging and ultraviolet light/environmental exposure. HA formulations developed according to molecular weight or with additional components, for example, cross-linking reagents, are limited by their low biological activity and concentration limit. NAHYCO™ technology has enabled the production of hybrid cooperative complexes (HCCs) of low and high molecular weight HA. Developed for injection into the fat compartments of the face and previously demonstrating potential benefits for adipose tissue restoration, Profhilo Structura® is a new 2 mL HCC formulation comprising low molecular weight HA (45 mg/mL) and high molecular weight HA (45 mg/mL). To evaluate the efficacy and tolerability of Profhilo Structura® to restore adipose tissue compartments in the lateral cheek fat compartment. Fifty healthy enrolled subjects received two injections, 1 month apart, and were evaluated 3 months posttreatment. Investigators performed clinical evaluations (Facial Volume Loss Scale [FVLS] and Wrinkle Severity Rating Scale [WSRS]) at different time points. Subjects also completed self-evaluation assessments following treatment. A significant improvement in FVLS and WSRS clinical scores after the first treatment was observed; treatment benefit was maintained 3 months after treatment completion and confirmed by subject self-assessment. Most participants reported an improvement, particularly a marked reduction of wrinkles and increased skin firmness. No serious adverse events were reported, confirming the excellent safety profile of HCC injectable devices. Overall, the study highlighted the efficacy and tolerability of the studied medical device proving its effect on adipose tissue.