Vitamin E (Skin)

Background and Objectives: Rosacea is a chronic inflammatory dermatosis with a complex pathophysiology that continues to challenge effective long-term disease management. Rosacea is characterized by immune dysregulation, oxidative stress, neurovascular dysfunction, and impaired epidermal barrier integrity, while current therapeutic options remain limited. Hippophae rhamnoides (sea buckthorn) is a phytochemically rich medicinal plant with reported anti-inflammatory and dermo-reparative properties. Materials and Methods: A systematic literature review was conducted following PRISMA guidelines using the PubMed database. Studies published from 2020 onward evaluating sea buckthorn extracts, oils, or isolate bioactive compounds in the in vitro, in vivo, and limited clinical contexts were included, with emphasis on rosacea relevant mechanisms. Results: Twenty-six studies show that sea buckthorn compounds modulate inflammation, oxidative stress, vascular and immune responses, and barrier function in preclinical models. They consistently reduce pro-inflammatory mediators, improve barrier integrity, and attenuate immune or vascular activation, suggesting potential benefits for inflammatory skin disorders such as rosacea. Conclusions: Hippophae rhamnoides shows promising anti-inflammatory and skin-repairing effects that may benefit patients with rosacea. However, most evidence comes from preclinical studies, and clinical data specifically for rosacea are limited. Well-designed clinical trials are needed to confirm its effectiveness in treating this condition.

OBJECTIVE: This review aimed to synthesize evidence on the design characteristics, implementation considerations, and operational challenges of mobile cancer screening units. METHODS: A PRISMA-guided review was conducted. Data extracted included screening type, target population, program characteristics, mobile unit features, and reported implementation barriers. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Sixty-four articles published across 13 countries met the inclusion criteria. Most interventions focused on breast cancer screening (n = 37), followed by lung (n = 11), cervical (n = 6), colorectal, skin, prostate, and multi-cancer screening programs. MSUs were most frequently deployed in urban areas (21 urban/18 rural/17 both). Several comparative studies (fixed programs vs. MSUs) reported higher screening uptake in mobile programs, although findings varied substantially by setting, population, and study design. However, adherence and clinical outcomes varied, often reflecting baseline socioeconomic differences in the populations served. Common implementation barriers included follow-up coordination challenges, program costs, equipment and space limitations, and gaps in referral and reimbursement systems. CONCLUSIONS: These findings highlight the potential of mobile screening units as public health strategies to expand access to cancer screening while underscoring the need for stronger implementation frameworks and long-term evaluation of program outcomes.

BACKGROUND: Periosteal distraction (PD) has been used as a salvage strategy for diabetic foot (DF) and diabetic foot ulcer (DFU), yet its relative effectiveness compared with other approaches is still unclear. METHODS: Up to March 17, 2026, seven databases were searched for comparative studies assessing PD-related treatments in DF/DFU. Twenty-six studies were included for qualitative synthesis, and 14 contributed to the primary comparative evidence set. The studies were organized into three categories: PD-based interventions versus conventional treatment, pure PD versus transverse tibial transport (TTT), and PD-inclusive multimodal regimens versus non-equivalent regimens. RESULTS: A formal pooled meta-analysis could not be performed for Group A, so this group was synthesized descriptively. For Group B, pure PD showed no statistically significant differences from TTT with respect to ABI, pain, or adverse events. For Group C, PD-containing multimodal regimens were linked with beneficial short-term changes in surrogate perfusion-related measures (ABI, skin temperature, toe oxygen) and pain. However, when wound/ulcer healing time was pooled, the results suggested only a non-significant tendency favoring PD-containing multimodal regimens. CONCLUSIONS: Current findings do not support a clear superiority of pure PD over TTT. Apparent advantages were mainly seen in PD-containing multimodal regimens and were largely restricted to short-term surrogate outcomes. These findings should not be interpreted as evidence that PD alone has an independent effect, and robust limb-salvage endpoints remain insufficiently reported. © 2026. The Author(s).

OBJECTIVE: This study aimed to systematically compare robot-assisted nipple-sparing mastectomy (R-NSM) with conventional nipple-sparing mastectomy (C-NSM) in terms of perioperative safety and oncological outcomes through a meta-analysis. METHODS: A comprehensive literature search was conducted in PubMed/MEDLINE, Web of Science Core Collection, Embase, and the Cochrane Central Register of Controlled Trials from database inception to February 27, 2026. Controlled studies comparing robotic nipple-sparing mastectomy (R-NSM) and conventional nipple-sparing mastectomy (C-NSM) in women with early-stage breast cancer (stage 0-II, including a small proportion of risk-reducing mastectomy cases) were included. Study selection and data extraction were independently performed by two reviewers, with discrepancies resolved by consensus. Statistical analyses were conducted using Review Manager (RevMan) version 5.4. The primary outcomes were overall postoperative complications, major complications (Clavien-Dindo grade ≥ III), positive surgical margin, and local recurrence. Secondary outcomes included operative time, estimated intraoperative blood loss, length of hospital stay, reoperation rate, and individual postoperative complications (including nipple-areolar complex necrosis, skin-flap necrosis, surgical-site infection, hematoma, seroma, delayed wound healing, and implant loss). Perioperative mortality was not reported in the included studies. RESULTS: A total of 12 studies involving 2,312 patients (1 RCT and 11 non-randomized studies) were included in the quantitative synthesis. The reported follow-up duration across included studies ranged from 3 to approximately 51 months, with most studies reporting a median or mean follow-up of around 18-30 months. Compared with C-NSM, R-NSM was associated with a lower incidence of overall postoperative complications (RR = 0.82, 95% CI: 0.68-0.99, P = 0.04) and major complications defined as Clavien-Dindo grade ≥ III (RR = 0.44, 95% CI: 0.22-0.86, P = 0.02). R-NSM was also associated with a reduced risk of delayed wound healing (RR = 0.51, 95% CI: 0.26-0.98, P = 0.04). However, no statistically significant differences were observed betw

Staphylococcus pseudintermedius is the primary bacterial agent associated with canine pyoderma, with rising concern over methicillin-resistant strains in Asia. This systematic review and meta-analysis aimed to determine the prevalence of methicillin-susceptible (MSSP) and methicillin-resistant (MRSP) S. pseudintermedius from canine skin infections and to evaluate their antimicrobial resistance profiles. Following PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, studies published between 2015 and 2024 were retrieved from Scopus, PubMed, Web of Science, and Google. Only cross-sectional studies from Asian countries reporting disk diffusion susceptibility testing in dogs with pyoderma were included. Fifteen studies met the inclusion criteria, with overall moderate methodological quality. Fourteen studies were included in prevalence analyses. The pooled prevalence of MSSP was 27.9% (95% CI: 18.8-39.3) and MRSP was 30.7% (95% CI: 21.3-42.1), with high heterogeneity between the included studies (I2 = 93.85%; p < 0.001). The pooled prevalence of the mecA gene among MRSP was 11.9%. Meta-regression revealed no significant difference between MSSP and MRSP prevalence (p = 0.853). MSSP isolates had the lowest resistance to amoxicillin-clavulanic acid and oxacillin, whereas MRSP exhibited broader resistance, particularly to oxacillin, clindamycin, and doxycycline. These findings highlight the substantial burden of MRSP in canine pyoderma in Asia and reinforce the need for susceptibility-guided therapy and strengthened antimicrobial stewardship. © 2026. The Author(s).

BACKGROUND: Epicanthus, a prevalent aesthetic concern in Asian populations, can be surgically corrected using various techniques. The skin redraping method and Z-plasty are 2 widely adopted approaches. This study aimed to conduct a systematic meta-analysis to comprehensively compare the clinical efficacy and outcomes of these 2 dominant surgical methods for epicanthus correction. METHODS: A systematic literature search was performed across PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and VIP databases from their inception through December 2025. Randomized controlled trials (RCTs) and cohort studies directly comparing skin redraping and Z-plasty for congenital epicanthus were eligible. Primary outcomes included postoperative change in intercanthal distance (ICD), scar assessment via the Vancouver Scar Scale at 6 months, patient satisfaction, recurrence rate, and incidence of complications. Study quality was assessed using the Cochrane Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. Statistical synthesis was performed using Review Manager 5.4 and R metafor package, employing fixed-effect or random-effects models based on heterogeneity (I2 statistic). RESULTS: Fourteen studies (1539 patients) were included. All included studies were published in Chinese. Meta-analysis showed no significant difference in postoperative ICD reduction (mean difference = 0.56 mm, 95% confidence interval [CI]: -1.20 to 2.33, P = .53, I2 = 98%). Z-plasty yielded significantly better 6-month Vancouver Scar Scale scores (mean difference = 0.44, 95% CI: 0.31-0.57, P < .00001) and higher patient satisfaction (odds ratio [OR] = 0.39, 95% CI: 0.18-0.84, P = .02). Recurrence was significantly lower with Z-plasty (OR = 13.73, 95% CI: 2.53-74.49, P = .002), although this analysis was based on only 3 studies. Complication rates were similar (OR = 1.45, 95% CI: 0.65-3.23, P = .36). CONCLUSION: Both techniques effectively reduce ICD with comparable safety. Within the limited follow-up period of the included studies (up to 6 months), Z-plasty was associated with better scar appearance, higher satisfaction, and lower recurrence. The high heterogeneity

OBJECTIVE: To summarise the evidence regarding the incidence and risk factors of medical adhesive-related skin injury (MARSI) among patients in the intensive care unit (ICU). METHOD: A systematic review and meta-analysis was undertaken using articles available in nine databases: PubMed; the Cochrane Library; Web of Science; Embase; CINAHL; Chinese Biomedical Literature Database; China National Knowledge Infrastructure Database; Wanfang Database; and Weipu Database, from inception until 30 June 2024. Additional studies were identified by examining the references of relevant articles. The Stata 16.0 statistical platform (StataCorp LLC, US) was used for analysis. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality standards. RESULTS: Of 14,743 titles screened, 19 studies involving 5218 patients were included in the systematic review. The pooled incidence of MARSI was 21% (95% confidence interval (CI): 14%, 28%), and the incidence of MARSI among neonatal ICU, paediatric ICU and adult ICU was 15% (95% CI: 6%, 26%), 48% (95% CI: 35%, 60%) and 16% (95% CI: 11%, 22%), respectively. Significant risk factors in adult ICUs included oedema (odds ratio (OR): 8.144; 95%CI: 3.267, 20.304), Braden scale score (OR: 0.733; 95%CI: 0.641, 0.837), length of ICU stay (OR: 1.072; 95%CI: 1.026, 1.120), mechanical ventilation (OR: 3.698; 95%CI: 1.900, 7.199), sedative use (OR: 6.022; 95%CI: 2.859, 12.687), Nutritional Risk Screening 2002 score (OR: 4.241; 95%CI: 1.984, 9.065) and hypoalbuminaemia (OR: 4.321; 95%CI: 1.967, 9.488). CONCLUSION: This study found that MARSI is prevalent among ICU patients and is associated with multiple risk factors. Improved strategies for identifying and clinically managing MARSI in ICU patients are needed. Nevertheless, large-sample and multicentre studies are still warranted to validate the present study's findings.

BACKGROUND: Basal cell carcinoma (BCC) is the most prevalent non-melanoma skin cancer, with surgical excision as the gold standard-though it carries risks of cosmetic scarring and functional impairment. Photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) emerges as a non-invasive alternative, yet evidence on its relative efficacy across superficial (sBCC) and nodular (nBCC) subtypes remains inconsistent. METHODS: This systematic review and meta-analysis adhered to PRISMA 2020 guidelines, with a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science up to December 31, 2025. Eligible studies included randomized controlled trials (RCTs) and single-arm studies evaluating ALA-PDT/MLA-PDT for histologically confirmed sBCC or nBCC. Study quality was assessed via the Methodological Index for Non-Randomized Studies (MINORS) scale, and statistical analyses were performed using Review Manager 5.4. RESULTS: A comprehensive literature search identified 3832 records, with 55 eligible studies (41 for sBCC, 34 for nBCC) ultimately included, involving 2123 patients and 2995 lesions. For sBCC, the pooled complete response (CR) rate was 0.88 (95% CI: 0.85-0.91, p<0.00001) with high heterogeneity (I²=87%); no significant difference in CR rate was observed between ALA-PDT (0.87) and MAL-PDT (0.90) (p=0.47), and BF-200 ALA-PDT achieved a CR rate of 0.90. The pooled beauty effect rate for sBCC was 0.91 (95% CI: 0.87-0.95, p<0.00001), with a low pooled adverse event incidence of 0.08 (95% CI: 0.03-0.14, p=0.004) and a pooled recurrence rate of 0.13 (95% CI: 0.09-0.18, p<0.00001). For nBCC, the pooled CR rate was 0.75 (95% CI: 0.70-0.80, p<0.00001, I²=92%), with MAL-PDT (0.78) showing a statistically significant higher CR rate than ALA-PDT (0.69) (p=0.04); BF-200 ALA-PDT and AFL-MAL-PDT achieved CR rates of 0.89 and 0.84, respectively. The pooled beauty effect rate for nBCC was 0.90 (95% CI: 0.83-0.96, p<0.00001), with a pooled recurrence rate of 0.15 (95% CI: 0.10-0.20, p<0.00001); adverse event data were insufficient for pooling, with individual studies reporting mild, manageable local reactions. Subgroup analyses revealed

BACKGROUND: Skin diseases contribute to a massive and often overlooked component of the global disease burden, highlighting the need for a better understanding of the dermatologic research landscape and its key drivers of excellence. AIM: To explore the national, institutional, and individual-level determinants that shape dermatologic research excellence worldwide. METHODS: We analyzed the publicly available Stanford-Elsevier Lists of the top 2% most-cited scientists (2017-2023), extracting scholars classified in Dermatology & Venereal Diseases to identify excellent dermatologic scholars (EDS). EDS records were then linked, based on affiliation data, to country-level indicators (Universal Health Coverage [UHC], Human Development Index [HDI], Gender Inequality Index [GII], national budgets, and disease burden), institutional rankings (Quacquarelli Symonds [QS], Times Higher Education [THE], and Academic Ranking of World Universities [ARWU]), and individual attributes (gender and academic age). Outcomes were EDS counts by country/institution and scholar-level bibliometrics (citations excluding self-citations, modified H-index, and composite score). RESULTS: EDS were overwhelmingly based in high-income countries (97.9% career-long; 94.5% single-year) with the EURO region contributing ~48% of EDS and exhibiting highest densities (0.585 and 0.482 per 100,000), while low-income settings had ~0.002. The top 20 institutions hosted ~21% of all EDS. Women comprised 22.9% (career-long) and 28.6% (single-year) of EDS; men had higher median citations and modified H-indices. Academic age correlated positively with modified H-index (ρ = 0.312 career-long) and C-score (ρ = 0.145 single-year), and each additional year predicted higher citations (β = 84.1 career-long; β = 2.6 single-year). In adjusted models, higher HDI and UHC aligned with higher citation counts. CONCLUSION: Dermatologic research excellence remains concentrated in high-income, predominantly European and Anglophone ecosystems, within a small cadre of elite institutions and among older, male scholars. Policymakers should focus on targeted funding for under-represented regions and institutional reforms to ensure eq

OBJECTIVE: This meta-analysis evaluated the efficacy and safety of transcranial direct current stimulation (tDCS) for treating Attention-Deficit/Hyperactivity Disorder (ADHD). METHODS: Following PRISMA guidelines, we analyzed 28 randomized controlled trials (RCTs) involving 1,864 participants. Outcomes encompassed core ADHD symptoms, hot and cold executive functions (EFs)-including inhibitory control, working memory, and cognitive flexibility-as well as safety profiles based on adverse events. A multilevel meta-analysis was performed using a random-effects model. Subgroup analyses and meta-regressions were conducted to explore potential moderating factors. RESULTS: Compared to sham stimulation, tDCS did not significantly improve core ADHD symptoms (standardized mean difference (SMD) = -0.29, 95% CI [-0.59, 0.01], p= 0.05). Similarly, no significant overall effects were observed for cold EFs: inhibitory control (Hedges' g(g)= -0.11, 95% CI [-0.26, 0.05], p=0.19), working memory (g= 0.13, 95% CI [-0.06, 0.32], p= 0.26), or cognitive flexibility (SMD = -0.42, 95% CI [-1.13, 0.29], p= 0.24). The effect on hot EFs was also non-significant (g = 0.27, 95% CI [-0.14, 0.70], p = 0.19). Exploratory analyses indicated that anode placement at Fp2 was associated with improvement in both inhibitory control (g= -0.52, 95% CI [-0.93, -0.11], p=0.01) and working memory (g = 0.72, 95% CI [0.22, 1.22], p = 0.004), although the overall test for interaction was not significant for inhibitory control (p= 0.19). The most common adverse reactions were mild and transient local skin symptoms, such as itching and redness (RR = 1.42, p=0.04). CONCLUSION: tDCS was well-tolerated but did not demonstrate significant overall efficacy for core ADHD symptoms or executive functions. Anodal stimulation at Fp2 showed potential selective benefits warranting further investigation. tDCS is not currently recommended as a standalone treatment for ADHD. Future research should optimize stimulation protocols and explore combined interventions with behavioral or cognitive therapies. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024612055.

OBJECTIVE: The aim of this trial was to evaluate the effectiveness of foam dressings impregnated with ionic silver (AgF) compared to the traditional treatment of 1% silver sulfadiazine cream (SSD) in deep burns (deep dermal and full-thickness burns) and assess the cost-effectiveness ratio between the two treatments. METHOD: This was a randomised clinical trial of patients who were divided into two equal-sized treatment groups: Group 1-SSD or Group 2 - AgF. Inclusion criteria were patients aged between 18-60 years with burns of thermal origin affecting 10-30% of the body surface area, and with a comparable percentage of deep burns. The following outcomes were analysed: pain; discomfort; wound infection; need for new grafting; ease of dressing application; length of stay; and cost of treatment. RESULTS: A total of 40 patients took part (20 in each group). Regarding patients' experience of pain, data analysis revealed more effective pain control in patients treated with AgF. Additionally, the AgF dressing was considered safer, more comfortable and presented an average lower cost of 30.6% compared to the SSD. CONCLUSION: The findings of this trial showed that, compared to the SSD, the AgF dressings were more effective in treating deep burns, to prepare them for skin graft surgery.

BACKGROUND: Tranexamic acid (TXA) is widely used for pigmentary disorders, but its anti-ageing potential remains unclear. This study aimed to evaluate whether topical 3% TXA improves early periorbital wrinkles in women with facial melasma and to investigate whether TXA protects human dermal fibroblasts from D-galactose-induced senescence via the GPR30/MAPK pathway. METHODS: Fifty women with melasma were randomized to 3% TXA serum plus moisturizer or moisturizer alone for 8 weeks, with follow-up to week 12. Periorbital wrinkles were graded using a modified Fitzpatrick Wrinkle Scale (MFWS). Separately, D-gal-induced senescence in HDFs was assessed via viability, SA-β-gal activity, senescence markers, ROS, antioxidant enzymes, SASP/ECM gene expression, and MAPK activation. GPR30 involvement was examined using antagonist G15, shRNA knockdown, and molecular docking. RESULTS: Topical TXA produced significantly greater MFWS reductions versus moisturizer alone at weeks 4, 8, and 12, with benefit persisting post-treatment. In HDFs, TXA preserved viability, reduced SA-β-gal positivity, attenuated p21/p16, restored Lamin B1, decreased ROS, and rescued antioxidant activities. TXA downregulated IL-6, IL-8, MMP1, and MMP3, and suppressed D-gal-induced ERK, JNK, and p38 phosphorylation. These effects were weakened by G15 or GPR30 knockdown; docking supported a stable TXA-GPR30 interaction. CONCLUSIONS: TXA showed clinical anti-wrinkle activity in melasma patients and protected HDFs from D-gal-induced senescence, partly via GPR30-dependent modulation of oxidative stress, SASP/ECM expression, and MAPK signalling. TXA is a promising candidate for skin ageing intervention.

Pyroligneous extract, a refined wood vinegar from palm kernel shell biomass pyrolysis, could promote wound healing. The aim of the study was to assess the effect of a topical hydrogel containing this extract on diabetic foot ulcer. A double blind, randomised, placebo-controlled study was done. Sixteen volunteers with DFU were equally randomly assigned to either the treatment group receiving 150 μg/g extract in hydrogel or the control one receiving placebo. Hydrogels were applied to individual wounds once every other day for 13 weeks. Wound assessment and swab culture were done on weeks 1, 3, 5, 7, 9, 11 and 13. Tissues exfoliated during wound dressing were collected at baseline and completion for biomarkers detection. During the trial, three participants dropped out. No skin irritation was found in all participants. Mean wound shrinkage in the treatment group was significantly higher than that of the control from Week 7 onwards. The estimated half-lives presented as a 95% confidence limit of wound healing in the treatment and control groups were 4-7 days and 5-15 days, respectively. The extract may reduce the risk of infection as swab culture showed the decreased number of species of on-wounded site pathogens after treatment and so did the number of wounds with positive culture. mRNA expression of transdermal growth factor-β 1 in the treatment group significantly increased whereas tumour necrosis factor-α decreased compared with the placebo one. With clinical outcome, its TGF-βI up-regulating function with reduction of TNF-α level may decrease inflammatory response making Pyroligneous extract a novel agent to promote the healing in DFU wounds. © 2026 The Wound Healing Society.

BACKGROUND: While dipeptidyl peptidase-4 inhibitors (DPP-4is) are linked to autoimmune skin diseases, comparative data on glucagon-like peptide-1 receptor agonists (GLP-1 RAs) remain limited. METHODS: We emulated a randomized active-comparator trial using the TriNetX US Collaborative Network. Adults with type 2 diabetes (T2DM) initiating GLP-1 RAs or DPP-4is between January 1, 2018, and December 31, 2022, were identified, excluding prior users of either class. Balanced cohorts (n=169,630 each) were created using 1:1 propensity score matching. To address protopathic bias, outcomes occurring within 3 months after drug initiation were not considered. Patients were followed for up to 4 years for newly diagnosed autoimmune or inflammatory skin diseases. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Compared with DPP-4i initiation, GLP-1 RA initiation was associated with a higher risk of incident psoriasis (HR 1.19, 95% CI 1.11-1.28) and lower risks of pemphigus (HR 0.32, 95% CI 0.16-0.63) and bullous pemphigoid (HR 0.61, 95% CI 0.43-0.87). No significant differences were observed for other inflammatory or autoimmune skin outcomes after multiple-testing correction. Findings persisted across subgroup and sensitivity analyses. CONCLUSION: In a large, real-world study designed to emulate a clinical trial, GLP-1 RAs were linked to increased psoriasis and decreased autoimmune blistering diseases compared with DPP-4is over up to 4 years' follow-up. These results provide a dermatologic safety context to guide incretin therapy selection and highlight the importance of ongoing skin monitoring.

Secondary intent healing is a viable option for wound closure after facial tumour removal by Mohs micrographic surgery. Secondary intent healing involves prolonged healing time and carries risk of infection and complications related to scarring. Healing with an autologous patch made from the patient's own blood may be beneficial. This study on 22 patients evaluates the effect of applying an autologous patch to the wound after Mohs micrographic surgery. A randomized controlled assessor-blinded trial was carried out. Patients had Mohs micrographic surgery on day 0 and clinical evaluation on day 12, day 19, and after 6 months. Transepidermal water loss was measured on day 12 and day 19. Reflectance confocal microscopy was applied exploratively. At 6 months' follow-up the Patient and Observer Scar Assessment Scale was evaluated. Primary outcome was fully epithelialized wounds on day 19 and secondary outcome was 50% epithelialized wounds on day 12. One wound from each group was fully epithelialized and wound area reduction was higher in the patch group although not significant. Transepidermal water loss decreased to a larger extent, indicating that the patch creates a moist environment. Wound healing with an autologous patch is equivalent to secondary intent healing but may prompt benefits in certain wound healing factors. Patch healing appears safe with high patient satisfaction.

OBJECTIVES: This randomised controlled trial aimed to compare the efficacy of Alexandrite picosecond laser therapy combined with dermal polyrevitalisation (NCTF® 135 HA) with laser therapy alone for reducing the severity of melasma. The outcomes were assessed using 3D imaging and the Dermatology Life Quality Index (DLQI). The secondary objectives were to evaluate the safety and tolerability of the combined treatment, and its impact on patients' quality of life. MATERIALS AND METHODS: The study was conducted in a clinical dermatological setting in Moscow, Russia, in 2023. It was designed as a randomised controlled trial comparing two melasma treatment protocols: picosecond Alexandrite laser therapy alone versus the laser combined with the injectable polyrevitalising agent NCTF® 135 HA. RESULTS: A total of 31 patients participated in the study, including 27 women and four men aged between 32 and 61 years. The patients were divided into two groups: 12 patients in Group 1 received laser treatment only, while 19 patients in Group 2 received laser treatment and NCTF® 135 HA. 89.5% of patients in Group 2 reported an improvement in their skin condition compared to 66.7% in Group 1, and the mean reduction in pigmentation was 75% versus 40% respectively (p < 0.01). Erythema severity decreased by 70% in Group 2 and by 35% in Group 1 (p < 0.01). The recurrence rate was 5.3% in Group 2 and 25% in Group 1 (p < 0.05). CONCLUSIONS: The application of the combined treatment protocol for melasma over a period of two months resulted in the reduction, fragmentation, and lightening of pigmented lesions. However, further long-term studies with more extensive and diverse populations are needed to confirm these findings due to the small sample size and short follow-up period.

BACKGROUND: High‑protein diets are widely used by athletes but may disturb the gut environment and increase production of odor‑related metabolites. Probiotic supplementation has been proposed as a strategy to support gastrointestinal function under such dietary stress. This study aimed to explore the effects of Bifidobacterium longum BB536 on gastrointestinal symptoms, gut microbiota, and odor‑related metabolites in male athletes consuming a high‑protein diet. METHODS: In an exploratory, randomized, double‑blind, placebo‑controlled trial, 60 healthy male athletes (mean age: 18.62 ± 0.75 years; mean BMI: 22.35 ± 1.80 kg/m2) consumed a whey protein supplement (70 g/day) together with either BB536 (46 billion CFU/day, as measured at the start of the intervention) or placebo for 4 weeks. Gastrointestinal symptoms, gut microbiota composition, skin‑emitted volatile compounds, and fecal metabolites were assessed. Subgroup analyses based on responder status and baseline enterotype were conducted post hoc to generate hypotheses regarding microbiota‑dependent responses. RESULTS: In the overall cohort, no significant between‑group differences were observed across gastrointestinal outcomes, gut microbiota indices, or metabolite profiles. Within the BB536 group, diarrhea‑related scores improved from baseline. Post hoc analyses suggested that increases in Faecalibacterium were evident among responders. Enterotype‑based patterns also emerged: individuals with Ruminococcus‑dominant microbiota showed higher skin‑emitted short‑chain fatty acids after BB536 intake, whereas those with Faecalibacterium‑dominant microbiota exhibited reductions in odor‑related metabolites, including methyl mercaptan and ammonia. Corresponding fecal metabolite shifts were modest. CONCLUSION: BB536 supplementation was associated with improvements in diarrhea‑related symptoms and odor‑related metabolites in specific microbiota‑defined subgroups. As these findings did not extend to the full cohort, they should be interpreted as exploratory and hypothesis‑generating. Baseline gut microbiota composition may influence probiotic responsiveness, warranting confirmatory trials with prespecified endpoints.

PURPOSE: This study aims to examine the effect of paternal skin-to-skin contact on breastfeeding after cesarean section. BACKGROUND: Skin-to-skin contact can be used to strengthen breastfeeding in newborns. METHODS: The study was conducted between April 2023 and August 2023 in the obstetrics clinic of a hospital in a province in eastern Turkey, with a total of 126 postpartum women who had cesarean sections. A socio-demographic characteristics introduction form, a questionnaire on skin-to-skin contact and breastfeeding process, and the LATCH Breastfeeding Assessment Tool were used to collect research data. RESULTS: The time to initiate breastfeeding was determined as 67.54 ± 10.69 minutes in the skin-to-skin contact group and 86.38 ± 35.14 minutes in the control group. The mean LATCH score of postpartum women in the skin-to-skin contact group was 8.13 ± 1.27, while the mean LATCH score of mothers in the control group was 6.13 ± 1.69. Statistically significant differences were found between the groups in terms of time to initiate breastfeeding, postpartum women's first breastfeeding durations, time for the newborn to latch onto the breast, babies' first latch-on behavior, swallowing movement during sucking, behaviors after feeding, supplementary food intake, postpartum LATCH score, and LATCH score at discharge. CONCLUSIONS: The study concluded that skin-to-skin contact applied through fathers after cesarean section has a positive effect on breastfeeding behaviors. IMPLICATIONS FOR PRACTICE AND RESEARCH: As healthcare professionals, it is recommended that fathers be informed about skin-to-skin contact during the antenatal period, encouraged for skin-to-skin contact in the postpartum process, and that hospital policy health policies include policies that encourage fathers' active participation in the postpartum process.

Pharmacogenomics (PGx) is a key component of precision medicine, yet most PGx studies exclude pregnant people and children. The VICE (Vanderbilt Integrated Center of Excellence)-MPRINT (Maternal and Pediatric Precision in Therapeutics): Maternal and Pediatric Pharmacogenetics Trial is a single-center, randomized control trial to assess how PGx testing and return of results influence patients' understanding and perceived utility of PGx testing in a pregnancy and pediatric cohort. Pregnant individuals and families or guardians of children with a chronic health condition aged 0-16 were recruited. We assessed participants' knowledge and attitudes regarding PGx testing at baseline and after receiving results with patient-friendly interpretations. Cases received an educational video about PGx testing with return of results. Controls received PGx test results alone. We aimed to determine perspectives regarding PGx in these understudied populations with the goal of promoting research and clinical implementation of PGx for pregnant women and children. © 2026. The Author(s).

BACKGROUND: Adolescents frequently engage in behaviors that increase ultraviolet radiation (UVR) exposure, elevating their lifetime risk for skin cancer. This study examined cross-sectional associations between high school students' perceptions of the costs of UVR protection, the rewards of tanning, and their engagement in UVR-protective behaviors to identify targets for intervention. METHODS: Data were drawn from N = 2,105 students (46% male; 77% White; and 33.4% rural) at baseline who enrolled in the Sun-safe Habits Intervention and Education cluster-randomized trial conducted in Utah high schools from 2021 to 2023. Students completed self-reports of skin cancer prevention knowledge, time spent outdoors, perceived costs of UVR protection, perceived rewards of tanning, and UVR-protective behaviors. Analyses included bivariate tests and multivariable regression, adjusted for demographics and knowledge. RESULTS: Students who perceived higher costs of UVR protection (r = -0.34; P <0 .001) and greater rewards of tanning (r = -0.28; P <0 .001) engaged in fewer UVR-protective behaviors. In an adjusted model, lower sun-safe behavior was independently predicted by lower knowledge of UVR safety (B = 0.21; P <0 .01), higher perceived protection cost (B = -0.32; P <0 .001), and greater tanning reward (B = -0.19; P <0 .001). CONCLUSIONS: Perceived costs of UVR protection and appearance-based rewards of tanning are key attributes of adolescent UVR exposure. School-based skin cancer prevention should incorporate appearance-focused and tailored strategies (such as UV photography or photoaging feedback) to promote sustainable sun safety behaviors. IMPACT: Addressing both cognitive and motivational barriers to UVR protection during adolescence could strengthen early prevention efforts and reduce future skin cancer burden. ©2026 American Association for Cancer Research.

The basal layer (BL) of human skin is an ultrathin, melanin-rich absorber that plays a dominant role in near-surface optical absorption and photoacoustic (PA) wave generation. In many PA skin models, the epidermis is treated as a single effective layer to reduce anatomical complexity and computational cost; however, the impact of explicit BL resolution on time-domain PA waveforms remains unclear. This study aims at determining whether the BL must be modeled as an independent ultrathin absorber for quantitatively reliable time-domain PA analysis and reduced-layer representations of human skin. Because skin is a strongly scattering stratified medium, optical transport is diffusion-dominated. To address this question, a coupled optical-thermal-acoustic semi-analytical framework is applied to a physiologically representative nine-layer skin model and to reduced configurations with and without an explicitly resolved BL. Under excitation at a visible wavelength (λe=532 nm), increasing BL absorption raises the peak PA pressure by more than a factor of three, demonstrating the strong sensitivity of the PA amplitude to this localized source. Variations in BL thickness modify the amplitude and temporal-spectral characteristics of the PA waveform. Reduced models that preserve the BL reproduce the full-model response, whereas merging the BL into the epidermis leads to attenuation and temporal broadening due to source delocalization. These results show that preserving the spatial localization of the dominant absorber, rather than the anatomical layer count itself, is the governing physical criterion for model reduction and is essential for physically consistent time-domain PA analysis and inverse reconstruction in layered biological tissues. © 2026 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.

INTRODUCTION: Acellular dermal matrices are increasingly applied in regenerative medicine and wound healing because they mimic native dermal structure and exhibit low immunogenicity. However, decellularization methods vary, and no consensus exists on the optimal protocol for human full-thickness dermis. This study compared three decellularization approaches to identify the most effective method for generating biocompatible, structurally preserved acellular dermis suitable for clinical use. METHODS: Full-thickness human dermis was processed using: (1) alkaline NaOH treatment, (2) Triton X-100 followed by mild alkali, and (3) freeze-thaw cycling with surfactant and sonication. The resulting scaffolds were assessed macroscopically, histologically, and through cytocompatibility assays. In vivo wound healing was evaluated in a murine full-thickness wound model. RESULTS: Alkaline treatment effectively removed cells but damaged the extracellular matrix, reducing mechanical strength and biocompatibility. Triton X-100-based and freeze-thaw/surfactant protocols preserved dermal architecture and mechanical integrity while ensuring complete decellularization and cytocompatibility. Both supported improved cellular infiltration and tissue remodeling in vivo. Neoangiogenesis and graft orientation showed minimal influence on healing. CONCLUSION: Triton X-100-based and freeze-thaw/surfactant protocols achieved optimal balance between cell removal and matrix preservation, offering promising strategies for producing clinically applicable acellular dermal scaffolds. Plain Language Summary: Human skin grafts used in wound healing must be free of cells to avoid immune reactions, but the process of removing those cells (called decellularization) can also damage the tissue’s natural structure. This study compared three ways to clean human skin to create safe and effective grafts. The strong chemical (alkaline) method removed all cells but destroyed much of the skin’s supportive framework, making it brittle and less compatible with living tissue. In contrast, two gentler methods, one using a mild detergent (Triton X-100) and another using freeze–thaw cycles with surfactant and ultrasou

Short peripheral catheters (SPC) are the most widely used peripheral venous access devices in clinical practice. Despite being a relatively simple procedure, their placement is associated with a high rate of complications, including multiple venipunctures, phlebitis, dislodgement, occlusion, and, even if to a lesser extent, local and bloodstream infections. Recent studies suggest several strategies and techniques that, if adopted systematically, may reduce the incidence of both early and late catheter-related complications. This paper describes a structured, sequential insertion bundle - developed by the Italian Group of Long-Term Venous Access Devices (GAVeCeLT) and by the Italian Vascular Access Society (IVAS)-designated SISPeC (Safe Insertion of Short Peripheral Catheters), which consists of six evidence-based steps aiming to minimize complications related to SPC insertion in adults and children: (1) pre-procedural examination of both arms with and without tourniquet; (2) choice of the most appropriate site of venipuncture, preferably avoiding area of flexion (wrist, antecubital fossa) and choosing-when feasible-veins at the forearm or the cephalic vein at the upper arm; (3) appropriate hand hygiene and skin antisepsis; (4) puncture and cannulation of the vein by the cannula-over-needle technique, preferably using a tourniquet; (5) connection to the administration set; (6) appropriate securement of the device and protection of the exit site.

Effective monitoring of hybrid zones is essential for understanding evolutionary dynamics and mitigating species loss caused by human-mediated hybridisation. Conventional methods rely on sampling numerous individuals, which is costly, time-consuming and often impractical for rare or elusive species. Environmental DNA (eDNA) offers a promising alternative for locating hybrid zones but requires the detection of nuclear eDNA, which is typically scarce in natural ecosystems. While a few recent studies have successfully recovered sufficient nuclear eDNA to assess intraspecific variation, its application in hybridisation studies remains untested. This study provides the first empirical validation that nuclear eDNA can screen for hybrid populations. We present an eDNA-based toolkit that employs Kompetitive Allele-Specific PCR (KASP) to genotype a panel of species-diagnostic unlinked nuclear SNPs without sequencing, mapping end-point fluorescence to a hybrid index that reflects ancestry levels at the population scale. In mesocosms housing different combinations of individuals from two crested newt species (Triturus ivanbureschi and T. macedonicus) and their captive-bred F1 hybrids, we compared eDNA-derived ancestry estimates with genotypes obtained from skin swabs of the same individuals placed in the mesocosms. eDNA-based ancestry estimates showed strong concordance with individual genotypes across two eDNA sampling concentrations. This approach represents a promising non-invasive, fast and cost-efficient screening tool, qualities that make it well suited to locate and track putative hybrid zones and a scalable complement to conventional sampling for biodiversity monitoring and conservation. © 2026 The Author(s). Molecular Ecology Resources published by John Wiley & Sons Ltd.

Reconstruction after facial skin cancer excision requires balancing oncologic safety with cosmetic outcomes. Secondary intention healing (SIH) is a simple and cost-effective wound management approach that avoids complex reconstruction and permits close oncologic surveillance; however, it remains underutilized because of concerns regarding prolonged healing and unpredictable cosmetic results. Moreover, whether evidence derived primarily from Western populations can be extrapolated to Asian patients remains unclear. In this retrospective study, we reviewed 129 Japanese patients who underwent facial skin cancer excision, including 103 basal cell carcinomas and 26 squamous cell carcinomas. Among them, 87 patients were treated with SIH and 42 with surgical closure (SC). Cosmetic outcomes were evaluated in 48 patients by 10 independent evaluators using standardized postoperative photographs obtained approximately 1 year after surgery and assessed with a three-point scale ('noticeable', 'noticeable on close inspection', and 'not noticeable'). In the SIH group, the mean time to epithelialization was 39.51 ± 16.42 days, and defect size showed a significant positive correlation with epithelialization time. The median cosmetic score was 6.5 in the SIH group and 7.5 in the SC group, with no significant difference between groups (p = 0.755). Receiver operating characteristic curve analysis demonstrated that defects ≤ 14 mm in size were associated with a higher likelihood of favorable cosmetic outcomes. In univariate analysis, smaller defect size and concave surfaces of NEET (nose, eye, ear, and temple) location were associated with favorable cosmetic outcomes, whereas multivariate analysis identified defect size and female sex as independent predictors of unfavorable outcomes. These findings suggest that SIH is a cosmetically acceptable and clinically feasible reconstructive option after facial skin cancer excision in Japanese patients, in carefully selected cases with respect to sex, defect size and tumor location. © 2026 Japanese Dermatological Association.

Canine atopic dermatitis is a hereditary chronic inflammatory and pruritic skin disease, which is mediated by T cells and requires long-term, individualized management. In recent years, numerous studies have described a wide range of therapeutic approaches for canine atopic dermatitis, including fast-acting symptomatic treatments, long-term immune-modulating interventions, and strategies to support skin barrier function and microbial balance. This review summarizes the principal treatment modalities currently available, including glucocorticoids, cyclosporine A, mycophenolate, Janus kinase inhibitors, lokivetmab, and allergen-specific immunotherapy, as well as complementary strategies aimed at restoring skin barrier integrity. Emphasis is placed on the importance of a multimodal and personalized approach to optimize long-term disease control and improve quality of life in affected dogs. Providing an integrated overview of current evidence, this article aims to guide clinicians in making informed, evidence-based decisions and to support the safe and effective management of canine atopic dermatitis.

Skin wound management in veterinary medicine requires therapies able to control inflammation, limit microbial burden, and support tissue repair. This study evaluated the anti-inflammatory, wound-healing, and immunomodulatory effects of four novel topical formulations combining synthetic anti-inflammatory drugs, antibiotics, and plant extracts in rat experimental models. Burn injury was induced in male Wistar rats for wound-healing assessment, while kaolin- and dextran-induced paw edema models were used to assess anti-inflammatory activity. The tested formulations were meloxicam, dexamethasone, and levofloxacin; thyme extract with meloxicam and dexamethasone; burdock extract with dexamethasone and levofloxacin; and thyme extract combined with burdock extract. Wound evolution was monitored macroscopically, edema was quantified by plethysmometry, and selected inflammatory mediators were measured by immunoassay. In the burn model, the thyme-containing formulation with meloxicam and dexamethasone, and the thyme-burdock formulation, achieved complete wound closure by the end of follow-up, whereas the reference product did not. In the acute inflammation models, all innovative formulations significantly reduced edema at the main early time points compared with the negative control and outperformed the reference product. The thyme-burdock formulation also showed the most favorable immunomodulatory profile, including normalization of interleukin-10 and marked reduction in interleukin-1 beta in both models. These results support the potential of multi-component topical formulations, particularly plant extract-based combinations, as promising candidates for veterinary wound care.

Animal welfare monitoring is essential in pig production. On-farm animal welfare (AW) assessments may provide a comprehensive overview but are resource-intensive. Abattoir-based assessments allow pigs from multiple farms to be inspected in a single facility. However, data on the relationship between these assessments remain limited, especially for heavy pigs (160-170 kg). This study investigates these associations in Italian heavy pig production. At the abattoir, 18,333 pig carcasses from 185 batches across 86 farms were scored for tail, skin (cranial and caudal) and ear lesions. On-farm AW assessments (management, structures and animal-based measures) were obtained from the national surveillance system (ClassyFarm). Tail lesion scores were higher in pigs with intact tails, whereas ear scores showed the opposite trend, suggesting a substitution effect between tail and ear biting. This indicates that tail docking is insufficient to fully prevent abnormal behaviours. Higher skin and ear scores were associated with suboptimal management, but tail scores were not, likely due to the multifactorial nature of tail biting. Herd size had no significant effect on welfare indicators. These results highlight the complexity of assessing AW and the importance of combining abattoir and farm data to obtain a more integrated monitoring system.

This study evaluated the effects of a host-specific multi-lactic acid bacterial (MLAB) probiotic and sex on performance, carcass traits, meat quality, and gut microbiota in fattening pigs. Thirty-two crossbred pigs (10 ± 0.80 weeks; 23.43 ± 0.17 kg) were assigned to a 2 × 2 factorial design with diet (control or MLAB probiotics) and sex (barrow or female). The MLAB supplement consisted of seven lactic acid bacterial strains mixed in equal proportions (≈14.3% each)-Lactobacillus brevis, Lactobacillus reuteri, Weissella cibaria, Lactobacillus paraplantarum, Lactococcus lactis, Lactobacillus pentosus, and Pediococcus pentosaceus-administered at 1 × 109 CFU/kg feed for 12 weeks. MLAB probiotic supplementation reduced bone proportion while increasing skin and fat content (p < 0.05), with a treatment × sex interaction for loin eye area (p < 0.05). Meat quality improved in the MLAB group, showing higher ultimate pH and lower cooking loss (p < 0.05), indicating improved water-holding capacity. Female pigs exhibited higher early postmortem pH and protein content (p < 0.05). Microbiome analysis revealed increased abundances of Oxalobacteraceae and Paludibacteraceae and reduced Clostridium sensu stricto 6 (p < 0.05). These results suggest that host-adapted probiotics may support gut microbial balance and improve certain pork quality traits.

Convolutional neural networks (CNNs) have been widely used for acne image classification due to their effectiveness in capturing local texture of skin lesions. However, the locality of convolution operations limits their ability to model long-range dependencies. Vision Transformer (ViT) methods address this issue to some extent but their high computational complexity and reliance on large-scale pre-training present challenges. Although CNN-Transformer architecture alleviates this conflict to some extent, acne images present task-specific challenges, including indistinct lesion boundaries, subtle inter-class variations, and various facial interference factors. In this paper, we propose AcneFormer, a lesion-aware and noise-robust CNN-Transformer architecture for acne image classification. We introduce three modules especially for acne tasks: a Lesion Cue Enhancement (LCE) module to highlight discriminative multi-scale spatial patterns, a Cross-Layer Feature Transmission (CLFT) module to enhance cross-layer information flow in Transformers, and a Differential Semantic Denoising (DSD) module to suppress irrelevant responses during deep feature interaction. Extensive experiments show that AcneFormer outperforms several strong baselines. Ablation and external lesion-annotated analyses further show a consistent pattern: LCE mainly improves lesion-sensitive localization and class-balanced recognition, CLFT expands valid cross-depth lesion evidence, and DSD suppresses off-lesion semantic responses.