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Owing to the COVID-19 outbreak, the use of telemedicine applications has increased throughout the United States. Using an algorithm to analyze mobile application rankings, we were able to examine how applications with telemedicine services have increased in prevalence and rank pre- and post- COVID-19. Telemedicine apps saw an increase of 210.92 ranked positions on average. Within US telehealth, skin conditions have become the fifth most common diagnosis. Widespread use of teledermatology has been well-accepted. Dermatologists and patients report high satisfaction using teledermatology during COVID-19 and intend to continue using these services in the future. COVID-19 has assisted in reducing physician concerns previously preventing some dermatologists from utilizing teledermatology in their services. Additionally, the geographical and socioeconomic barriers preventing some patients from receiving dermatologic care have been minimized through the use of teledermatology. Addressing these obstacles for dermatologic care improves healthcare equity.

Genome sequencing has been widely deployed to study the evolution of SARS-CoV-2 with more than 90,000 genome sequences uploaded to the GISAID database. We published a method for SARS-CoV-2 genome sequencing (https://www.protocols.io/view/ncov-2019-sequencing-protocol-bbmuik6w) online on January 22, 2020. This approach has rapidly become the most popular method for sequencing SARS-CoV-2 due to its simplicity and cost-effectiveness. Here we present improvements to the original protocol: i) an updated primer scheme with 22 additional primers to improve genome coverage, ii) a streamlined library preparation workflow which improves demultiplexing rate for up to 96 samples and reduces hands-on time by several hours and iii) cost savings which bring the reagent cost down to £10 per sample making it practical for individual labs to sequence thousands of SARS-CoV-2 genomes to support national and international genomic epidemiology efforts.

Parkinson’s disease (PD) is a neurodegenerative disorder associated with multiple comorbidities, including seborrheic dermatitis (SD), which develops in more than half of PD patients. SD in patients with PD can be severe and frequently intractable by traditional topical therapy. Cannabinoids possess anti-inflammatory and neuromodulatory properties working within the intrinsic endocannabinoid system, the activation of which may alleviate the motor symptoms of PD. The effect of cannabinoids on SD is unknown. Here we explore the pathophysiological mechanisms and possible therapeutic role of oral cannabinoids in PD patients with SD, and review speculative mechanisms underlying the association of PD and SD. Current data supporting the use of cannabinoids in both PD and SD, as well as oral cannabinoid safety and tolerability, are presented. Cannabinoids may provide the possibility of simultaneous treatment of both SD and PD. Specific SD studies and additional safety data on oral cannabinoids are needed.

This study evaluated the use of field peas during two phases of production on fresh beef quality. Cattle (n = 232) were assigned to one of six dietary treatments in a 3x2 factorial design consisting of 3 pasture and 2 finishing supplementations. The pasture phase consisted of 1) no supplement, 2) field peas at 0.5% body weight (BW), or 3) dry-rolled corn supplement at 0.5% BW. The finishing phase consisted of 1) no field peas or 2) field peas at 20% dry-matter basis. Strip loin samples, aged 14 d, were subjected to retail display (RD) for an additional 7 d. Tenderness via Warner-Bratzler shear force (WBSF) and Slice Shear force (SSF), objective (L*, a*, and b*) and subjective color, lipid oxidation (TBARS) and fatty acid composition were evaluated. Dietary treatment had no effect on tenderness. Steak discoloration was low (< 3%). All objective color measurements displayed interactions between pasture and finishing diets (L*, P = 0.0035; a*, P = 0.0189; b*, P < 0.0001) yet no consistent patterns among treatments could be identified. Extended aging periods would be required to visually influence consumer color perception. Beef finished with field peas had slightly greater lipid oxidation than samples from cattle not receiving field peas during finishing (1.56 vs. 1.44 mg malonaldehyde/kg tissue, respectively; P = 0.0541). There was a significant interaction between pasture and finishing treatments for C15:1 (P = 0.0331). Feeding field peas during the pasture phase increased C 18:2 (P = 0.0381) relative to cattle supplemented with corn; cattle without supplement in the pasture phase had intermediate amounts of C18:2. Total saturated, unsaturated, monounsaturated, and polyunsaturated fatty acids (P > 0.05) were unaffected by dietary treatments. Field peas may be used for cattle with minimal negative impact on fresh meat quality.

Impacts of climate change adaptation strategies need to be evaluated using principled methods spanning sectors and longer time frames. We propose machine-learning approaches to study the long-term impacts of flood protection in Bangladesh. Available data include socio-economic survey and events data (death, migration, etc.) from 1983&ndash, 2014. These multidecadal data, rare in their extent and quality, provide a basis for using machine-learning approaches even though the data were not collected or designed to assess the impact of the flood control investments. We test whether the embankment has affected the welfare of people over time, benefiting those living inside more than those living outside. Machine-learning approaches enable learning patterns in data to help discriminate between two groups: here households living inside vs. outside. They also help identify the most informative indicators of discrimination and provide robust metrics to evaluate the quality of the model. Overall, we find no significant difference between inside/outside populations based on welfare, migration, or mortality indicators. However, we note a significant difference in inward/outward movement with respect to the embankment. While certain data gaps and spatial heterogeneity in sampled populations suggest caution in any conclusive interpretation of the flood protection infrastructure, we do not see higher benefits accruing to those living with higher levels of protection. This has implications for Bangladesh&rsquo, s planning for future and more extreme climate futures, including the national Delta Plan, and global investments in climate resilient infrastructure to create positive social impacts.

To review the current literature regarding complementary and alternative treatment options for acne vulgaris. Acne vulgaris is an increasingly prevalent disease worldwide. While conventional methods of treatment are still primarily used to treat acne, complementary and alternative methods of treatment are becoming utilized in conjunction or in place of prescription medications. Studies have shown comparable benefit of Complementary and Alternative Medicine (CAM) therapies to conventional treatment. Oral green tea extract was a moderately effective treatment of inflammatory acne without significant side effects. Nicotinamide oral and topical preparations demonstrated efficacy in the treatment of moderate inflammatory acne without significant side effects. Oral zinc gluconate was not as effective as oral minocycline in the treatment of inflammatory acne. CAM therapy has relatively few reported side effects for acne vulgaris, and is mildly effective in treatment of inflammatory and comedonal acne. More studies are needed for further comparison of CAM modalities with each other as well as with conventional treatment.

Background Game-based approaches, or gamification, are popular learning strategies in medical education for health care providers and patients alike. Gamification has taken the form of serious educational games and simulations to enable learners to rehearse skills and knowledge in a safe environment. Dermatology learners in particular may benefit from gamification methods, given the visual and procedural nature of the field. Objective This narrative review surveys current applications of gamification within general medical training, in the education of dermatology students, and in dermatology patient outreach. Methods A literature search was performed using PubMed, Google Scholar, and ResearchGate to access and review relevant medical education- and dermatology-related gamification studies published in peer-reviewed journals. Two independent researchers with education and experience in dermatology screened publications to select studies featuring a diversity of gamification approaches and study subjects for in-depth examination. Results A total of 6 general medical education–related and 7 dermatology-specific gamification studies were selected. Gamification generally increased motivation and engagement, improved reinforcement of learning objectives, and contributed to more enjoyable and positive educational experiences compared to traditional modes of instruction. Enhancing examination scores, building confidence, and developing stronger team dynamics were additional benefits for medical trainees. Despite the abundance of gamification studies in general medical education, comparatively few instances were specific to dermatology learning, although large organizations such as the American Academy of Dermatology have begun to implement these strategies nationally. Gamification may also a provide promising alternative means of diversifying patient education and outreach methods, especially for self-identification of malignant melanoma. Conclusions Serious games and simulations in general medical education have successfully increased learner motivation, enjoyment, and performance. In limited preliminary studies, gamified approaches to dermatology-specific medical education enhanced diagnostic accuracy and interest in the field. Game-based interventions in patient-focused educational pilot studies surrounding melanoma detection demonstrated similar efficacy and knowledge benefits. However, small study participant numbers and large variability in outcome measures may indicate decreased generalizability of findings regarding the current impact of gamification approaches, and further investigation in this area is warranted. Additionally, some relevant studies may have been omitted by the simplified literature search strategy of this narrative review. This could be expanded upon in a secondary systematic review of gamified educational platforms.