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BACKGROUND: Mohs Micrographic Surgery (MMS) is a minimally invasive technique designed to treat skin cancers in cosmetically sensitive areas. MMS involves the sequential removal of horizontal layers of the tumor, which are processed in real-time to determine if the margins are cancer-free. As it relates to the development of tumors, certain activities and lifestyles may render patients susceptible to uneven distributions of sun exposure favoring specific literalities of skin lesions. METHODS: To determine if there were any differences in laterality in patients with squamous cell carcinomas (SCCs) undergoing MMS, a retrospective chart review was conducted. This analysis included 255 patients with SCCs confirmed by biopsy who had undergone MMS at a single academic center. We evaluated the anatomical location of the tumor, preoperative tumor size, postoperative wound size, and number of layers removed during surgery. We then computed the average and standard deviation values for left- versus right-sided SCC tumors for the above parameters. Subsequently, we computed a two-tailed T-test to determine if there was a statistically significant difference. RESULTS: Of the 255 patients analyzed, 121 had right-sided SCCs and 134 had left-sided SCCs. The means for the preoperative tumor size for the right versus left SCC tumors were 1.73 cm3 versus 1.79 cm3, respectively (standard deviation of 1.56 versus 2.83 cm3, respectively). The means for the layers removed for the right versus left SCC tumors were 1.69 versus 1.61 layers, respectively (standard deviation of 0.72 versus 0.69, respectively). The means for the postoperative wound size for the right versus left SCC tumors were 3.44 cm3 versus 3.63 cm3, respectively (standard deviation of 2.92 versus 4.98 cm3, respectively). The p-values were all above 0.1 for left versus right SCC comparing these three metrics. CONCLUSION: Despite the slight leftward preponderance of the SCC cases, there was no statistical difference in preoperative tumor size, postoperative wound size, or number of layers removed during surgery. Therefore, differences in occupational or activity-based lateral sun exposure did not appear to have a significant effect on SCC tumor size laterality in this patient cohort. The increase in left-sided cases could be due to leftward sun exposure or could be due to normal statistical variation. Further research may analyze a larger patient cohort to better quantify the prevalence of left-sided tumors.

BACKGROUND: Cellulitis accounts for $3.7 billion in ambulatory healthcare costs. We wanted to determine statewide trends for inpatient cellulitis cases as well as anatomic distribution of cases. METHODS A retrospective analysis was performed using California’s Department of Health Care Access and Information’s “Hospital Inpatient - Diagnosis, Procedure, and External Cause Codes. Codes were extracted relevant to cellulitis, analyzed in excel to compile data on temporal trends and summating anatomical distribution over the timespan of 2017-2022. RESULTS: We found 986,655 cases of inpatient cellulitis over the time frame with a nadir during 2020 (151,100 cases) and a peak at 2019 (175,360 cases). The anatomic location with the highest prevalence of cellulitis was the lower limbs (295,913 in right lower limbs, 295,162 cases in left lower limbs over the timeframe). CONCLUSION: The shifts in patient cases may be due to changes in access to care during the COVID-19 pandemic that could inform future care during future pandemics. Additionally, the anatomical locational distribution favoring the lower limbs could be explained by preponderance of wound generation in this region. Future research could evaluate factors such as wound severity in a similar patient cohort in relation to anatomic location as well as analyzing epidemiological factors that could better explain the temporal trends observed around 2020

BACKGROUND: Advances in artificial intelligence (AI) with machine learning have allowed for the use of this technology to identify the contents of images and answer questions about the contents of the images. Technologies, such as artificial intelligence, offer a potential avenue to improve medical care to marginalized communities. In this study we attempted to see how well the Liner AI model was able to detect ten dermatological diseases from Skin of Color images of the diseases. METHODS: To test the model, two to three images each from the Dermatology Atlas for Skin of Color for the following diseases: vitiligo, mycosis fungoides, tinea, lentigines, acne vulgaris, rosacea, hidradenitis suppurativa, basal cell carcinoma, squamous cell carcinoma, and melanoma were input into the AI model and the AI model was prompted with the question: “What is the differential diagnosis?” RESULTS: Liner generated variable length lists for the images and these differential diagnoses lists were analyzed. Liner’s accuracy of correctly diagnosing the correct diagnosis as the first diagnosis in the generated differential diagnosis list was only 34.6%, but the accuracy of the model to generate a differential diagnosis list that contained the correct diagnosis was 53.8%. CONCLUSION: Liner demonstrated limited diagnostic accuracy, critically missing all the basal cell carcinoma cases, demonstrating present diagnostic limitations for potential future clinical use. Further, research could look to compare Liner against other patient demographics to see if the limitations were limited to the Skin of Color cases tested and to guide future development of this technology.

BACKGROUND: Artificial Intelligence (AI) is being increasingly utilized in healthcare and offers a potential alternative for gathering medical information in the future. The gold standard for many physicians on guiding their approach to medical management has been UpToDate and PubMed. In this review we attempted to see how well three AI models (ChatGPT, Pi, and Claude) could perform in generating first line treatment recommendations when compared against UpToDate. METHODS: To test the performance of these AI models, medical scenarios describing physical exam findings and patient histories, were sourced from the clinician generated medical education platform for ten dermatological diseases and inputted into the models. The models were then prompt with the query: “What is the first line treatment?” RESULTS: The results were tabulated, and it was found that Claude could successfully generated first line treatment recommendations that corresponded to UpToDate for all ten of the diseases tested with the other models successfully predicting nine of the ten correct treatment regimes. However, ChatGPT and Pi mistakenly diagnosed the squamous cell carcinoma vignette as actinic keratosis and provided inaccurate treatment advice. CONCLUSION: These AI models demonstrate that future developments in artificial intelligence may offer a free alternative to UpToDate as improvements in management recommendations are made as artificial intelligence models are further refined. However, the benefits of future utilization must be weighed against the risks of overreliance on this type of technology, especially if proper validation of information does not take place.

Abstract Neurodegenerative disorders are complex, progressive, and life-threatening. They cause mortality and disability for millions of people worldwide. Appropriate treatment for neurodegenerative diseases (NDs) is still clinically lacking due to the presence of the blood-brain barrier (BBB). Developing an effective transport system that can cross the BBB and enhance the therapeutic effect of neuroprotective agents has been a major challenge for NDs. Exosomes are endogenous nano-sized vesicles that naturally carry biomolecular cargoes. Many studies have indicated that exosome content, particularly microRNAs (miRNAs), possess biological activities by targeting several signaling pathways involved in apoptosis, inflammation, autophagy, and oxidative stress. Exosome content can influence cellular function in healthy or pathological ways. Furthermore, since exosomes reflect the features of the parental cells, their cargoes offer opportunities for early diagnosis and therapeutic intervention of diseases. Exosomes have unique characteristics that make them ideal for delivering drugs directly to the brain. These characteristics include the ability to pass through the BBB, biocompatibility, stability, and innate targeting properties. This review emphasizes the role of exosomes in alleviating NDs and discusses the associated signaling pathways and molecular mechanisms. Furthermore, the unique biological features of exosomes, making them a promising natural transporter for delivering various medications to the brain to combat several NDs, are also discussed.

Introduction: Health systems have obtained valuable experience in dealing with various epidemics. The present study, by systematically reviewing the successful experiences of countries, presents a model for a coordinated response to pandemics by various actors in the primary healthcare system. Methods: Thirty-eight articles were obtained from Magiran, SID, PubMed, Scopus, Web of Science, and Google Scholar databases after applying the search strategy, inclusion and exclusion criteria, time-bound of 2005 to 2022, and quality assessment by Strobe checklist. The articles were assessed in terms of title, abstract, and text, and after removing duplicate and irrelevant ones, the final articles were selected.Results: This study assumed the PHC system as a leafy tree, which requires 25 background factors to strengthen its roots. Three groups of health policymakers, healthcare providers, and society must carry out the necessary measures in a coordinated and synergistic program in the four phases of crisis management, including prevention, preparedness, response, and recovery.Conclusion: Strengthening PHC in prevention, screening, testing, and outpatient treatment and mobilizing the community to take care of itself are the most successful experiences dealing with epidemics compared to treating patients in hospitals and spending significant financial and life costs.

Living cationic ring-opening polymerization of cyclic ethers in the presence of diol was modeled using the method of moments. A widespread kinetic model was developed based on previous experimental studies. Then, the moment and population balance of reactants were obtained. Modeling results were employed to study the influence of initiator and water amounts (as the impurity) as well as feeding policy in polymerization kinetics and final properties of the polymer. In addition, the sensitivity of modeling results to initiation, backbiting, and finally propagation via activated monomer reactions were investigated. Results showed the population of chains is the function of their precursors. In a typical polymerization, chains with diol functionality are the majority. Therefore, most of the polymerized monomers are incorporated into those chains. This makes the chains with diol functionality the determining group in Molecular Weight Distribution (MWD). The kinetics of polymerization and properties of the reactor’s product are highly dependent on the ratio of the rate of propagation via the Activated Monomer (AM) mechanism to the rate of propagation via active chain end (ACE). An increase in this ratio decreases the probability of occurrence of backbiting reaction. Therefore, cyclic dimers are less formed and MWD narrows. On the other hand, decreasing this ratio results in less diol reacted with protonated monomers. Consequently, the rate of regeneration of the initiator and hence the rate of polymerization is decreased. These findings give complete facts about the ring-opening syntheses of polyethers and are valuable for evolving new grades as well as optimization current processes.

In this study, the modeling of polymerization of 1, 3-butadiene in the presence of hydrogen peroxide has been reported for the first time. For this purpose, the Method of double moments was applied. The modeling has been performed to investigate the effect of reaction condition on the properties of synthesized Polybutadiene, and the role of kinetic coefficients on the output of model i.e. sensitivity analysis. A comprehensive kinetic model was developed based on previous experimental studies. Then, the moment and population balance of the reactants were obtained. Modeling results were used to study the role of initiator concentration and the type of solvent in polymerization kinetics and final polymer properties. In addition, the sensitivity of modeling results in a transfer to the initiator, radical coupling, and finally transfer to polymer reactions was investigated. This study opens a way for the engineering of manufacturing the Hydroxyl-Terminated PolyButadiene (HTPB) process to obtain the desired products with optimized reaction conditions. Results show that initiator concentration and type of solvent are important in polymerization kinetics and properties of HTPBs. A higher amount of initiator increases radical concentration and consequently rates of bimolecular termination and at the lower level, rate of propagation, and polymer double bonds reactions.

Keloids are scars that extend beyond the margins of an insulting cutaneous injury. Keloids are often thought to be primarily a cosmetic issue, as they are typically quite raised and pigmented. However, these scars also present with functional symptoms of pruritus and pain that significantly impact quality of life. The symptom of pruritus is frequently overlooked by dermatologists, and treatments are often primarily focused on the gross appearance of the scar. This review describes the prevalence and importance of pruritus in keloids. In addition, the putative mechanisms underlying the development of keloid pruritus, which include neuronal and immunological mechanisms, are discussed. Furthermore, this review describes keloid treatments that have been shown to reduce pruritus, treatments that specifically target the itch, and emerging therapies.

Introduction While laser technology has expanded the armamentarium of treatment for various skin diseases during the past years, heterogeneity in study outcomes hampers comparability and appropriate evidence synthesis. Part of these issues can be addressed by developing a generic outcome set. Using the Delphi method, this study aims to seek consensus between key stakeholders on relevant generic outcomes (what to measure) for implementation in the international registry on Laser trEAtments in Dermatology (LEAD). The registry is focused on collecting research data on various laser treatments for skin disorders.Methods and analysis By reviewing the literature and involvement of key stakeholder groups and adult patients in need or after laser surgery and health professionals, a preliminary list of outcomes will be generated and categorised into domains. Using these outcomes, an international three-round Delphi study will be performed to rate the importance of outcomes in the selection of a generic outcome set. Participants are allowed to provide new outcomes to the preliminary list for revisions during the first Delphi round. Finally, results will be discussed during a consensus meeting to agree on generic outcomes to be used in the LEAD registry.Ethics and dissemination An ethics approval was not applicable (W19_290 # 18.336). The study is registered with the Cochrane Skin Core OUtcome Set INitiative) and the Core Outcome Measures in Effectiveness Trials initiative. Procedures will be conducted according to the Declaration of Helsinki. The findings will be disseminated through peer-reviewed publications and conference presentations.

Background: Time management skills are a determining factor in a manager's success. These skills comprise a wide range of activities including planning, scoping, analyzing spent time, monitoring, organizing, scheduling, and prioritizing. This study investigated the relationship between the personal and organizational time management skills of managers at Zabol Medical Sciences University. Methods: This descriptive-analytical study was conducted in 2015. The study’s statistical population included all managers of hospitals and centers covered by Zabol Medical Sciences University. A total of 75 managers were selected for participation using the simple random sampling method, and the response rate was 93%. Data was gathered using a two-part questionnaire composed by the researcher. The first part of the questionnaire measured personal time management skills, and the second part measured the organizational skill of time management and six dimensions of it. Results: The findings showed that even though the relationship between interpersonal skills and organizational skills of time management is a positive one with a 0.45 correlation coefficient, the mean interpersonal and organizational skills of time management scores of managers, both male and female, undergraduate and high school level, had no significant statistical differences. Conclusion: Time management is one principle of management; it requires special organizational and individual skills and plays an important role in improving leadership and organizational productivity. Thus, it is essential that all centers and organizations of a country, especially educational and health centers, put considerable focus on this issue.

Pearly penile papules (PPP) are common, benign lesions that appear on the corona of the glans penis during adolescence or early adulthood. Despite their benign nature, PPP are known to cause significant distress because of their resemblance to sexually transmitted infections such as condyloma acuminata. PPP can be clinically distinguished based on their uniform, dome-shaped papules that orient in one to two rows around the glans penis. There is no association between PPP and sexually transmitted infections, and treatment is generally reserved for patients with excessive concern. Physicians should be aware of this distinction in order to adequately reassure anxious patients. For patients who still desire treatment after counseling, cryotherapy and laser therapy represent two reliable treatment options with low rates of recurrence.

[This corrects the article DOI: 10.1371/journal.pone.0166772.].

Hollow microspheres or microballoons are gas-filled spherical particles with diameters between 1 to 1000 micrometers. The wall material may be made from glass, ceramic oxides, polymers or even metals. The typical thickness of the wall is in the range of 1 to 10% of the outer diameter of the sphere. Hollowmicrospheres have low density and high specific surface. They are widely used as toners, immobilization carriers, chromatographic packings, and sound dampening or adsorption materials. Thermally expandable microspheres are hollow balloons that consist of a thermoplastic shell with a liquid blowing agent as the core. These microspheres are expanded by applying temperatures higher than the glass transition temperature of the thermoplastic shell. The particles expand due to the evaporation of the encapsulated solvent which causes an internal pressure. In this study the primary expandable particles were synthesized via suspension polymerization of methacrylate monomers in the presence of pentane as a blowing agent and benzoyl peroxide as a thermal initiator. In the second step, the particles consisting of PMMA shell and pentane core were expanded at elevated temperature to obtain microballoons with a very low density. Morphology of the particles was studied using scanning electron microscopy. The results showed that the process successfully resulted in formation of spherical microballoons. The mean diameter of unexpanded particles was about 30 μm and thickness of the shell was about 2 μm while, their mean diameter after expansion was about 90 μm and the thickness of the shell decreased to 400 nm. The diameter to wall thickness ratio of expanded particles was about 1:200 which provided particles with a very low density of 0.05 g/cm3.

In this work, we demonstrate a strained Si single nanowire tunnel field effect transistor (TFET) with gate-all-around (GAA) structure yielding Ion-current of 15 μA/μm at the supply voltage of Vdd = 0.5V with linear onset at low drain voltages. The subthreshold swing (SS) at room temperature shows an average of 76 mV/dec over 4 orders of drain current Id from 5 × 10−6 to 5 × 10−2 µA/µm Optimized devices also show excellent current saturation, an important feature for analog performance.

Decoupling shading and reflectance from complex scene-images is a long-standing problem in computer vision. We introduce a framework for decomposing an image into the product of an illumination component and a reflectance component. Due to the ill-posed nature of the problem, prior information on shading and reflectance is mandatory. The proposed method adopts the premise that pixels in a region with similar chromaticity values should have the same reflectance. This assumption was used to minimize the l2 norm of the local per-pixel reflectance gradients to extract the shading and reflectance components. To obtain smooth chromatic regions, texture was treated in a new style. Texture was removed in the first step of the algorithm and the smooth image was processed for intrinsic decomposition. In the final step, texture details were added to the intrinsic components based on the material of each pixel. In addition, user-assistance was used to further refine the results. The qualitative and quantitative evaluation on the MIT intrinsic dataset indicated that the quality of intrinsic image decomposition was improved in comparison with previous methods.

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology.

The interaction between the mind and diseases of the skin has been the study focus for many researchers worldwide. The field of Psychodermatology, or Psychocutaneous Medicine, is the result of the merging of two major medical specialties, psychiatry and dermatology. Although the history of Psychodermatology is rather old and interesting, the field has only recently gained popularity. Since ancient times, philosophers, surgeons, dermatologists and psychiatrists have reported the presence of psychocutaneous diseases in various scenarios. In this article, the authors describe curious and remarkable facts in the history of Psychodermatology.

Photodynamic inactivation (PDI) is a new and promising strategy for eliminating foodborne pathogenic bacteria in food preservation, reducing associated health risks for consumers. This study aimed to develop an innovative PDI-based system to inactivate Salmonella Enteritidis PT4 on eggshells. The system includes 405 nm light-emitting diodes (LEDs) and the application of curcumin or carvacrol as photosensitizers. The antibacterial activity of the system was investigated in eggshells inoculated with S. Enteritidis PT4 at different temperatures (4, 25, and 37°C) and exposure times (15, 30, and 45 min). Carvacrol + LEDs application was completely inhibited S. Enteritdis PT4 at 4 (after 30 min), 25, and 37°C at the 45th min. Curcumin + LED completely inhibited bacterial growth after 45 min at 4 and 25°C. The results showed that simultaneous use of carvacrol or curcumin with LEDs at various temperatures exhibited significant antibacterial activity against the bacteria depending on the exposure time. The application of curcumin or carvacrol sourced via PDI in the originally developed system resulted in any significant changes in egg quality parameters and sensory properties. This study demonstrated that PDI-based system using curcumin or carvacrol as photosensitizers could be a potential tool for decontamination of eggs contaminated with S. Enteritidis PT4., (© 2025 The Author(s). Veterinary Medicine and Science published by John Wiley & Sons Ltd.)