Perceptions of Healthcare Safety Nets among Tertiary Hospital and Long-Term Care Hospital Nurses during the COVID-19 Pandemic: A Q-Methodological Approach.

This study was conducted to identify the types of perceptions toward healthcare safety nets. This study applied a Q-methodology. From a Q-population of 91 samples that included a review of the related literature and interviews with five tertiary hospital nurses and five long-term care (LTC) hospital nurses, 33 Q-samples were selected. The data were analyzed with the PC-QUANL program. We recruited 32 nurses in a tertiary hospital and 33 nurses in an LTC hospital. The perceptions of the healthcare safety net of tertiary hospital nurses were categorized into four types: (1) systematic system request; (2) realistic work support; (3) government support; and (4) emotional support. The perceived subjectivity of the healthcare safety net of LTC hospital nurses were categorized into four types: (1) reward system and facility environmental support; (2) realistic work support; (3) social prevention infrastructure support; and (4) government support. This study provides basic data for these different hospital settings, as well as to inform future government policy and system improvements in an era characterized by infectious diseases. Specifically, this study presents the types of perceptions of healthcare safety nets of nurses in two hospital settings that deliver care for patients.

Therapeutic Communication Experiences of Nurses Caring for Patients with Hematology.

Nurses who take care of patients with hematology have more difficulty in therapeutic communication. The aim of this study is to explore the therapeutic communication experiences of nurses caring for patients with hematology and the meaning of the essential structure of therapeutic communication. Colaizzi's phenomenological method was applied to explore the essential structures and meanings of therapeutic communication in depth through a focus group interview. The interview was conducted at a tertiary care hospital with 20 nurses caring for patients with hematology. As a result of the analyses, 22 themes, 14 theme clusters, and 5 categories were derived. The categories derived from the analyses included "acquiring core competencies as nursing professionals", "improving patient-centered nursing performance", "forming a partnership treatment relationship", "obtaining clinical performance skills to solve problems", and "preparing efficient system improvement". Based on this study's results, it will be possible to provide high-quality nursing to patients by improving the therapeutic communication ability of nurses caring for patients with hematology. In addition, it will be the basis for the development of a nurses' therapeutic communication promotion program for nurses caring for such patients.

Chemical Distance Measurement and System Pharmacology Approach Uncover the Novel Protective Effects of Biotransformed Ginsenoside C-Mc against UVB-Irradiated Photoaging.

Long-term exposure to ultraviolet light induces photoaging and may eventually increase the risk of skin carcinogenesis. Rare minor ginsenosides isolating from traditional medicine Panax (ginseng) have shown biomedical efficacy as antioxidation and antiphotodamage agents. However, due to the difficulty of component extraction and wide variety of ginsenoside, the identification of active antiphotoaging ginsenoside remains a huge challenge. In this study, we proposed a novel in silico approach to identify potential compound against photoaging from 82 ginsenosides. Specifically, we calculated the shortest distance between unknown and known antiphotoaging ginsenoside set in the chemical space and applied chemical structure similarity assessment, drug-likeness screening, and ADMET evaluation for the candidates. We highlighted three rare minor ginsenosides (C-Mc, Mx, and F2) that possess high potential as antiphotoaging agents. Among them, C-Mc deriving from American ginseng (Panax quinquefolius L.) was validated by wet-lab experimental assays and showed significant antioxidant and cytoprotective activity against UVB-induced photodamage in human dermal fibroblasts. Furthermore, system pharmacology analysis was conducted to explore the therapeutic targets and molecular mechanisms through integrating global drug-target network, high quality photoaging-related gene profile from multiomics data, and skin tissue-specific expression protein network. In combination with in vitro assays, we found that C-Mc suppressed MMP production through regulating the MAPK/AP-1/NF-κB pathway and expedited collagen synthesis via the TGF-ß/Smad pathway, as well as enhanced the expression of Nrf2/ARE to hold a balance of endogenous oxidation. Overall, this study offers an effective drug discovery framework combining in silico prediction and in vitro validation, uncovering that ginsenoside C-Mc has potential antiphotoaging properties and might be a novel natural agent for use in oral drug, skincare products, or functional food.

Efficacy of a 4-Week Nurse-Led Exercise Rehabilitation Program in Improving the Quality of Life in Women Receiving a Post-Mastectomy Reconstruction Using the Motiva ErgonomixTM Round SilkSurface.

We assessed the efficacy of a 4-week nurse-led exercise rehabilitation (ER) program in improving the quality of life (QOL) of breast cancer survivors (BCS) receiving an implant-based breast reconstruction. The eligible patients were equally randomized to either of both groups: the intervention group (n = 30; a 4-week nurse-led ER program) and the control group (n = 30; a 4-week physical therapist-supervised one). Both after a 4-week ER program and at baseline, the patients were evaluated for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Fatigue Severity Scale (FSS) scores. There was a significantly higher degree of increase in global health status/QOL scores, physical functioning scores, role functioning scores, and emotional functioning scores at 4 weeks from baseline in the intervention group as compared with the control group (p = 0.001). However, there was a significantly higher degree of decrease in fatigue scores, nausea/vomiting scores, pain scores, dyspnea scores, and FSS scores in the intervention group as compared with the control group (p = 0.001). In conclusion, our results indicate that a 4-week nurse-led ER program might be effective in the QOL in BCS receiving a post-mastectomy implant-based reconstruction using the Motiva ErgonomixTM Round SilkSurface.

Effects of the Resilience of Nurses in Long-Term Care Hospitals during on Job Stress COVID-19 Pandemic: Mediating Effects of Nursing Professionalism.

PURPOSE: To investigate nursing professionalism as a mediating factor in the relationship between resilience and job stress levels for nurses working in long-term care hospitals during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted from January to March 2021 in seven long-term care hospitals in the Seoul metropolitan area to measure resilience, nursing professionalism, and job stress among nurses. Simple and multiple regression analyses along with the Sobel test were performed to verify the mediating effect of nursing professionalism. RESULTS: Data from 200 nurses were included in the final analysis. Results showed that individual and occupational characteristics could lead to differences in nurses' resilience, job stress levels, and nursing professionalism. Nursing professionalism had a significant mediating effect on the relationship between resilience and job stress levels. The effect of resilience on job stress levels was significant (ß = -0.16, p = 0.024). After controlling for nursing professionalism, the effect declined and was not statistically significant (ß = -0.09, p = 0.251). CONCLUSION: There is a need to increase individual resilience and nursing professionalism through intervention programs and policy proposals to manage job stress among long-term care hospital nurses during the COVID-19 pandemic.

Feelings of Entrapment during the COVID-19 Pandemic Based on ACE Star Model: A Concept Analysis.

This study aimed to analyze the concept of the "feelings of entrapment" during the COVID-19 (coronavirus disease 2019) pandemic using a systematic review. We included literature based on content and outcomes related to feelings of entrapment, such as antecedents, attributes, and consequences. The exclusion criteria were studies that did not have inappropriate subject, content, conceptual definition, and degree thesis was excluded. Walker and Avant's process of concept analysis was used in this systematic literature review. The attributes of the concept of feelings of entrapment during the COVID-19 pandemic were found to be feelings of: (1) being out of control, (2) no escape, (3) being trapped, (4) being robbed, and (5) hopelessness. The causes for these were identified as (1) the COVID-19 pandemic, (2) lockdown system, (3) restricted situation, (4) uncertain future, (5) economic hardship, and (6) poor coping abilities. Consequences of the concept were: (1) increased suicide, (2) decreased mental health, and (3) decreased well-being. In situations such as COVID-19, it is important need to know what feelings of entrapment's antecedents and attributes are to prevent suicide and enhance mental health and well-being. Based on the results of this study, counseling services, policies, and systems for relieving feelings of entrapment in the COVID-19 situation are recommended.

Healthcare Safety Nets during the COVID-19 Pandemic Based on Double Diamond Model: A Concept Analysis.

The purpose of this study was to analyze the concept of the "healthcare safety net" during the COVID-19 pandemic. Walker and Avant's process of concept analysis was used in this systematic literature review. The attributes of the concept of a healthcare safety net during the COVID-19 pandemic were found to be: (a) capacity, (b) accessibility, (c) health equality, and (d) education. In consideration of these defining criteria, antecedents to the concept were identified as: (a) the COVID-19 pandemic, (b) health inequalities (internal factors and external factors), and (c) healthcare systems (health insurance, screening, protective equipment, medicine, and medical services). Consequences of the concept were: (a) meeting healthcare needs, (b) quality of life, and (c) a decrease in morbidity and mortality. A healthcare safety net is an important concept during the COVID-19 pandemic. In situations like COVID-19, healthcare safety nets are designed to meet safety needs, improve quality of life, and reduce patient turnover and mortality. Based on the results of this study, the development of standardized tools for measuring a healthcare safety net as well as that of policies and systems for resolving a healthcare safety net in the COVID-19 situation is recommended.

Development and Effect of a Fall Prevention Program Based on King's Theory of Goal Attainment in Long-Term Care Hospitals: An Experimental Study.

A fall prevention program based on King's goal attainment theory was developed to verify its effect on those in long-term care hospitals. The experiment was conducted at K Long-Term Care Hospital in S city for eight weeks. The study employed 57 elderly patients and 58 nurses. The program comprised an individual training conducted in a ward and hospital room for 20-30 min and a group training held in a conference room for 60 min. Significance levels were analyzed at p < 0.05 via frequency analysis, descriptive statistics, independent sample t-test, χ2-test, Mann-Whitney's U test, Wilcoxon code rank test, and Cronbach's α, and the clinical trial number was KCT0005908. In the patient intervention group, fall prevention behavior and knowledge increased, and the fear of falling decreased. Fall prevention behavior and knowledge increased in the nurse intervention group. Patient and nurse interaction satisfaction also increased. In contrast, the number of falls and nurses' burden did not decrease. The fall prevention program was verified via the interaction of personal, interpersonal, and social systems. Thus, the patient's fear of falling was reduced. Moreover, the program was effective for the fall knowledge, interaction satisfaction, and fall prevention behavior of both the patient and nurse.

Effects of Nurse-Led Intervention Programs Based on Goal Attainment Theory: A Systematic Review and Meta-Analysis.

This study aimed to evaluate the effects of the goal attainment theory-based nurse-led intervention programs using a systematic review and meta-analysis. Randomized and non-randomized controlled trials, published from January 2001 to December 2020, were examined using four international databases and four domestic databases. The search, selection, and coding were performed independently by two researchers. R version 4.0.3 and Review Manager (version 5.3) were employed for meta-analysis and quality assessment, respectively. Of the 7529 articles retrieved, 18 were selected for analysis. The random overall effect size of the programs was 0.77 (95% CI = 0.61-0.94). Effect size by dependent variables were 2.36 (95% CI = 0.91-3.82), 1.25 (95% CI = 0.66-1.83), 0.83 (95% CI = 0.55-1.10), 0.64 (95% CI = 0.39-0.89), and 0.58 (95% CI = 0.30-0.85) for interpersonal, cognitive, health behavior, psychological, and indicators of physical health, respectively. Effect size by independent variables were 1.25 (95% CI = 0.86-1.64), 0.76 (95% CI = 0.48-1.03), 0.72 (95% CI = 0.37-1.06), 0.35 (95% CI = 0.21-0.49), and 1.35 (95% CI = -0.15-2.85) for prevention, health promotion, counseling and education, goal-setting and health contract, and parent participation programs, respectively. The effect size by control variables was 1.72 (95% CI = 0.88-2.56) at age ≤17, 0.85 (95% CI = 0.54-1.15) at time (min) 61-90, 1.04 (95% CI = 0.76-1.32) at sessions seven to eight, and 0.93 (95% CI = 0.66-1.19) at duration (weeks) five to eight. Thus, these programs were effective in improving various health aspects. Additionally, they can be recommended in various settings. Because efficacy is also influenced by control variables, considering treatment designs based on intervention characteristics and methodological approaches is warranted.

Camu-Camu Fruit Extract Inhibits Oxidative Stress and Inflammatory Responses by Regulating NFAT and Nrf2 Signaling Pathways in High Glucose-Induced Human Keratinocytes.

Myrciaria dubia (HBK) McVaugh (camu-camu) belongs to the family Myrtaceae. Although camu-camu has received a great deal of attention for its potential pharmacological activities, there is little information on the anti-oxidative stress and anti-inflammatory effects of camu-camu fruit in skin diseases. In the present study, we investigated the preventative effect of 70% ethanol camu-camu fruit extract against high glucose-induced human keratinocytes. High glucose-induced overproduction of reactive oxygen species (ROS) was inhibited by camu-camu fruit treatment. In response to ROS reduction, camu-camu fruit modulated the mitogen-activated protein kinases (MAPK)/activator protein-1 (AP-1), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and nuclear factor of activated T cells (NFAT) signaling pathways related to inflammation by downregulating the expression of proinflammatory cytokines and chemokines. Furthermore, camu-camu fruit treatment activated the expression of nuclear factor E2-related factor 2 (Nrf2) and subsequently increased the NAD(P)H:quinone oxidoreductase1 (NQO1) expression to protect keratinocytes against high-glucose-induced oxidative stress. These results indicate that camu-camu fruit is a promising material for preventing oxidative stress and skin inflammation induced by high glucose level.

Ginsenoside Absorption Rate and Extent Enhancement of Black Ginseng (CJ EnerG) over Red Ginseng in Healthy Adults.

Red ginseng (RG) and black ginseng (BG, CJ EnerG) were prepared from fresh ginseng using one and nine cycles of steaming and drying, respectively. This process reduces the molecular weight (MW) of ginsenoside-active compounds in ginseng by removing sugar moieties from their dammaranes. We compared the pharmacokinetic characteristics of ginsenosides between BG comprising mainly low-MW ginsenosides (Rg3, Rg5, Rk1, and Rh1) and RG that predominantly contains high-MW ginsenosides (Rb1, Rb2, Rc, Rd, Re, and Rg1). The safety profiles and tolerability were also studied using a randomized, double-blind, single-dose, crossover clinical trial. A combination of Rb1, Rg1, and Rg3, well-known representative and functional RG components, exhibited a 1 h faster absorption rate (Tmax) and 58% higher exposure (24 h area under the concentration-time curve, AUC24) in BG than in RG. Furthermore, the combination of Rg3, Rg5, and Rk1, the major and most efficient components in BG, displayed 824% higher absorption (AUC24) in BG than in RG. The total ginsenoside showed a 5 h rapid intestinal absorption (Tmax) and 79% greater systemic exposure (AUC24) in BG than in RG. No clinically significant findings were observed in terms of safety or tolerability. Thus, BG extract was more effective than RG extract.

Anti-inflammatory Effects of Achillea millefolium on Atopic Dermatitis-Like Skin Lesions in NC/Nga Mice.

Achillea millefolium L. (AM) is an aromatic herb with a variety of pharmacological properties, such as anti-inflammatory and anti-allergic activities. However, AM's effects on atopic dermatitis (AD) have not been investigated. This study evaluates the anti-AD activity of 50% ethanol-extracted AM in murine macrophage Raw 264.7 cells, in tumor necrosis factor-alpha/interferon-gamma (TNF-[Formula: see text]/IFN-[Formula: see text])-stimulated human immortal keratinocyte HaCaT cells in vitro, and in Biostir-AD-treated NC/Nga mice in vivo. The results showed that AM significantly downregulated expression of pro-inflammatory cytokines, such as INOS, COX-2, and interleukin (IL)-6 in lipopolysaccharide (LPS)-treated Raw 264.7 cells. The mRNA expressions of INOS, COX-2, and IL-6 decreased by 76.1%, 69.3%, and 31.8%, respectively. Overexpression of chemokines, such as activation-regulated chemokine and macrophage-derived chemokine, regulated on activation of normal T-cell expressed and secreted, and IL-8 was inhibited by 70.01%, 52.91%, 73.53%, and 18.93%, respectively, in TNF-[Formula: see text]/IFN-[Formula: see text]-stimulated HaCaT cells by downregulating the mitogen-activated protein kinase, I[Formula: see text]B[Formula: see text], and the signal transducer and activator of transcription 1 signaling pathways. AD-like symptoms, such as elevated serum immunoglobin E levels, epidermal thickening, high dermatitis severity score, transepidermal water loss, and reduced skin hydration, were relieved by the dietary administration of AM in Biostir-AD-treated NC/Nga mice. In addition, filaggrin expression increased significantly in AM-treated groups. These results suggest that AM could be a useful candidate for AD treatment.

Inhibitory Effects of Urtica thunbergiana Ethanol Extract on Atopic Dermatitis-Induced NC/Nga Mice.

Atopic dermatitis (AD) is a chronic, inflammatory skin disease that persists or repeatedly recurs in both childhood and adulthood. Urtica thunbergiana (UT) is an aroma herb with little-known pharmacological effects and anti-inflammatory activities against AD. This study investigated the immunomodulatory efficacy of 50% ethanol-extracted UT in necrosis factor-alpha/interferon-gamma (TNF-α/IFN-γ)-stimulated HaCaT cells in vitro and AD-Biostir-induced NC/Nga mice in vivo. The results showed that UT exhibits a dose-dependent increase in scavenged free radicals, reaching 76.0% ± 1.4% of scavenged 1,1-diphenyl-2-picrylhydrazyl at a concentration of 250 µg/mL. In addition, UT significantly downregulated the mRNA expression of the following pro-inflammatory cytokines and chemokines in TNF-α/IFN-γ-stimulated HaCaT cells: interleukin (IL)-6, IL-8, thymus- and activation-regulated chemokine, macrophage-derived chemokine, and regulated on activation normal T expressed and secreted. UT-treated HaCaT cells showed inhibition of the overexpression of chemokine-regulated signaling molecules, such as nuclear factor-kappa B, inhibitor of kappa B (IκBα), signal transducer and activator of transcription 1, and mitogen-activated protein kinases (MAPKs). UT dietary administration in AD-Biostir-induced NC/Nga mice treated and improved AD-like symptoms, such as scales, epidermal thickening, the dermatitis severity score, high trans-epidermal water loss, reduced skin hydration, increased mast cells, elevated serum immunoglobulin E levels, and an enlarged spleen. UT treatment inhibited the expression of phosphorylated forms of MAPKs, nuclear factor of activated T-cells 1, and regulator IκBα. It also upregulated filaggrin (FLG) production. Therefore, UT shows high anti-AD activity both in vitro and in vivo, and can be a useful anti-AD agent.

Flavonoids in common and tartary buckwheat hull extracts and antioxidant activity of the extracts against lipids in mayonnaise.

Buckwheat hulls, generally discarded as waste, have been known to possess various flavonoids and high antioxidant activities. The objective of this study was to determine effect of extracting solvents [water, ethanol (20%, 50%, 80%, and 100%), methanol, and acetone] on total phenolic content, flavonoid content and composition, and antioxidant activities of common and tartary buckwheat hull extracts. Antioxidative effect of common and tartary buckwheat hull extracts on lipids in mayonnaise was also investigated. Vitexin, isovitexin, isoorientin, orientin, rutin, isoquercetin, and quercetin were identified in the common buckwheat hull extracts, while rutin, quercetin, isoorientin, and isoquercetin were in the tartary buckwheat hull extracts. The methanol and 80% ethanol extracts had more flavonoids than the others, while the aqueous ethanol extracts from both of the hulls had more total phenolics and antioxidant activities. Oxidative stability of lipids in mayonnaises added with common and tartary buckwheat hull extracts (0.02 and 0.08%, w/w) prepared by 50% ethanol were higher than that in the mayonnaise with butylated hydroxytoluene (0.02%) and control. Oxidative stability was not significantly different between the mayonnaises added with the two buckwheat hull extracts.

Photoprotective and Anti-Inflammatory Properties of Vina-Ginsenoside R7 Ameliorate Ultraviolet B-Induced Photodamage in Normal Human Dermal Fibroblasts.

Vina-ginsenoside R7 (R7) has been exhibited to engage in multiple pharmacological activities, such as antioxidant and anti-inflammatory activities. However, no photoaging-related studies have been performed on R7. Research is being conducted with the aim of assessing whether treatment with R7 has a protective effect on UVB-induced photoaging skin. Our results show that UVB exposure directly reduces matrix metalloproteinase (MMP) secretion through R7 by restraining the AP-1/MAPK pathway and blocks extracellular matrix (ECM) expression degradation. In addition, R7 improves the expression of transforming growth factor beta 1 (TGF-ß1), and type I procollagen also facilitates the synthesis of collagen by the TGF-ß/Smad signal transduction pathway. Finally, R7 valid blocks nuclear factor-κB (NF-κB) activation and enhances antioxidative stress capacity through activated nuclear factor (erythroid derived 2)-like 2 (Nrf2). In particular, the application of R7 restrains pro-inflammatory cytokines (TNF-α, IL-6, iNOS), which trigger ECM, degrade enzyme production, and suppress vascular endothelial growth factor (VEGF) secretion. In conclusion, R7 may constitute a promising cosmetic ingredient that can protect against skin photodamage resulting from detrimental UVB irradiation.

[Development and Effect of a Fall Prevention Program Based on the King's Goal Attainment Theory for Fall High-Risk Elderly Patients in Long-Term Care Hospital].

PURPOSE: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. METHODS: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ²-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. RESULTS: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). CONCLUSION: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

Ginsenoside C-Mx Isolated from Notoginseng Stem-leaf Ginsenosides Attenuates Ultraviolet B-mediated Photoaging in Human Dermal Fibroblasts.

Notoginseng is a traditional herbal medicine widely used for medicinal therapy in Asia, as it contains numerous ginsenosides with pharmacological effects. In this study, we submitted Notoginseng stem-leaf (NGL) ginsenosides to an enzyme to create a reaction with the monomer products of ginsenoside C-Mx and then investigated the ability of ginsenoside C-Mx to protect the skin against ultraviolet B-induced injury in normal human dermal fibroblasts (NHDFs). Ginsenoside C-Mx alleviated UVB-induced intracellular reactive oxygen species (ROS), MMP-1 and IL-6 expression while accelerating TGF-ß and procollagen type I secretion. In addition, ginsenoside C-Mx reversed UVB-induced procollagen type I reduction by regulating the TGF-ß/Smad signaling pathway. Moreover, ginsenoside C-Mx inhibited activation of AP-1 transcription factor, an inducer of MMPs. Ginsenoside C-Mx displayed an outstanding antioxidant capacity, increasing expression of cytoprotective antioxidants such as HO-1 and NQO-1 expression by enhancing the nuclear accumulation of Nrf2. Interestingly, application of ginsenoside C-Mx treatment (1, 10, 20 µm) significantly diminished UVB-induced suppressed NF-κB expression, decreasing the over-released inflammatory cytokines. Taken together, our findings indicated that ginsenoside C-Mx may act as a promising natural cosmetic ingredient for prevention and treatment of UVB-induced skin damage.

Borago officinalis L. attenuates UVB-induced skin photodamage via regulation of AP-1 and Nrf2/ARE pathway in normal human dermal fibroblasts and promotion of collagen synthesis in hairless mice.

Ultraviolet B (UVB) irradiation is regarded as the main cause of skin photodamage. After exposure to UVB irradiation, collagen degradation is accelerated by upregulation of matrix metalloproteinases (MMPs), and collagen synthesis is decreased via downregulation of transforming growth factor (TGF)-ß1 signaling. Borago officinalis L. (BO) is an annual herb with medicinal and culinary applications. Although BO has been demonstrated to have antioxidant and anti-inflammatory activities, its potential anti-photoaging effects have not been examined. In this study, we examined the protective effects of BO against skin photodamage in UVB-exposed normal human dermal fibroblasts (NHDFs) in vitro and hairless mice in vivo. BO downregulated the expression of MMP-1, MMP-3, and IL-6, and enhanced TGF-ß1 by modulating activator protein (AP-1) and nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE) signaling in UVB-irradiated NHDFs. We also found that dietary BO reduced wrinkle formation, epidermal thickness, and erythema in UVB-exposed skin. Moreover, skin hydration and collagen synthesis were improved by dietary BO treatment. Our results demonstrate that BO can be used in functional foods, cosmetic products, and medicines for prevention and treatment of UVB-induced skin photodamage.

Protective effect of dietary Alchemilla mollis on UVB-irradiated premature skin aging through regulation of transcription factor NFATc1 and Nrf2/ARE pathways.

BACKGROUND: Alchemilla mollis (lady's mantle) is a common ingredient in skin care products. However, the protective mechanism of A. mollis against skin problems has not been elucidated. PURPOSE: This study was to investigate the effects of A. mollis ethanolic extract (AM) on UVB-irradiated normal human dermal fibroblasts (NHDF) and hairless mice. METHODS: The in vitro anti-photoaging effect of AM was performed in NHDFs. The antioxidant activities were assessed through DPPH, ABTS, and reactive oxygen species (ROS) assays. Matrix metalloproteinase 1 (MMP-1), IL-6, procollagen type I, and transforming growth factor-ß1 (TGF-ß1) were measured by kits. The protein levels of p-c-Jun, p-c-Fos, Nrf2, NQO-1, HO-1, nuclear NFATc1 and cytosolic p-NFATc1 were evaluated by western blotting. In in vivo, H&E and Masson's trichrome staining were carried out. Skin texture was analyzed using the roughness parameters. The expression of MMP-1, procollagen type I, TGF-ß1 and elastin were measured by western blot. RESULTS: AM included gallic acid as an active constituent. AM exhibited a strong antioxidant effect by inhibiting DPPH and ABTS free radicals, as well as ROS production. It was also found to upregulate transforming growth factor ß1, type I procollagen and elastin expression, and to downregulate matrix metalloproteinase-1 and interleukin-6 expression in AM-treated NHDFs under UVB irradiation. These effects were attributed to AP-1 and Nrf2/ARE signaling pathways. Significantly, it was demonstrated that AM regulated the UVB-induced NFATc1 dephosphorylation in nucleus. Based on dietary data, AM was effective for the prevention of wrinkle formation, skin thickening, water loss, and erythema in UVB-exposed mouse skin. CONCLUSION: Our data indicate that A. mollis provides protection from UVB exposure in both hairless mice skin in vivo and NHDFs in vitro. AM might therefore be useful as a cosmetic material and functional food for the prevention of UVB-induced human skin photoaging.

Eucalyptus globulus extract protects against UVB-induced photoaging by enhancing collagen synthesis via regulation of TGF-ß/Smad signals and attenuation of AP-1.

UV irradiation triggers the overproduction of matrix metalloproteinases and collagen degradation, which in turn causes increased pigmentation, dryness, and deep wrinkling of the skin. These chronic symptoms are collectively referred to as photoaging. Eucalyptus globulus is an evergreen tree that is widely used in cosmetics because of its antimicrobial activity. In this study, we investigated the protective effect of 50% ethanol extracts of Eucalyptus globulus on UV-induced photoaging in vitro and in vivo. Normal human dermal fibroblasts were treated with Eucalyptus globulus at concentrations ranging from 1 to 100 µg/mL after UVB or non-UVB irradiation. We found that Eucalyptus globulus suppressed the expression of MMPs and IL-6, but increased the expression of TGF-ß1 and procollagen type 1. In addition, Eucalyptus globulus inhibited activation of the AP-1 transcription factor, an inducer of MMPs. Eucalyptus globulus was also found to regulate TGF-ß/Smad signaling by reversing the activity of negative Smad regulators. Lastly, in vivo studies showed that topical application of Eucalyptus globulus on UVB-irradiated hairless mice reduced wrinkle formation and dryness by down-regulating MMP-1 and up-regulating expression of elastin, TGF-ß1, and procollagen type 1. Taken together, these data suggest that Eucalyptus globulus may be a useful agent in cosmetic products.