Barriers and future improvements of workplace-based learning in Korean medicine clinical clerkship: perspectives of graduates.

BACKGROUND: Workplace-based learning (WPBL) has emerged as an essential practice in healthcare education. However, WPBL is rarely implemented in Korean medicine (KM) due to the passive attitude of teachers and possible violation of medical laws that limit the participation of trainees in medical treatment. In this study, we implemented WPBL in the clinical clerkship of Acupuncture and Moxibustion Medicine at a single College of KM and explored the barriers and future improvements of WPBL. METHODS: The WPBL was implemented from January to July 2019. During the clerkship, each senior student was assigned an inpatient at the university hospital. WPBL was conducted as follows: patient presentation by the supervisor, interaction with the patient at the bedside, preparation of medical records, oral case presentation, and discussion with feedback. The student performed a physical examination and review of systems as a clinical task. In addition, six doctors of KM who are currently practicing after three years of WPBL were interviewed in September 2022 to investigate the real-world effects and unmet needs of WPBL in their workplaces. RESULTS: Two major themes identified from the interview were: "the experience of novice doctors of KM with KM practice" and "Current state of KM clinical education." The five subcategories were: "Clinical competency priorities vary according to the KM workplace," "Difficulties faced by doctors of KM immediately after graduation," "WPBL experience of the interviewees," "Necessary but difficult to implement real patient learning," and "Unmet needs for clinical clerkship in KM." CONCLUSION: It is essential to consider the unique characteristics of KM practice and the duties required in various workplaces for successful WPBL. We anticipate our study to be a starting point for improving the WPBL and addressing the unmet needs in KM clinical education.

Effects of the COVID-19 Pandemic on the Medical Use of Elderly Patients with Hypertension: A Nationwide Cohort Study in Korea.

Background: The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare services, including chronic disease management, for vulnerable groups, such as older individuals with hypertension. This study aimed to evaluate hypertension management in South Korea's elderly population during the pandemic using treatment consistency indices such as the continuity of care (COC), modified, modified continuity index (MMCI), and most frequent provider continuity (MFPC). Methods: This study used the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service cohort (K-COV-N cohort) from the National Health Insurance Service between 2017 and 2021. The research included a total of 4,097,299 hypertensive patients aged 65 years or older. We defined 2018 and 2019 as the baseline period before the COVID-19 pandemic and 2020 and 2021 as the COVID-19 period and calculated the indices of medical continuity (number of visits, COC, MMCI, and MFPC) on a yearly basis. Results: The number of visits decreased during the COVID-19 period compared to the baseline period (59.64±52.75 vs. 50.49±50.33, P<0.001). However, COC, MMCI, and MFPC were not decreased in the baseline period compared to the COVID-19 period (0.71±0.21 vs. 0.71±0.22, P<0.001; 0.97±0.05 vs. 0.96±0.05, P<0.001; 0.8±0.17 vs. 0.8±0.17, P<0.001, respectively). Conclusion: COVID-19 had no significant impact on the continuity of care but affected the frequency of outpatient visits for older patients with hypertension. However, this study highlights the importance of addressing healthcare inequalities, especially in older patients with hypertension, during pandemics and advocates for policy changes to ensure continued care for vulnerable populations.

Health Inequities in Cancer Incidence According to Economic Status and Regions Are Still Existed Even under Universal Health Coverage System in Korea: A Nationwide Population Based Study Using the National Health Insurance Database.

PURPOSE: The purpose of this study is to determine the level of health equity in relation to cancer incidence. MATERIALS AND METHODS: We used the National Health Insurance claims data of the National Health Insurance Service between 2005 and 2022 and annual health insurance and medical aid beneficiaries between 2011 and 2021 to investigate the disparities of cancer incidence. We calculated age-sex standardized cancer incidence rates by cancer and year according to the type of insurance and the trend over time using the annual percentage change. We also compared the hospital type of the first diagnosis by cancer type and year and cancer incidence rates by cancer type and region in 2021 according to the type of insurance. RESULTS: The total cancer incidence increased from 255,971 in 2011 to 325,772 cases in 2021. The absolute difference of total cancer incidence rate between the NHI beneficiaries and the medical aid (MA) recipients increased from 510.1 cases per 100,000 population to 536.9 cases per 100,000 population. The odds ratio of total cancer incidence for the MA recipients increased from 1.79 (95% confidence interval [CI], 1.77 to 1.82) to 1.90 (95% CI, 1.88 to 1.93). Disparities in access to hospitals and regional cancer incidence were profound. CONCLUSION: This study examined health inequities in relation to cancer incidence over the last decade. Cancer incidence was higher in the MA recipients, and the gap was widening. We also found that regional differences in cancer incidence still exist and are getting worse. Investigating these disparities between the NHI beneficiaries and the MA recipients is crucial for implementing of public health policies to reduce health inequities.

Association between smoking status and handgrip strength in Korean male adults: based on Korea National Health and Nutrition Examination Survey 2016-2019.

Background: Smoking is a well-known risk factor of frailty. Handgrip strength (HGS) is highly representative of muscular strength and is used in the diagnosis of frailty; however, the relationship between smoking and HGS is not clear. We evaluated the relationship between smoking status and HGS. Objectives: This study aimed to evaluate the association between HGS and smoking status. Methods: We enrolled adult males between the ages of 19 and 80 years who participated in the Korea National Health and Nutrition Examination Survey VII-VIII. A chi-square test and ANOVA were performed to compare the mean handgrip strength (mean HGS) between non-smokers, ex-smokers, and current smokers. Logistic regression analysis was performed to determine the association between the smoking status and mean HGS, and additional analyses were performed by dividing subgroups by age. Results: A total of 7,649 participants were analyzed. When the mean HGS and mean dominant HGS were compared according to smoking status, HGS was higher in the right hand (value of p = 0.03) and left hand (value of p < 0.001) in the order of current smokers, ex-smokers, and non-smokers. Comparing HGS of stronger hands, the mean HGS ex-smokers [aOR, (95% confidence interval): 0.61 (0.46-0.82)] and current smokers: 0.55 (0.38-0.78) was higher than that of non-smokers. When subgroup analysis was performed according to age, current smokers aged >60 years had a higher grip strength than non-smokers. Conclusion: Current smokers had a stronger mean HGS than that of ex-smokers and non-smokers. Current smokers older than 60 years appeared to have a stronger mean HGS than ex-smokers and non-smokers of the same age group.

Ratiometric measurement of MAM Ca2+ dynamics using a modified CalfluxVTN.

Mitochondria-associated ER membrane (MAM) is a structure where these calcium-regulating organelles form close physical contact sites for efficient Ca2+ crosstalk. Despite the central importance of MAM Ca2+ dynamics in diverse biological processes, directly and specifically measuring Ca2+ concentrations inside MAM is technically challenging. Here, we develop MAM-Calflux, a MAM-specific BRET-based Ca2+ indicator. The successful application of the bimolecular fluorescence complementation (BiFC) concept highlights Ca2+-responsive BRET signals in MAM. The BiFC strategy imparts dual functionality as a Ca2+ indicator and quantitative structural marker specific for MAM. As a ratiometric Ca2+ indicator, MAM-Calflux estimates steady-state MAM Ca2+ levels. Finally, it enables the visualization of uneven intracellular distribution of MAM Ca2+ and the elucidation of abnormally accumulated MAM Ca2+ from the neurons of Parkinson's disease mouse model in both steady-state and stimulated conditions. Therefore, we propose that MAM-Calflux can be a versatile tool for ratiometrically measuring dynamic inter-organellar Ca2+ communication.

Efficacy of fermented grain using Bacillus coagulans in reducing visceral fat among people with obesity: a randomized controlled trial.

Background: Obesity is a socioeconomic problem, and visceral obesity, in particular, is related to cardiovascular diseases or metabolic syndrome. Fermented grains and various microorganisms are known to help with anti-obesity effects and weight management. Studies on the relationship between Bacillus coagulans and anti-obesity effects are not well known, and studies on the application of fermented grains and microorganisms to the human body are also insufficient. Objectives: This study aimed to evaluate the efficacy of Curezyme-LAC, an ingredient mixed with six-grain types fermented by B. coagulans, in reducing fat mass in adults with obesity. Methods: In this randomized double-blinded placebo-controlled study, 100 participants [aged 40-65 years; body mass index (BMI) ≥ 25 to ≤ 33 kg/m2) were randomly allocated to two groups: 4 g/day Curezyme-LAC administered as a granulated powder or placebo (steamed grain powder mixture). Results: After 12 weeks, visceral adipose tissue decreased significantly in the Curezyme-LAC group compared with that in the placebo group (mean ± standard error, SE of -9.3 cm2 ± 5.1) vs. (6.8 cm2 ± 3.4; p = 0.008). Compared to the placebo group, the Curezyme-LAC group also showed significant reductions in total fat mass (-0.43 ± 0.24 kg vs. 0.31 ± 0.19 kg, p = 0.011), body weight (-0.4 ± 0.3 kg vs. 0.3 ± 0.2 kg, p = 0.021), BMI (-0.14 ± 0.12 vs. 0.10 ± 0.07, p = 0.028), and waist circumference (-0.6 ± 0.2 cm vs. -0.1 ± 0.2 cm, p = 0.018) without a change in dietary intake and physical activity. Conclusion: Curezyme-LAC supplementation for 12 weeks may benefit individuals with obesity by reducing visceral fat mass.

Gcap14 is a microtubule plus-end-tracking protein coordinating microtubule-actin crosstalk during neurodevelopment.

Regulation of microtubule dynamics is required to properly control various steps of neurodevelopment. In this study, we identified granule cell antiserum-positive 14 (Gcap14) as a microtubule plus-end-tracking protein and as a regulator of microtubule dynamics during neurodevelopment. Gcap14 knockout mice exhibited impaired cortical lamination. Gcap14 deficiency resulted in defective neuronal migration. Moreover, nuclear distribution element nudE-like 1 (Ndel1), an interacting partner of Gcap14, effectively corrected the downregulation of microtubule dynamics and the defects in neuronal migration caused by Gcap14 deficiency. Finally, we found that the Gcap14-Ndel1 complex participates in the functional link between microtubule and actin filament, thereby regulating their crosstalks in the growth cones of cortical neurons. Taken together, we propose that the Gcap14-Ndel1 complex is fundamental for cytoskeletal remodeling during neurodevelopmental processes such as neuronal processes elongation and neuronal migration.

Comparison of Concordance between Chuna Manual Therapy Diagnostic Methods (Palpation, X-ray, Artificial Intelligence Program) in Lumbar Spine: An Exploratory, Cross-Sectional Clinical Study.

Before Chuna manual therapy (CMT), a manual therapy applied in Korean medicine, CMT spinal diagnosis using palpation or X-ray is performed. However, studies on the inter-rater concordance of CMT diagnostic methods, concordance among diagnostic methods, and standard CMT diagnostic methods are scarce. Moreover, no clinical studies have used artificial intelligence (AI) programs for X-ray image-based CMT diagnosis. Therefore, this study sought a feasible and standard CMT spinal diagnostic method and explored the clinical applicability of the CMT-AI program. One hundred participants were recruited, and the concordance within and among different diagnostic modalities was analyzed by dividing them into manual diagnosis (MD), X-ray image-based diagnosis (XRD) by experts and non-experts, and XRD using a CMT-AI program by non-experts. Regarding intra-group concordance, XRD by experts showed the highest concordance (used as a gold standard when comparing inter-group concordance), followed by XRD using the AI program, XRD by non-experts, and then MD. Comparing diagnostic results between the groups, concordance with the gold standard was the highest for XRD using the AI program, followed by XRD by non-experts, and MD. Therefore, XRD is a more reasonable CMT diagnostic method than MD. Furthermore, the clinical applicability of the CMT-AI program is high.

Impact of Sleep Duration on Decline in Kidney Function in Adult Patients with Hypertension: A Community-Based Prospective Cohort Study.

BACKGROUND: Sleep duration is associated with various health conditions, including chronic kidney disease. However, the association between sleep duration and decline in kidney function in the South Korean population remains unclear. We aimed to investigate the impact of sleep duration on kidney function decline in adult patients with hypertension. METHODS: This cohort study was performed using data obtained from the Korean Genome and Epidemiology Study; 2,837 patients with hypertension who initially had normal kidney function were included. Glomerular filtration rates (GFRs) were estimated at baseline and throughout the 16 years of follow-up. A person was considered to have a decline in kidney function if they had a GFR <60 mL/min/1.73 m2. Sleep duration data were obtained through interviewer-assisted questionnaires. Sleep durations were classified as short (<6 hours), normal (≥6 hours but <9 hours), and long (≥9 hours). The Cox proportional hazards model was applied, with adjustments for covariates. RESULTS: After adjusting for covariates, sleep duration was not associated with a decline in kidney function. However, among men with poorly controlled hypertension at baseline, compared to men with normal sleep durations, men with sleep durations <6 hours had a significantly higher risk of kidney function decline (hazard ratio, 1.56; 95% confidence interval, 1.02-2.36). CONCLUSION: Short sleep duration did not seem to be associated with an increased risk of decline in kidney function; however, it may be a risk factor for the decline in kidney function in men with poorly controlled hypertension.

Implementation of Objective Structured Clinical Examination on Diagnostic Musculoskeletal Ultrasonography Training in Undergraduate Traditional Korean Medicine Education: An Action Research.

This study aimed to report the specific methods and investigate the educational effects of diagnostic musculoskeletal ultrasound training and the Objective Structured Clinical Examination (OSCE) for traditional medicine students. Scanning volar wrist and diagnosing carpal tunnel syndrome were selected for musculoskeletal ultrasound to train students to use the basic functions of the ultrasound device and scan various structures including tendons, nerves, and arteries. The students were divided into two groups: one group had 8 weeks of training with mock OSCE experience and received feedback about their scan images, and the other group had 3 weeks of training with flipped learning. The OSCE was implemented on the last day of the training. The subjective learning outcomes were analyzed as students' evaluation with a 5-point scale, and the objective learning outcomes were analyzed using OSCE scores evaluated with a pre-validated checklist. Of the 111 students, 60 (54.1%) responded to the questionnaire. Overall satisfaction with this ultrasound training was high (4.5 ± 0.60). The average OSCE score in the 8-week group was significantly higher than that in the 3-week group. The students' self-assessment showed no significant differences between the two groups. Proficiency in using ultrasound is affected by the practice time and feedback. Ultrasound training should be further expanded as a required curriculum to meet students' needs and achieve learning objectives in the clinical skills education of Korean medicine colleges. Further studies are needed on ultrasound education, especially guided interventions for traditional medicine students.

Prediction value of the LACE index to identify older adults at high risk for all-cause mortality in South Korea: a nationwide population-based study.

BACKGROUND: As a tool to predict early hospital readmission, little is known about the association between LACE index and all-cause mortality in older adults. We aimed to validate the LACE index to predict all-cause mortality in older adults and also analyzed the LACE index outcome of all-cause mortality depending on the disease and age of the participants. METHODS: We used the National Health Insurance Service (NHIS) cohort, a nationwide claims database of Koreans. We enrolled 7491 patients who were hospitalized at least once between 2003 and 2004, aged ≥65 years as of the year of discharge, and subsequently followed-up until 2015. We estimated the LACE index using the NHI database. The Cox proportional hazards model was used to estimate the hazard ratio (HR) for all-cause mortality. Furthermore, we investigated all-cause mortality according to age and underlying disease when the LACE index was ≥10 and < 10, respectively. RESULTS: In populations over 65 years of age, patients with LACE index ≥10 had significantly higher risks of all-cause mortality than in those with LACE index < 10. (HR, 1.44; 95% confidence interval, 1.35-1.54). For those patients aged 65-74 years, the HR of all-cause mortality was found to be higher in patients with LACE index≥10 than in those with LACE index < 10 in almost all the diseases except CRF and mental illnesses. And those patients aged ≥75 years, the HR of all- cause mortality was found to be higher in patients with LACE index ≥10 than in those with LACE index < 10 in the diseases of pneumonia and MACE. CONCLUSION: This is the first study to validate the predictive power of the LACE index to identify older adults at high risk for all-cause mortality using nationwide cohort data. Our findings have policy implications for selecting or managing patients who need post-discharge management.

In vivo method to evaluate antioxidative activity using UVA-induced carbonylated protein on human skin.

BACKGROUND: Skin is continuously exposed to oxidative stress caused by reactive oxygen species (ROS) produced by the ultraviolet (UV) light, and it is important to evaluate the antioxidant activity. Carbonylated proteins (CPs) are candidate markers of oxidative modification as a result from the ROS. We aimed to develop the CP-based method to assess the efficacy of antioxidants in human skin. METHODS: Ten healthy females were enrolled in the study to determine the UVA dosage for CP production, and another 10 females were included to evaluate the antioxidative activity. The stratum corneum was collected from test skin using D-Squame tape, and CPs from the SC were stained by fluorescence labeling and observed using a fluorescence microscope. RESULTS: CP level significantly increased with UVA irradiation from 15J/cm2 to 50J/cm2 compared to the control (non-UVA) area. CP production significantly increased by 34.38% and 35.22% in UVA irradiation and squalene (vehicle) areas. 5% α-tocopherol and ß-carotene significantly increased the CP production by 20.77% and 19.34% after 2 hours of 30J of UVA irradiation compared to control area. Inhibition rate of CPs in 5% α-tocopherol and 5% ß-carotene showed 41.45% and 45.37% after 2 hours of UVA irradiation. CONCLUSION: This study developed the simple, visual, and direct in vivo method to evaluate the antioxidative activity for products in human skin by measuring the CP level as an oxidative modification caused by UVA-induced ROS generation.

Evaluation of facial skin age based on biophysical properties in vivo.

OBJECTIVE: The evaluation of skin age, reflecting overall facial characteristics, has not been established. Previous studies focused on visual assessment or individual-specific feature such as wrinkles or skin color. We studied the evaluation model of skin age index (SAI) including the overall aging features including wrinkles, skin color, pigmentation, elasticity, and hydration. METHODS: Total 300 healthy women aged between 20 and 69 years included in this study. Pearson correlation analysis performed to identify the key factors among the biophysical properties with aging and developed the prediction model of SAI. Statistical regression analysis and machine learning technique applied to build the prediction model using the coefficient of determination (R2 ) and root mean square error (RMSE). Validation study of the SAI model performed on 24 women for 6 weeks application with anti-aging product. RESULTS: Prediction model of SAI consisted of skin elasticity, wrinkles, skin color (brightness, Pigmented spot, and Uv spot), and hydration, which are major features for aging. The cforest model to assess a SAI using machine learning identified the highest R2 and lowest RMSE compared to other models, such as svmRadial, gaussprRadial, blackboost, rpart, and statistical regression formula. The cforest prediction model confirmed a significant decrease of predicted SAI after 6 weeks of application of anti-aging product. CONCLUSION: We developed a prediction model to evaluate a SAI using machine learning, and led to accurate predicted age for overall clinical aging. This model can a good standard index for evaluating facial skin aging and anti-aging products.

Efficacy of ethyl ascorbyl ether-containing cosmetic cream on blue light-induced skin changes.

BACKGROUND: Office workers are consistently exposed to blue light, mainly from sunlight and digital device. Recent studies report that blue light has various harmful effects, including cellular changes via reactive oxygen species. Studies on blue light-induced skin changes have only been conducted in vitro and have not been clinically confirmed. OBJECTIVE: We provide novel methods to evaluate the effect of the product on the recovery of skin changed by blue light. METHODS: Internet surveys were conducted for workers in their 20s and 40s regarding exposure time to blue light in various environments. To study the effects of long-term exposure to blue light (456 nm) on the skin, we designed three light intensity conditions, and various skin characteristics were observed. After blue light irradiation, various skin characteristics were analyzed before and after applying ethyl ascorbyl ether (EAE)-containing cosmetic cream for 2 weeks. RESULTS: When exposed to strong blue light for approximately 16 days, the L* value, skin hydration, transparency, and elasticity decreased, and the melanin index, erythema index, a* value, and b* value increased. Furthermore, after short-term blue light irradiation (dose, 269 J/cm2 , the equivalent of blue light exposure for approximately 38 days in daily life), the L* value and elasticity decreased, and the melanin index and erythema index increased. However, when EAE cream was applied on skin for 1-2 weeks, the skin recovered. CONCLUSION: This study clinically confirms the skin changes caused by blue light and the effect of EAE in relieving such changes.

Disrupted-in-schizophrenia 1 enhances the quality of circadian rhythm by stabilizing BMAL1.

Disrupted-in-schizophrenia 1 (DISC1) is a scaffold protein that has been implicated in multiple mental disorders. DISC1 is known to regulate neuronal proliferation, signaling, and intracellular calcium homeostasis, as well as neurodevelopment. Although DISC1 was linked to sleep-associated behaviors, whether DISC1 functions in the circadian rhythm has not been determined yet. In this work, we revealed that Disc1 expression exhibits daily oscillating pattern and is regulated by binding of circadian locomotor output cycles kaput (CLOCK) and Brain and muscle Arnt-like protein-1 (BMAL1) heterodimer to E-box sequences in its promoter. Interestingly, Disc1 deficiency increases the ubiquitination of BMAL1 and de-stabilizes it, thereby reducing its protein levels. DISC1 inhibits the activity of GSK3ß, which promotes BMAL1 ubiquitination, suggesting that DISC1 regulates BMAL1 stability by inhibiting its ubiquitination. Moreover, Disc1-deficient cells and mice show reduced expression of other circadian genes. Finally, Disc1-LI (Disc1 knockout) mice exhibit damped circadian physiology and behaviors. Collectively, these findings demonstrate that the oscillation of DISC1 expression is under the control of CLOCK and BMAL1, and that DISC1 contributes to the core circadian system by regulating BMAL1 stability.

What is the source of pressure pain during abdominal examination in Korean medicine?

BACKGROUND: This study aimed to observe which anatomical structures change in the abdominal cavity and are involved in pressure pain during the pressurization of CV12 by using an ultrasonic diagnostic device in healthy subjects. METHODS: We recruited 52 healthy people and performed ultrasound imaging by gradually pressurizing the subject's CV12. We analyzed ultrasound images to observe the changes in abdominal anatomical structures during pressurization. RESULTS: A significant change in thickness appeared at the space above the peritoneum and stomach and at the space between the stomach and the abdominal aorta while pressing on CV12. Pressure pain occurred in the following two cases. One was when from the posterior side of the stomach to the inner surface of the rectus abdominis became approximately 1.8 cm. The other was when the anterior side of the abdominal aorta approached the inner surface of the rectus abdominis by approximately 3 cm. Pressure pain occurred when CV12 was pressed to a depth of approximately 2.4 cm for females, 3.1 cm for males and 2.7 cm on average. CONCLUSION: The stomach and tissues around the stomach undergo the greatest pressure change during the pressurization of CV12, and in particular, pressure pain occurs when the posterior wall of the stomach is under pressure. However, further study should be done for clinical application.

Clinical evaluation method for blue light (456 nm) protection of skin.

BACKGROUND: Blue light from electronic devices enriched with a peak at 456 nm affects circadian rhythm and antioxidant balance of skin, necessitating the study of photoprotection against the 456-nm blue light. AIMS: This study aims to report that blue light (456 nm) can cause skin pigmentation and proposes a new clinical evaluation method for blue light (456 nm) protection based on the skin pigmentation level. PATIENTS/METHODS: We developed a clinical device (ABC deviceTM ) that emits blue light (peak = 456 nm). Based on the minimal persistent pigment darkening dose (MPPD) determined from visual evaluation and melanin index measurements, we proposed the "protection grade of blue light (PB)" guideline to assess the protective ability of skin against blue light. RESULTS: Human skin irradiated with blue light (456 nm) showed a light dose-dependent degree of pigmentation. The MPPD on unprotected and protected skin was 135 J/cm2 or 180 J/cm2 and 135-225 J/cm2 , respectively. The ABC device™ and the proposed clinical method were used to test the four blue light blocking assessments of TiO2 . Consequently, the inorganic filter with TiO2 effectively blocked the blue light (456 nm). The AP product demonstrated the ability to block blue light by 1.15 times (PB = 1.15), which significantly lowered the melanin index of the skin after irradiation as compared to that of the unprotected skin (P < .001). CONCLUSION: We propose an objective clinical evaluation method for blue light protection. This study elucidates the properties of blue light blockers for customers suffering from blue light pollution.

Age-related biophysical changes of the epidermal and dermal skin in Korean women.

INTRODUCTION: The clinical characteristics of skin were investigated to study the inter-relationship and changes in the biophysical properties of the epidermal and dermal layers associated with aging using noninvasive methods. METHODS: Our study included 100 healthy women aged between the early 20s and late 60s. Biophysical characteristics of skin such as color (brightness and spots), transparency, wrinkle on crow's feet, elasticity, hydration, sebum content, glossiness, and transepidermal water loss measured under controlled conditions. RESULTS: This study performed in a Korean population demonstrated that aging significantly affects human skin in terms of parameters such as wrinkles, skin color, elasticity, and epidermal hydration. Age-related changes in skin hydration showed varying patterns between the epidermis and dermis. Skin color showed heterogeneous characteristics between the upper and lower epidermal layers associated with aging. Skin elasticity and wrinkles were observed to show and inversely proportional relationship in the early 40s. CONCLUSIONS: We confirmed the significant influence of aging on the biophysical properties of skin and determined the distinct age-related biophysical changes in the epidermal and dermal layers of skin using noninvasive method. This study indicates the need for further research to investigate the distinctive age-related changes in characteristics of the epidermal and dermal layers of human skin.

Biophysical properties of striae rubra and striae alba in human skin: Comparison with normal skin.

BACKGROUND: Striae distensae are common dermal lesions that progress through two different stages: the striae rubra, which appears to be erythematous, and striae alba, which is characterized by a hypopigmented feature. The clinical characteristics between striae distensae stages and normal skin remain unknown. OBJECTIVES: We aimed to investigate the clinical characteristics according to stages of striae distensae in terms of their biophysical properties, using objective noninvasive measurements in comparison with adjacent normal skin. METHODS: Sixty-one healthy female subjects with striae distensae were included as follows: 30 with striae rubra and 31 with striae alba on the abdomen and thighs. Hydration of the epidermis and dermis, skin color brightness, and Erythema index were measured. Skin elasticity, roughness, and dermal echo-density of the skin with striae distensae and adjacent normal skin were also measured. RESULTS: Hydration of the epidermis and dermis showed no significant difference between the skin with striae distensae and normal skin. Brightness of skin with striae alba and normal skin was significantly higher than that of skin with striae rubra. Erythema index of skin with striae rubra was significantly higher than that of skin with striae alba and normal skin. Skin with striae rubra and striae alba had a rougher surface than normal skin. Elasticity and dermal echo-density were significantly lower in striae distensae skin. CONCLUSIONS: Striae rubra and striae alba had similar biophysical properties in terms of skin hydration, elasticity, roughness, and dermal density. Moreover, striae distensae have less elasticity, more roughness, and lower dermal density than normal skin.

Rapid Iodine Sensing on Mechanically Treated Carbon Nanofibers.

In this work, we report on a rapid, efficient electrochemical iodine sensor based on mechanically treated carbon nanofiber (MCNF) electrodes. The electrode’s highly graphitic content, unique microstructure, and the presence of nitrogen heteroatoms in its atomic lattice contribute to increased heterogeneous electron transfer and improved kinetics compared to conventional pyrolytic carbons. The electrode demonstrates selectivity for iodide ions in the presence of both interfering agents and high salt concentrations. The sensor exhibits clinically relevant limits of detection of 0.59 µM and 1.41 µM, in 1X PBS and synthetic urine, respectively, and a wide dynamic range between 5 µM and 700 µM. These results illustrate the advantages of the material’s unique electrochemical properties for iodide sensing, in addition to its simple, inexpensive fabrication. The reported iodine sensor eliminates the need for specimen processing, revealing its aptitude for applications in point-of-care diagnostics.