Acne care in health care providers during the COVID-19 pandemic: A national survey.

The medical face mask, widely used by health care providers (HCPs) during the COVID-19 pandemic, is reported to be associated with adverse reactions, among which acne is one of the most common. This study aims to evaluate treatment strategies employed by HCPs affected by acne in association with prolonged medical face mask use, their openness towards accessing telemedicine as a patient, and other lifestyle factors with potential influence on the evolution of their acne. Our online-based cross-sectional survey was distributed between December 17, 2020, and February 17, 2021, and targeted HCPs from different medical centers in Romania. From the n = 134 respondents, 50% reported current acne lesions and 56.7% required treatment. Of the latter, 65.8% self-medicated and 34.2% sought medical advice. The most common treatment associations between anti-acne topical products were: retinoids and salicylic acid (18.18%; n = 8), retinoids and benzoyl peroxide (13.64%; n = 6), salicylic acid and benzoyl peroxide (13.64%; n = 6), and azelaic acid together with salicylic acid (9.09%; n = 4). The health care provider responders were reluctant to use telemedicine, as only 14.2% participants were open to telemedicine. Our results suggest inadequate management of acne in HCPs using medical face masks. As with other occupational hazards and proper usage of personal protective equipment, HCPs should receive adequate screening, training, and treatment for this condition.

Age of Exposure 2.0: Estimating word complexity using iterative models of word embeddings.

Age of acquisition (AoA) is a measure of word complexity which refers to the age at which a word is typically learned. AoA measures have shown strong correlations with reading comprehension, lexical decision times, and writing quality. AoA scores based on both adult and child data have limitations that allow for error in measurement, and increase the cost and effort to produce. In this paper, we introduce Age of Exposure (AoE) version 2, a proxy for human exposure to new vocabulary terms that expands AoA word lists through training regressors to predict AoA scores. Word2vec word embeddings are trained on cumulatively increasing corpora of texts, word exposure trajectories are generated by aligning the word2vec vector spaces, and features of words are derived for modeling AoA scores. Our prediction models achieve low errors (from 13% with a corresponding R2 of .35 up to 7% with an R2 of .74), can be uniformly applied to different AoA word lists, and generalize to the entire vocabulary of a language. Our method benefits from using existing readability indices to define the order of texts in the corpora, while the performed analyses confirm that the generated AoA scores accurately predicted the difficulty of texts (R2 of .84, surpassing related previous work). Further, we provide evidence of the internal reliability of our word trajectory features, demonstrate the effectiveness of the word trajectory features when contrasted with simple lexical features, and show that the exclusion of features that rely on external resources does not significantly impact performance.

The Tool for the Automatic Analysis of Cohesion 2.0: Integrating semantic similarity and text overlap.

This article introduces the second version of the Tool for the Automatic Analysis of Cohesion (TAACO 2.0). Like its predecessor, TAACO 2.0 is a freely available text analysis tool that works on the Windows, Mac, and Linux operating systems; is housed on a user's hard drive; is easy to use; and allows for batch processing of text files. TAACO 2.0 includes all the original indices reported for TAACO 1.0, but it adds a number of new indices related to local and global cohesion at the semantic level, reported by latent semantic analysis, latent Dirichlet allocation, and word2vec. The tool also includes a source overlap feature, which calculates lexical and semantic overlap between a source and a response text (i.e., cohesion between the two texts based measures of text relatedness). In the first study in this article, we examined the effects that cohesion features, prompt, essay elaboration, and enhanced cohesion had on expert ratings of text coherence, finding that global semantic similarity as reported by word2vec was an important predictor of coherence ratings. A second study was conducted to examine the source and response indices. In this study we examined whether source overlap between the speaking samples found in the TOEFL-iBT integrated speaking tasks and the responses produced by test-takers was predictive of human ratings of speaking proficiency. The results indicated that the percentage of keywords found in both the source and response and the similarity between the source document and the response, as reported by word2vec, were significant predictors of speaking quality. Combined, these findings help validate the new indices reported for TAACO 2.0.

Cohesion network analysis of CSCL participation.

The broad use of computer-supported collaborative-learning (CSCL) environments (e.g., instant messenger-chats, forums, blogs in online communities, and massive open online courses) calls for automated tools to support tutors in the time-consuming process of analyzing collaborative conversations. In this article, the authors propose and validate the cohesion network analysis (CNA) model, housed within the ReaderBench platform. CNA, grounded in theories of cohesion, dialogism, and polyphony, is similar to social network analysis (SNA), but it also considers text content and discourse structure and, uniquely, uses automated cohesion indices to generate the underlying discourse representation. Thus, CNA enhances the power of SNA by explicitly considering semantic cohesion while modeling interactions between participants. The primary purpose of this article is to describe CNA analysis and to provide a proof of concept, by using ten chat conversations in which multiple participants debated the advantages of CSCL technologies. Each participant's contributions were human-scored on the basis of their relevance in terms of covering the central concepts of the conversation. SNA metrics, applied to the CNA sociogram, were then used to assess the quality of each member's degree of participation. The results revealed that the CNA indices were strongly correlated to the human evaluations of the conversations. Furthermore, a stepwise regression analysis indicated that the CNA indices collectively predicted 54% of the variance in the human ratings of participation. The results provide promising support for the use of automated computational assessments of collaborative participation and of individuals' degrees of active involvement in CSCL environments.

HOMA-IR Index and Pediatric Psoriasis Severity-A Retrospective Observational Study.

Psoriasis is a chronic inflammatory disease with specific cutaneous and nail lesions. Recent data has emphasized its systemic nature, highlighting metabolic conditions found in patients. Insulin resistance was identified in adult psoriasis, sometimes related to psoriasis severity. Data regarding this relationship in children are limited. Consequently, we tested the association between the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Psoriasis Area and Severity Index (PASI) using a retrospective dataset of 43 children with various types of psoriasis. First, we attempted to replicate the relationship between the HOMA-IR and PASI. Second, we explored potential associations between these variables and others in the dataset. The results illustrated no association between HOMA-IR and PASI (p-value = 0.512). The exploratory findings hinted at a connection between nail pitting and insulin resistance (p-value = 0.038), yet Bonferroni adjustments suggested the risk of a false-positive finding. Noteworthy associations were found between the HOMA-IR and body mass index (BMI) (p-value = 0.001), the PASI and quality of life impairment (p-value = 0.005), and psoriasis severity and type (p-value = 0.001). The null hypothesis that insulin resistance in children is not positively associated with psoriasis severity cannot be rejected. Pilot estimates of variables and covariates of interest are provided for further confirmatory studies assessing this hypothesis.

Epidemiological Characteristics of Inherited Epidermolysis Bullosa in an Eastern European Population.

Background/Objectives: Epidermolysis bullosa (EB) is a hereditary condition characterized by skin and mucosal fragility, with various degrees of severity. This study's objectives are to obtain updated epidemiological data that will help identify the specific types and subtypes of EB, determine the case distribution in Romania, and establish the incidence and prevalence of the condition. Methods: This population-based observational study included Romanian patients and collected data from 2012 to 2024. The following information was recorded: date of birth, status (deceased or alive), date of death (if applicable/available), sex, county, and city of residence, EB type and subtype if available, diagnosis (clinical and/or immunofluorescence mapping, transmission electron microscopy, genetic molecular analysis), affected genes, inheritance, and affected family members. Results: The study included a total of 152 patients. The point prevalence (the proportion of the population with a condition at a specific point in time) and the incidence of EB in Romania were 6.77 per million population and 24.23 per million live births, respectively. EB simplex (EBS), junctional EB (JEB), dystrophic EB (DEB), Kindler EB (KEB), and not otherwise specified EB, as well as EB (NOS), were the main types of the condition identified in 21%, 3%, 63%, 2%, and 11% of the total cases. The point prevalence and incidence for the same time intervals were 1.58 and 5.28 in EBS, 0.10 and 1.76 in JEB, 4.72 and 12.34 in DEB, 0.16 and 0 in KEB, and 0.21 and 4.85 in EB (NOS). Conclusions: The study provides updated epidemiological data for Romania and underlines the necessity for accurate diagnosis, facilitated by access to genetic molecular testing and better reporting systems.

Validation of the Cardiff acne disability index and the impact of educational materials in a Romanian cultural adaptation context.

BACKGROUND: Acne has a high impact on patients being a chronic, common, and visible skin condition. Knowledge regarding treatment improves outcomes. The Cardiff Acne Disability Index (CADI) is commonly used in clinical practice for quality-of-life assessment. It has been validated in many languages, however, not in Romanian. AIMS: To validate the Romanian adaptation of the CADI and educational materials for acne patients. PATIENTS AND METHOD: A 12-week prospective cross-sectional Web-based study, including 3rd- to 5th-year medical students attending our university was conducted. We obtained permission from the CADI copyright owner and performed the steps of the standardized translation process. The Romanian CADI adaptation was delivered online in a test-retest setup, during which participants were offered acne educational materials and completed a knowledge evaluation questionnaire. RESULTS: A total of 95 complete answers were analyzed. The Romanian CADI adaptation showed good internal consistency, with Cronbach's α = 0.807 in the first application and Cronbach's α = 0.839 in the second. High test-retest reliability was observed, with interclass correlation coefficient ICC = 0.987 and Spearman's rank correlation coefficient rs  = 0.970 for the overall CADI scores between the two administrations. The mean baseline score in the knowledge evaluation questionnaire was 15.52 points (±1.556), with a statistically significant improvement after exposure to the educational material (Z = -7.207, p < 0.001). This material was considered useful or very useful by 78(82.8%) participants. CONCLUSION: Romanian acne patients can benefit from CADI, a reliable and disease-specific tool for quality-of-life evaluation, together with validated, guideline-aligned educational material in their language.

Before and during COVID-19: A Cohesion Network Analysis of students' online participation in moodle courses.

The COVID-19 pandemic has changed the entire world, while the impact and usage of online learning environments has greatly increased. This paper presents a new version of the ReaderBench framework, grounded in Cohesion Network Analysis, which can be used to evaluate the online activity of students as a plug-in feature to Moodle. A Recurrent Neural Network with LSTM cells that combines global features, including participation and initiation indices, with a time series analysis on timeframes is used to predict student grades, while multiple sociograms are generated to observe interaction patterns. Students' behaviors and interactions are compared before and during COVID-19 using two consecutive yearly instances of an undergraduate course in Algorithm Design, conducted in Romanian using Moodle. The COVID-19 outbreak generated an off-balance, a drastic increase in participation, followed by a decrease towards the end of the semester, compared to the academic year 2018-2019 when lower fluctuations in participation were observed. The prediction model for the 2018-2019 academic year obtained an R 2 of 0.27, while the model for the second year obtained a better R 2 of 0.34, a value arguably attributable to an increased volume of online activity. Moreover, the best model from the first academic year is partially generalizable to the second year, but explains a considerably lower variance (R 2 = 0.13). In addition to the quantitative analysis, a qualitative analysis of changes in student behaviors using comparative sociograms further supported conclusions that there were drastic changes in student behaviors observed as a function of the COVID-19 pandemic.

Prevention of Hand Eczema among Nurse Apprentice (PREVEDERM): An Interventional Study.

BACKGROUND: Workers in the healthcare sector are at high risk of developing occupational hand eczema mainly due to frequent exposure to irritants and/or allergens. Amongst workers in healthcare, nurses are at higher risk of developing hand dermatitis. OBJECTIVES: To evaluate the effectiveness of a short educational intervention program in preventing occupational hand eczema in nurse apprentices, using two objective tools, namely TEWL and EH, and the HECSI score. METHODS: Data regarding professions, wet work exposure, activities performed during working hours, self-reported eczema were collected from 230 nurse students, divided in two study groups: the intervention and the control group (CG). The intervention group (IG) was given education about risks and proper skin care and was provided with cosmeceuticals to be used for skin care during hospital activity. The evaluation of skin properties was performed using questionnaires, HECSI score, measurement of transepidermal water loss (TEWL) and epidermal hydration (EH). RESULTS: A number of 139 apprentice nurses completed the study. Of those participants who completed the study, 19.1% from CG and 19.6% from IG reported, at T1, hand eczema in the last 3 months, while at T2 (3 months later), 59.52 % of the CG and only 11.34 % from the IG stated having eczema in the last 3 months. In the IG, results showed an improvement of CM with 17% and of TEWL with 16%, with only a 0.5% improvement of CM in CG and a marked impairment of TEWL by 33%. CONCLUSION: Hand eczema is a common occupational dermatosis affecting the medical staff, even during apprenticeship. Early preventive training programs are effective in reducing the burden of occupational contact dermatitis.

Is Occupational Skin Cancer More Aggressive than Sporadic Skin Cancer?

Background: Non-melanoma skin cancer (NMSC) represents the most frequently diagnosed cancer in humans. Occupational solar UV radiation exposure is associated with a higher-risk of developing NMSC, but still Romania does not acknowledge this affliction as an occupational disease. The study aims to determine if occupationally-induced NMSC is associated with more aggressive clinical and histopathological features compared to sporadic NMSC. Material and methods: A retrospective, analytical, comparative study was conducted during 2017-2019 in a University Department of Dermato-venereology in Bucharest, Romania, with focus on patients presenting with NMSC who underwent surgical excision of lesions followed by histopathological examination, classified as outdoor or indoor workers. High-risk clinical and histopathological characteristics were analysed and correlated with outdoor UV exposure. Outcomes: The study included 51 consecutive patients diagnosed with NMSC, of which 25 outdoor workers (OW) and 26 controls as indoor workers with no occupational UV exposure background. OW presented with 21 BCC and four SCC, while controls with 22 BCC and four SCC. Males were predominant in both groups and most patients came from urban environment. The mean age value was lower for the OW group compared to controls. OW had a 4.66 times higher risk of developing NMSC with aggressive location and size χ² (1, N=51) = 6.246, p=0.013, OR=4.66 (95% CI: 1.34, 16.23) and a 24-fold risk of developing NMSC with clinically poorly defined margins χ² (1, N=51) = 21.697, p<0.001, OR=24.44 (95% CI: 5.38,110.92). The risk of developing a high-risk histopathological subtype was 15 times greater for OW χ² (1, N=51) = 13.814, p<0.001, OR=15.27 (95% CI: 2.94,79.08). Moderate to severe desmoplastic reaction was 8.57 more frequent in controls χ² (1, N=51) = 12.244, p=0.001, OR=8.57 (95% CI: 2.42, 30.30). Grades 2 and 3 of actinic elastosis were significantly associated with outdoor work (χ² (1, N=51) = 33.382, p<0.001, OR=131.25 (95% CI: 13.60, 1266.37). The presence of ulceration and pigment association of tumors on the histopathological report were not significantly associated with outdoor working. Conclusion: 1. Occupational NMSC in Romania is associated with high-risk clinical features; 2. Poorly defined borders is a significant clinical high-risk factor associated with occupational UV exposure in NMSC; 3. High-risk histopathological subtypes are more frequently encountered in outdoor workers diagnosed with NMSC compared to indoor workers with no occupational UV exposure background; 4. Occupational NMSC is associated with significantly higher grades of desmoplastic reaction and of actinic elastosis compared to indoor workers.