Microneedling with a Novel, n-3-PUFA-Rich Formulation Accelerates Inflammation Resolution to Improve Skin Recovery Outcomes in Adults with Healthy Skin.

INTRODUCTION: Microneedling is a cosmetic procedure that leverages the skin's natural ability to heal in order to promote collagen formation and skin rejuvenation. To provide improved results, the technique can be combined with topical formulations. A new formulation of multiple actives, including omega-3 (n-3) polyunsaturated fatty acids (PUFAs), was designed to accelerate the resolution of inflammation and wound healing following micro-injury treatments, while enhancing the visible appearance of procedure results, including erythema, luminosity and skin texture. METHODS: In this randomised, controlled, split-face study, we examined 32 healthy female participants aged 30-70 years for 4 weeks following microneedling treatment with a novel multiple-active-ingredient formulation or conventional microneedling protocol with a hyaluronic acid control serum. Changes in skin condition were assessed by blinded clinical photography and expert evaluation. Measurements were collected at baseline, 1 h, 1 day, 7 days and 28 days post treatment. RESULTS: Significantly greater improvements in expert-assessed erythema, luminosity and skin texture were reported following application of the novel multiple-active-ingredient formulation than the hyaluronic acid control serum. This was confirmed by representative VISIA®-CR imaging. CONCLUSION: These data provide new evidence for the role of a novel multiple-active-ingredient formulation for improving skin outcomes up to 28 days following microneedling in adults with healthy skin when compared with a hyaluronic acid serum. The n-3 PUFA content of this formulation may drive accelerated inflammation resolution and wound healing alongside the complementary action of the other active ingredients, leading to the observed improvements in erythema, luminosity and skin texture.

Sleep, Activity, and Nutrition Among an Army Sample: Strengths, Deficits, and Demographic Differences.

Sleep, activity, and nutrition (SAN) are key components in overall health, and an individual's knowledge about and self-confidence to engage in healthy SAN behaviors can have an impact on their actions. This evaluation examined SAN knowledge, self-confidence, and behaviors among U.S. Army Soldiers prior to participating in a health promotion program. Baseline surveys from participating Soldiers provide evidence in this evaluation. U.S. Army Soldiers (N = 11,485) participating in a health promotion program completed surveys. Participants completed an online survey assessing SAN knowledge, self-confidence, and behaviors (among other constructs). We examined the common patterns of SAN behaviors, the associations between them, and the differences based on gender and rank. Knowledge, self-confidence, and behaviors were correlated within each of the three SAN domains. Men reported more aerobic exercise (d = .48) and more resistance training (d = .34) per week than women. Officers reported greater self-confidence in their ability to consume a post-exercise snack (i.e., refuel; d = .38), greater refueling behaviors (d = .43), greater activity knowledge (d = .33), and greater self-confidence in their ability to achieve activity goals (d ranging from .33 to .39), compared to enlisted Soldiers. Finally, greater confidence in one's ability to achieve healthy sleep correlated with getting more sleep, both during workweek (r = .56, p < .001) and weekend (r = .25, p < .001). These baseline data support the need for health promotion of SAN behaviors among these Soldiers.

Association of Early Clinical Response to Laser Rejuvenation of Photoaged Skin with Increased Lipid Metabolism and Restoration of Skin Barrier Function.

Laser resurfacing treatments for photoaged skin have improved dramatically over the past decades, but few studies have examined the molecular mechanisms underlying differences in clinical response. Seventeen white female participants with moderate-to-severe photoaging received nonablative fractional laser treatment on the face and forearm once monthly for 6 months. Biopsies for microarray analysis were performed at baseline and 7 days after facial treatment and at baseline and 1, 7, 14, and 29 days after forearm treatment in each participant, resulting in 119 total samples. Participants were stratified into fast (n = 11) and slow (n = 6) responders on the basis of the presence of clinical improvement after the first treatment. Microarray analysis revealed the upregulation of genes associated with matrix metalloproteinases, collagen and extracellular components, TGF-ß signaling, double-stranded RNA signaling, and retinoic acid synthesis after treatment that did not differ significantly between fast and slow responders. Cluster and enrichment analyses suggested significantly greater activation of lipid metabolism and keratinocyte differentiation in fast responders, who showed greater upregulation of acyltransferases, fatty acid elongases, fatty acid 2-hydroxylase, fatty acid desaturases, and specific keratins that may contribute to epidermal barrier function. These results create, to our knowledge, a previously unreported atlas of molecular changes that correlate with improvements in photoaging after laser therapy.

A consistent skin care regimen leads to objective and subjective improvements in dry human skin: investigator-blinded randomized clinical trial.

BACKGROUND: Dry, itchy skin can lower quality of life (QoL) and aggravate skin diseases. Moisturizing skin care products can have beneficial effects on dry skin. However, the role of a daily skin care routine is understudied. OBJECTIVE: To understand how daily skin care with a mild cleanser and moisturizer impacts skin health and patients' QoL, in dry skin population. METHODS: A randomized, investigator-blinded study of 52 participants with moderate to severe dry skin. The treatment group (n = 39) used mild cleanser and moisturizer twice daily for two weeks whereas the control group (n = 13) used mild cleanser without moisturizer. Total Clinical Score (TCS; erythema, scale and fissures), Visual Dryness Score (VDS) and subjective itch-related quality of life (ItchyQoL) were collected. RESULTS: The treatment group showed significantly more improvement in TCS and VDS compared to the control group after two weeks. Among the three components of the ItchyQoL (symptoms, functioning, and emotions), symptom showed significantly greater improvement in the treatment compared to the control group. Over 80% of participants in the treatment group agreed that the regimen led to decrease in dryness/pruritus and improved skin texture. CONCLUSIONS: A consistent skin care regimen should be an integral component of management of dry skin.

Role of pH in skin cleansing.

BACKGROUND: The importance of maintaining the acid-mantle of human stratum corneum to maintain its healthy barrier and skin's biological functions such as desquamation and lipid biosynthesis is well recognized in the literature. An outcome of this has been an increase in the number of skincare products formulated at or near the skin pH with an implication that a product formulated at skin pH will be good for skin. Such an assumption often does not take into account the specific interactions of ingredients in the product with the stratum corneum under skin pH conditions. OBJECTIVE: The objective of this research was to determine whether a skin cleansing product by virtue of its pH being same as "skin pH" is milder to skin. METHODS: A well established Forearm Controlled Application Test (FCAT) protocol was used in clinical studies to compare "skin pH" cleansing systems with neutral pH cleansing systems. Specifically, certain commercially available "skin pH" cleansing bars were compared with a neutral pH syndet bar in two separate FCAT studies. Since these bars differed in their surfactant composition, in a separate FCAT study, two identical prototype bar formulations differed only in their pH were compared. Additionally, two body wash liquid prototypes, identical in composition but differing only in their pH were also compared in another FCAT study. RESULTS: The results obtained showed that skin-cleansing systems formulated solely or predominantly with anionic surfactants under skin pH conditions can result in increased skin dryness and irritation compared to those under neutral pH conditions. The results are explained in terms of the increased electrostatic interaction of anionic surfactants with stratum corneum under low pH conditions compared to neutral pH conditions. CONCLUSION: Skin-cleansing systems formulated solely or predominantly with anionic surfactants under skin pH conditions can result in increased skin dryness and irritation compared to those under neutral pH conditions. Any skin cleansing product by virtue of its pH being same as that of "skin pH" does not guarantee that it will be good for skin. The mildness of a cleanser will be determined by the interactions of its surfactants and other ingredients with stratum corneum under its formulated pH conditions.

CONTEXTE: l'importance de la protection du manteau acide de la couche cornée humaine en vue de maintenir une barrière saine et les fonctions biologiques de la peau, telles que la desquamation et la biosynthèse lipidique, est bien reconnue dans la littérature médicale. Cela a eu pour résultat l'augmentation du nombre de produits cosmétiques formulés à un pH proche ou identique au pH de la peau, impliquant ainsi qu'un produit formulé au pH de la peau sera bon pour la peau. Cette hypothèse ne tient souvent pas compte des interactions spécifiques des ingrédients du produit avec la couche cornée dans des conditions de pH de la peau. OBJECTIF: l'objectif de cette recherche était de déterminer si un nettoyant pour la peau formulé à un pH identique au « pH de la peau ¼ est, pour cette raison, plus doux pour la peau. MÉTHODES: un protocole bien établi de test d'application contrôlée sur l'avant-bras (Forearm Controlled Application Test, FCAT) a été utilisé dans des études cliniques pour comparer les nettoyants à « pH de la peau ¼ et les nettoyants à pH neutre. Plus précisément, certains savons à « pH de la peau ¼ disponibles dans le commerce ont été comparés à un savon surgras à pH neutre dans deux études distinctes faisant appel au FCAT. La composition en termes d'agents de surface de ces savons étant différente, une étude distincte faisant appel au FCAT a comparé deux prototypes de savons de composition identique mais de pH différent. De plus, deux prototypes de savon liquide pour le corps, de composition identique mais de pH différent, ont également été comparés dans une autre étude faisant appel au FCAT. RÉSULTATS: les résultats obtenus ont montré que les nettoyants pour la peau formulés uniquement ou principalement avec des agents de surface anioniques dans des conditions de pH de la peau peuvent entraîner une augmentation de la sécheresse et de l'irritation cutanées, par rapport à ceux formulés dans des conditions de pH neutre. Les résultats s'expliquent par l'interaction électrostatique accrue des agents de surface anioniques avec la couche cornée dans des conditions de pH faible par rapport aux conditions de pH neutre. CONCLUSION: les nettoyants pour la peau formulés uniquement ou principalement avec des agents de surface anioniques dans des conditions de pH de la peau peuvent entraîner une augmentation de la sécheresse et de l'irritation cutanées, par rapport à ceux formulés dans des conditions de pH neutre. La formulation d'un nettoyant pour la peau à un pH identique au « pH de la peau ¼ ne garantit pas qu'il sera bon pour la peau. La douceur d'un nettoyant sera déterminée par les interactions de ses agents de surface et de ses autres ingrédients avec la couche cornée dans ses conditions de formulation en termes de pH.

Explainable AI reveals changes in skin microbiome composition linked to phenotypic differences.

Alterations in the human microbiome have been observed in a variety of conditions such as asthma, gingivitis, dermatitis and cancer, and much remains to be learned about the links between the microbiome and human health. The fusion of artificial intelligence with rich microbiome datasets can offer an improved understanding of the microbiome's role in human health. To gain actionable insights it is essential to consider both the predictive power and the transparency of the models by providing explanations for the predictions. We combine the collection of leg skin microbiome samples from two healthy cohorts of women with the application of an explainable artificial intelligence (EAI) approach that provides accurate predictions of phenotypes with explanations. The explanations are expressed in terms of variations in the relative abundance of key microbes that drive the predictions. We predict skin hydration, subject's age, pre/post-menopausal status and smoking status from the leg skin microbiome. The changes in microbial composition linked to skin hydration can accelerate the development of personalized treatments for healthy skin, while those associated with age may offer insights into the skin aging process. The leg microbiome signatures associated with smoking and menopausal status are consistent with previous findings from oral/respiratory tract microbiomes and vaginal/gut microbiomes respectively. This suggests that easily accessible microbiome samples could be used to investigate health-related phenotypes, offering potential for non-invasive diagnosis and condition monitoring. Our EAI approach sets the stage for new work focused on understanding the complex relationships between microbial communities and phenotypes. Our approach can be applied to predict any condition from microbiome samples and has the potential to accelerate the development of microbiome-based personalized therapeutics and non-invasive diagnostics.

Mental health outcomes associated with profiles of risk and resilience among U.S. Army spouses.

The current study examined patterns of risk and protective factors among military families and associations with mental health diagnoses among U.S. Army spouses. Spouses (N = 3,036) completed a survey of family psychosocial fitness, which informed protective factors including coping, family cohesion, and social support. Survey results were linked with Department of Defense archival data, which provided information on military-specific risks, including relocation, deployments, and reunification, as well as mental health care diagnoses. The three-step method of latent profile analysis identified six profiles, suggesting significant heterogeneity in military families with respect to their access to resources and exposure to risk. The largest profile of families (40.48% of the sample) had limited risk exposure and considerable strengths. Variability in risk and protection across profiles was associated with statistically significant differences in the prevalence of mental health diagnoses among spouses (χ² = 108.968, df = 5, p < .001). The highest prevalence of mental health diagnoses among Army spouses (41.2%) was observed in the profile with the lowest levels of protective factors. Findings point to the importance of evaluating both concurrent risk and protective factors. Increasing access to resources may be a fruitful avenue for prevention among military families that are struggling. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mental Health Outcomes Associated with Risk and Resilience among Military-Connected Youth.

The present study aimed to describe patterns of risk and protective factors affecting U.S. Army families and their association with mental health diagnoses among military-connected children. Wartime military service is associated with increased adverse outcomes for military-connected youth, but few studies have explored the impact of concurrent risk and access to protective factors. Using big data methods to link existing datasets, protective factors (e.g., marital and family functioning) were drawn from a voluntary survey completed by 1,630 US Army spouses. Risk factors (e.g., parent mental health, family moves, deployment) were drawn from Department of Defense (DoD) archival data. Rates of mental health diagnoses among youth were derived from DoD healthcare records. Using the three-step method of latent profile analysis, five profiles emerged with variability across risk and protective factors. The largest group (40% of the sample) had considerable protective factors and limited risk exposure. Statistically significant differences in the prevalence of mental health diagnoses among military-connected youth were observed across profiles (χ2  = 30.067, df = 4, p < .001), with the highest rates (31.1% and 30.5%) observed in the two profiles with the lowest protective factors. Findings suggest most military families are faring well and highlight the importance of a thorough assessment that evaluates both the stressors military families face and the strengths they possess.

el presente estudio tuvo como finalidad describir los patrones de riesgo y los factores protectores que afectan a las familias del Ejército de los Estados Unidos y su asociación con los diagnósticos de salud mental entre niños relacionados con los militares. El servicio militar en tiempos de guerra está asociado con mayores consecuencias adversas para los jóvenes relacionados con los militares, pero pocos estudios han analizado el efecto del riesgo simultáneo y el acceso a los factores protectores. Utilizando métodos de datos masivos para conectar conjuntos de datos existentes, se extrajeron los factores protectores (p. ej.: funcionamiento familiar y conyugal) de una encuesta voluntaria contestada por 1630 cónyuges de militares del Ejército de los Estados Unidos. Los factores de riesgo (p. ej.: la salud mental de los padres, las mudanzas familiares, las comisiones) se obtuvieron de los datos de archivo del Departamento de Defensa (DoD). Los índices de los diagnósticos de salud mental entre los jóvenes se extrajeron de los expedientes de asistencia sanitaria del DoD. Utilizando el método de tres pasos del análisis de perfiles latentes, surgieron cinco perfiles con variabilidad entre los factores de riesgo y los factores protectores. El grupo más grande (el 40% de la muestra) tuvo factores protectores considerables y una exposición a riesgos limitada. Se observaron diferencias estadísticamente significativas en la prevalencia de diagnósticos de salud mental entre los jóvenes relacionados con los militares en los perfiles (χ2 = 30.067, df = 4, p < .001), y los índices más altos (31.1% and 30.5%) se observaron en los 2 perfiles con factores protectores más bajos.Los resultados sugieren que la mayoría de las familias militares se encuentran bien y destacan la importancia de una evaluación exhaustiva que evalúe tanto los factores desencadenantes de estrés que enfrentan las familias de militares como las fortalezas que poseen.

Preliminary Psychometrics and Potential Big Data Uses of the U.S. Army Family Global Assessment Tool.

The purpose of the present study is to explore the psychometric properties of the U.S. Army's Family Global Assessment Tool (GAT), which assesses the psychosocial fitness of Army families. With data from 1,692 Army spouses, we examined the structure, reliability and validity of the GAT, using confirmatory factor analysis (CFA) and two validity studies. Fifty-three items and 9 factors were retained following CFA. This model provided a good fit, and scales demonstrated strong internal consistency. Bivariate correlations and results from a theoretically driven model provide preliminary evidence of validity. Findings support the usefulness of the GAT for measuring psychosocial fitness of Army spouses.

The Spectrum of Sensitive Skin: Considerations for Skin Care in Vulnerable Populations

Sensitive skin is a multifactorial condition, where the underlying pathology is not fully understood, and the clinical signs may not always be present or obvious. Despite this challenge, there has been recent progress to understand the different subtypes of sensitive skin, as well as new methods to measure the sensorial response that may not be obvious from visual examination. Similarly, there has been progress in understanding in the management of symptoms through skin care regimens designed for sensitive skin. The implications of this new research indicate the potential of better clinical outcomes for sensitive skin sufferers, as well as regimens more personalized to different triggers in the full spectrum of sensitive skin. J Drugs Dermatol. 2019;18(1 Suppl):s68-74

Recent Advances in Mild and Moisturizing Cleansers

Mild and moisturizing cleanser technologies, and the science underpinning them, have progressed significantly over the past decade. This includes introduction of amino-acid based milder surfactants into the cleansing arena, a deeper understanding of the roles of stratum corneum lipids and proteins in their interaction with cleanser surfactants, the role of pH in skin cleansing, and the development of improved methodologies for predicting skin irritation and drying potential of cleansers. In this paper, the recent advances in these areas as well as newer technologies are reviewed, and the future directions are outlined. J Drugs Dermatol. 2019;18(1 Suppl):s80-88

Current directions in military health-care provider resilience.

After more than a decade of war, the US military continues to place significant emphasis on psychological health and resilience. While research and programs that focus on the broader military community's resilience continue to emerge, less is known about and until recently little focus has been placed on military medical provider resilience. In this article, we review the literature on military medical provider resilience, provide an overview of the programmatic and technological advances designed to sustain and develop military medical provider resilience, and finally offer recommendations for future research.

A meta-analytic review of internalizing, externalizing, and academic adjustment among children of deployed military service members.

Parental deployment during military conflicts has the potential to impact child adjustment. As increased numbers of military Service members have children, it is critical to understand the association between military deployment and child adjustment. In order to resolve inconsistencies in the existing literature, we performed a meta-analytic review of 16 studies that report associations of military deployment with internalizing, externalizing, and academic adjustment among children. Results indicate a small association between deployment and poorer adjustment. This association varied across several features of the studies. Age moderation was such that the associations are strongest in middle childhood and weakest during adolescence. The method that adjustment was assessed also moderated this association, such that maladjustment was evident primarily with parents' reports. Study design also moderated associations, such that comparisons to civilian controls indicated associations with maladjustment, whereas comparisons to nondeployed military and prepost comparisons did not. These findings summarize the existing quantitative literature to indicate that parental deployment has a negligible association with child maladjustment and provide a foundation for future research.

Reduction of "Ashiness" in Skin of Color with a Lipid-rich Moisturizing Body Wash.

OBJECTIVES: In people with darkly pigmented skin, classified as Fitzpatrick type IV, V, or VI skin, xerosis or dry skin can be associated with a whitish coloring and a reduction in skin shininess known as "ashiness." The authors investigated whether mild and moisturizing cleansers can repair dry skin in people with type IV, V, or VI skin by improving barrier function and reducing ashiness. DESIGN: This study has a balanced, randomized, double-blind monadic design comprising two cells of approximately 30 participants per cell. PARTICIPANTS were randomly assigned to either receive the marketed directly esterified fatty isethionate-based moisturizing body wash or the marketed syndet bar for general bathing purposes for three weeks. SETTING: A clinical testing facility in Dallas, Texas. PARTICIPANTS: Healthy women with visible signs of ashy skin on their lower legs, forearms, and elbows. MEASUREMENTS: Skin assessments were performed at six defined sites and included expert visual grading of dryness, dermatologist grading of ashiness, instrumental measurements, and a self-assessment questionnaire. RESULTS: Twenty-seven participants received body wash and 28 participants received the syndet bar. Use of body wash was associated with significant improvement in transepidermal water loss and expert- and self-assessed dryness. PARTICIPANTS reported reduced ashiness at all sites after use of body wash. Similar results were seen with use of the syndet bar. CONCLUSION: In study participants with type IV, V, or VI skin, regular use of the body wash or syndet bar repaired the condition of the skin, improving barrier function and reducing visual dryness. Support of the epidermal barrier by mild and moisturizing cleansers was associated with reduced ashiness.

The impact of parental deployment on child social and emotional functioning: perspectives of school staff.

PURPOSE: Since 2001, many military families have experienced multiple and extended deployments. Little is known about the effect of parental deployment on the well-being of children, and few, if any, studies to date have engaged school staff to understand whether and how parental deployments affect the behavioral, social, and emotional outcomes of youth in the school setting. METHODS: Focus groups and semi-structured interviews were conducted with teachers, counselors, and administrative staff at schools serving children from U.S. Army families (N=148 staff). Participants were queried about the academic, behavioral, and emotional issues faced by children of deployed soldiers. Data were analyzed for themes in these areas, with attention to differences by service component (Active Component vs. Army Reserve and National Guard). RESULTS: Although some children seem to be coping well with deployment, school staff felt that children's anxiety related to parental absence, increased responsibilities at home, poor mental health of some nondeployed parents, and difficulty accessing mental health services affected the ability of other students to function well in school. CONCLUSIONS: School staff felt that parental deployment negatively affected social and emotional functioning for some children and youth, although they felt others were coping well. Future research should examine factors related to youth outcomes during parental deployment (e.g., mental health of the non-deployed parent) and assess the effects of deployment on other measures of behavior such as school engagement and academic performance.

Cleansing, moisturizing, and sun-protection regimens for normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin.

Acquiring or maintaining healthy skin requires a multifunctional approach: mild cleansing, moisturizing, and sun protection. The clinical benefits of a daily, healthy facial skin-care regimen comprising a mild cleanser and moisturizer were evaluated on normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin for a period of up to 4 weeks. Subjects with normal, healthy skin were photographed with a calibrated, high-resolution digital camera, and the average improvement in overall health was calculated using image morphing and facial averaging techniques, following a 2-week period of product application. In a second study that included subjects with self-assessed sensitive facial skin, changes in skin hydration, skin dryness, and skin sensitivity (determined by means of a lactic acid sting test and subject self-assessment) were monitored during a 3-week regimen of mild cleansing and moisturizing with products designed for sensitive skin. The third study involved dermatologist-assessed highly sensitive skin patients (mostly rosacea with an atopic background in some cases). These patients underwent a 4-week skin-care regimen involving mild cleansing and moisturizing. In all three studies, significant improvements in skin health/quality were observed by means of expert assessments, instrumental evaluations, and subjective self-assessment.