The effects of daylight saving time clock changes on accelerometer-measured sleep duration in the UK Biobank.

We explored the effects of daylight saving time clock changes on sleep duration in a large accelerometer dataset. Our sample included UK Biobank participants (n = 11,780; aged 43-78 years) with accelerometer data for one or more days during the 2 weeks surrounding the Spring and Autumn daylight saving time transitions from October 2013 and November 2015. Between-individual t-tests compared sleep duration on the Sunday (midnight to midnight) of the clock changes with the Sunday before and the Sunday after. We also compared sleep duration on all other days (Monday-Saturday) before and after the clock changes. In Spring, mean sleep duration was 65 min lower on the Sunday of the clock changes than the Sunday before (95% confidence interval -72 to -58 min), and 61 min lower than the Sunday after (95% confidence interval -69 to -53). In Autumn, the mean sleep duration on the Sunday of the clock changes was 33 min higher than the Sunday before (95% confidence interval 27-39 min), and 38 min higher than the Sunday after (95% confidence interval 32-43 min). There was some evidence of catch-up sleep after both transitions, with sleep duration a little higher on the Monday-Friday than before, although this was less pronounced in Autumn. Future research should use large datasets with longer periods of accelerometer wear to capture sleep duration before and after the transition in the same individuals, and examine other aspects of sleep such as circadian misalignment, sleep fragmentation or daytime napping.

Evening prolonged relatively low melanopic equivalent daylight illuminance light exposure increases arousal before and during sleep without altering sleep structure.

Light can influence many psychophysiological functions beyond vision, including alertness, circadian rhythm, and sleep, namely the non-image forming (NIF) effects of light. Melanopic equivalent daylight illuminance (mel-EDI) is currently recommended as the predictor of the NIF effects of light. Although light dose is also critical for entraining and regulating circadian cycle, it is still unknown whether relatively low mel-EDI light exposure for prolonged duration in the evening would affect pre-sleep arousal and subsequent sleep. In all, 18 healthy college students (10 females, mean [standard deviation] age 21.67 [2.03] years) underwent 2 experimental nights with a 1 week interval in a simulated bedroom environment. During experimental nights, participants were either exposed to high or low mel-EDI light (73 versus 38 lx mel-EDI, 90 versus 87 photopic lx at eye level, 150 photopic lx at table level) for 3.5 h before regular bedtime, and their sleep was monitored by polysomnography. Subjective sleepiness, mood, and resting-state electroencephalography during light exposure were also investigated. Results showed no significant differences in sleep structure and sleep quality between the two light conditions, whereas 3.5 h of exposure to high versus low mel-EDI light induced marginally higher physiological arousal in terms of a lower delta but higher beta power density before sleep, as well as a lower delta power density during sleep. Moreover, participants felt happier before sleep under exposure to high versus low mel-EDI light. These findings together with the current literature suggest that evening prolonged relatively low mel-EDI light exposure may mildly increase arousal before and during sleep but affected sleep structure less.

The British Sleep Society position statement on Daylight Saving Time in the UK.

There is an ongoing debate in the United Kingdom and in other countries about whether twice-yearly changes into and out of Daylight Saving Time should be abolished. Opinions are divided about whether any abolition of Daylight Saving Time should result in permanent Standard Time, or year-long Daylight Saving Time. The British Sleep Society concludes from the available scientific evidence that circadian and sleep health are affected negatively by enforced changes of clock time (especially in a forward direction) and positively by the availability of natural daylight during the morning. Thus, our recommendation is that the United Kingdom should abolish the twice-yearly clock change and reinstate Standard Time throughout the year.

Is there an association between daylight hours and serum testosterone levels in men?

BACKGROUND: Studies assessing variability of serum testosterone levels associated with seasonal environmental factors have been contradictory. DESIGN: We assessed associations between the seasons and changes (δ) in seasonality indices and male serum total testosterone (δTT) variability. PATIENTS AND MEASUREMENTS: Data were collected in 144 men with paired serum TT samples (126 non-fasting/18 fasting) analysed at Walsall Manor Hospital, UK (52.3 degrees North). Seasonal factors (ambient temperature within 15 min of sampling, humidity, precipitation, duration of daylight on the day of sampling, monthly average ambient temperature, and precipitation) were obtained from local weather-station archives. Sign-rank test determined inter-sample differences between TT and seasonality indices. Linear regression analyses studied associations between δTT and δ seasonal indices in the total cohort and subgroups (stratified by medians of age, TT and men with paired non-fasting samples). Sign-rank determined whether serum TT differed between the seasons. RESULTS: Median inter-sample interval was 63 days. No significant inter-sample differences were evident regarding serum TT levels and seasonality indices. No associations were noted between δTT and δ seasonality indices in the total cohort and subgroups stratified by age and TT. Interestingly, δ ambient temperature (p = 0.012) and daylight duration (p = 0.032) were inversely associated with δTT in the 126 men in the non-fasting group (dependent variable). Only a small degree of the variability in the δTT was accounted by the above-mentioned independent variables. The seasons did not appear to influence serum TT values. CONCLUSIONS: No relation was shown between seasonality and serum TT in the total cohort, thus possibly eliminating a confounding variable that could affect laboratory and clinical practice. It may be that seasonal variation in length of day is too modest at this latitude to demonstrate significant associations, hence our findings are latitude specific. We suggest that further data analysis to address this question in areas with greater seasonal variation would be appropriate.

Impact of repeated short light exposures on sustained pupil responses in an fMRI environment.

Light triggers numerous non-image-forming, or non-visual, biological effects. The brain correlates of these non-image-forming effects have been investigated, notably using magnetic resonance imaging and short light exposures varying in irradiance and spectral quality. However, it is not clear whether non-image-forming responses estimation may be biased by having light in sequential blocks, for example, through a potential carryover effect of one light onto the next. We reasoned that pupil light reflex was an easy readout of one of the non-image-forming effects of light that could be used to address this issue. We characterised the sustained pupil light reflex in 13-16 healthy young individuals under short light exposures during three distinct cognitive processes (executive, emotional and attentional). Light conditions pseudo-randomly alternated between monochromatic orange light (0.16 melanopic equivalent daylight illuminance lux) and polychromatic blue-enriched white light of three different levels (37, 92, 190 melanopic equivalent daylight illuminance lux). As expected, higher melanopic irradiance was associated with larger sustained pupil light reflex in each cognitive domain. This result was stable over the light sequence under higher melanopic irradiance levels compared with lower ones. Exploratory frequency-domain analyses further revealed that sustained pupil light reflex was more variable under lower melanopic irradiance levels. Importantly, sustained pupil light reflex varied across tasks independently of the light condition, pointing to a potential impact of light history and/or cognitive context on sustained pupil light reflex. Together, our results emphasise that the distinct contribution and adaptation of the different retinal photoreceptors influence the non-image-forming effects of light and therefore potentially their brain correlates.

Developmental changes in colour constancy in a naturalistic object selection task.

When the illumination falling on a surface change, so does the reflected light. Despite this, adult observers are good at perceiving surfaces as relatively unchanging-an ability termed colour constancy. Very few studies have investigated colour constancy in infants, and even fewer in children. Here we asked whether there is a difference in colour constancy between children and adults; what the developmental trajectory is between six and 11 years; and whether the pattern of constancy across illuminations and reflectances differs between adults and children. To this end, we developed a novel, child-friendly computer-based object selection task. In this, observers saw a dragon's favourite sweet under a neutral illumination and picked the matching sweet from an array of eight seen under a different illumination (blue, yellow, red, or green). This set contained a reflectance match (colour constant; perfect performance) and a tristimulus match (colour inconstant). We ran two experiments, with two-dimensional scenes in one and three-dimensional renderings in the other. Twenty-six adults and 33 children took part in the first experiment; 26 adults and 40 children took part in the second. Children performed better than adults on this task, and their performance decreased with age in both experiments. We found differences across illuminations and sweets, but a similar pattern across both age groups. This unexpected finding might reflect a real decrease in colour constancy from childhood to adulthood, explained by developmental changes in the perceptual and cognitive mechanisms underpinning colour constancy, or differences in task strategies between children and adults. HIGHLIGHTS: Six- to 11-year-old children demonstrated better performance than adults on a colour constancy object selection task. Performance decreased with age over childhood. These findings may indicate development of cognitive strategies used to overcome automatic colour constancy mechanisms.

Summertime and the drivin' is easy? Daylight saving time and vehicle accidents.

We investigate how exogenous variation in daylight caused by Daylight Saving Time affects road safety as measured by the count of vehicle crashes. We use administrative daily data from Greece covering the universe of all types of recorded vehicle accidents during the 2006-2016 period. Our regression discontinuity estimates support an ambient light mechanism that reduces the counts of serious vehicle accidents during the Spring transition and increases the count of minor ones during the Fall transition. The effects are driven from the hour intervals that are mostly affected from seasonal clock changes. We then discuss the potential cost implications of those seasonal transitions. In light of the talks about abolishing seasonal clock changes in the European Union (EU), our findings are policy relevant and can inform the public debate as empirical evidence for the block is scarce.

The Alarm Clock Against the Sun: Trends in Google Trends Search Activity Across the Transitions to and from Daylight Saving Time.

The human circadian timing system depends on the light/dark cycle as its main cue to synchronize with the environment, and thus with solar time. However, human activities depend also on social time, i.e. the set of time conventions and restrictions dictated by society, including Daylight Saving Time (DST), which adds an hour to any degree of desynchrony between social and solar time. Here, we used Google Trends as a data source to analyze diurnal variation, if any, and the daily peak in the relative search volume of 26 Google search queries in relation to the transitions to/from DST in Italy from 2015 to 2020. Our search queries of interest fell into three categories: sleep/health-related, medication and random non sleep/health-related. After initial rhythm and phase analysis, 11 words were selected to compare the average phase of the 15 days before and after the transition to/from DST. We observed an average phase advance after the transition to DST, and a phase delay after the transition to civil time, ranging from 25 to 60 minutes. Advances or delays shorter than 60 minutes, which were primarily observed in the sleep/health-related category, may suggest that search timing for these queries is at least partially driven by the endogenous circadian rhythm. Finally, a significant trend in phase anticipation over the years was observed for virtually all words. This is most likely related to an increase in age, and thus in earlier chronotypes, amongst Google users.

Virtual Light Sensing Technology for Fast Calculation of Daylight Autonomy Metrics.

Virtual sensing technology uses mathematical calculations instead of natural measurements when the latter are too difficult or expensive. Nowadays, application of virtual light sensing technology becomes almost mandatory for daylight analysis at the stage of architectural project development. Daylight Autonomy metrics should be calculated multiple times during the project. A properly designed building can reduce the necessity of artificial lighting, thus saving energy. There are two main daylight performance metrics: Spatial Daylight Autonomy (sDA) and Annual Sunlight Exposure (ASE). To obtain their values, we have to simulate global illumination for every hour of the year. A light simulation method should therefore be as efficient as possible for processing complex building models. In this paper we present a method for fast calculation of Daylight Autonomy metrics, allowing them to be calculated within a reasonable timescale. We compared our method with straightforward calculations and other existing solutions. This comparison demonstrates good agreement; this proves sufficient accuracy and higher efficiency of the method. Our method also contains an original algorithm for the automatic setting of the sensing area. The sDA metric is calculated considering blinds control, which should open or close them depending on overexposure to direct sunlight. Thus, we developed an optimization procedure to determine the blinds configuration at any time.

Determination and Measurement of Melanopic Equivalent Daylight (D65) Illuminance (mEDI) in the Context of Smart and Integrative Lighting.

In the context of intelligent and integrative lighting, in addition to the need for color quality and brightness, the non-visual effect is essential. This refers to the retinal ganglion cells (ipRGCs) and their function, which were first proposed in 1927. The melanopsin action spectrum has been published in CIE S 026/E: 2018 with the corresponding melanopic equivalent daylight (D65) illuminance (mEDI), melanopic daylight (D65) efficacy ratio (mDER), and four other parameters. Due to the importance of mEDI and mDER, this work synthesizes a simple computational model of mDER as the main research objective, based on a database of 4214 practical spectral power distributions (SPDs) of daylight, conventional, LED, and mixed light sources. In addition to the high correlation coefficient R2 of 0.96795 and the 97% confidence offset of 0.0067802, the feasibility of the mDER model in intelligent and integrated lighting applications has been extensively tested and validated. The uncertainty between the mEDI calculated directly from the spectra and that obtained by processing the RGB sensor and applying the mDER model reached ± 3.3% after matrix transformation and illuminance processing combined with the successful mDER calculation model. This result opens the potential for low-cost RGB sensors for applications in intelligent and integrative lighting systems to optimize and compensate for the non-visual effective parameter mEDI using daylight and artificial light in indoor spaces. The goal of the research on RGB sensors and the corresponding processing method are also presented and their feasibility is methodically demonstrated. A comprehensive investigation with a huge amount of color sensor sensitivities is necessary in a future work of other research.

Improved Simulated-Daylight Photodynamic Therapy and Possible Mechanism of Ag-Modified TiO2 on Melanoma.

Simulated-daylight photodynamic therapy (SD-PDT) may be an efficacious strategy for treating melanoma because it can overcome the severe stinging pain, erythema, and edema experienced during conventional PDT. However, the poor daylight response of existing common photosensitizers leads to unsatisfactory anti-tumor therapeutic effects and limits the development of daylight PDT. Hence, in this study, we utilized Ag nanoparticles to adjust the daylight response of TiO2, acquire efficient photochemical activity, and then enhance the anti-tumor therapeutic effect of SD-PDT on melanoma. The synthesized Ag-doped TiO2 showed an optimal enhanced effect compared to Ag-core TiO2. Doping Ag into TiO2 produced a new shallow acceptor impurity level in the energy band structure, which expanded optical absorption in the range of 400-800 nm, and finally improved the photodamage effect of TiO2 under SD irradiation. Plasmonic near-field distributions were enhanced due to the high refractive index of TiO2 at the Ag-TiO2 interface, and then the amount of light captured by TiO2 was increased to induce the enhanced SD-PDT effect of Ag-core TiO2. Hence, Ag could effectively improve the photochemical activity and SD-PDT effect of TiO2 through the change in the energy band structure. Generally, Ag-doped TiO2 is a promising photosensitizer agent for treating melanoma via SD-PDT.

Pharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: A Review.

Actinic keratosis (AK) is among the most commonly diagnosed skin diseases with potentially life-threatening repercussions if left untreated. Usage of pharmacologic agents represents one of many therapeutic strategies that can be used to help manage these lesions. Ongoing research into these compounds continues to change our clinical understanding as to which agents most benefit particular patient populations. Indeed, factors such as past personal medical history, lesion location and tolerability of therapy only represent a few considerations that clinicians must account for when prescribing appropriate treatment. This review focuses on specific drugs used in either the prevention or treatment of AKs. Nicotinamide, acitretin and topical 5-fluorouracil (5-FU) continue to be used with fidelity in the chemoprevention of actinic keratosis, although some uncertainty persists in regard to which agents should be used in immunocompetent vs. immunodeficient/immunosuppressed patients. Topical 5-FU, including combination formulations with either calcipotriol or salicylic acid, as well as imiquimod, diclofenac and photodynamic light therapy are all accepted treatment strategies employed to target and eliminate AKs. Five percent of 5-FU is regarded as the most effective therapy in the condition, although the literature has conflictingly shown that lower concentrations of the drug might also be as effective. Topical diclofenac (3%) appears to be less efficacious than 5% 5-FU, 3.75-5% imiquimod and photodynamic light therapy despite its favorable side effect profile. Finally, traditional photodynamic light therapy, while painful, appears to be of higher efficacy in comparison to its more tolerable counterpart, daylight phototherapy.

Driving fatigue increases after the Spring transition to Daylight Saving Time in young male drivers: A pilot study.

The Spring transition to Daylight Saving Time (DST) has been associated with several health and road safety issues. Previous literature has focused primarily on the analysis of historical crash and hospitalization data, without investigating specific crash contributing factors, such as driving fatigue. The present study aims to uncover the effects of DST-related circadian desynchrony and sleep deprivation on driving fatigue, by means of a driving simulator experiment. Eighteen participants (all males, age range 21-30 years, mean = 24.2, SD = 2.9) completed two 50-minute trials (at one week distance, same time and same day of the week) on a monotonous highway environment, the second one taking place in the week after the Spring transition to DST. Driving fatigue was evaluated by analysing several different variables (including driving-based, physiological and subjective indices) and by comparison with a historical cohort of pertinent, matched controls who had also undergone two trials, but in the absence of any time change in between. Results showed a considerable rise in fatigue levels throughout the driving task in both trials, but with significantly poorer performance in the post-DST trial, documented by a worsening in vehicle lateral control and an increase in eyelid closure. However, participants seemed unable to perceive this decrease in their alertness, which most likely prevented them from implementing fatigue-coping strategies. These findings indicate that DST has a detrimental effect on driving fatigue in young male drivers in the week after the Spring transition, and provide valuable insights into the complex relationship between DST and road safety.

Effect of Prolonged Exposure to Short Daylight and a Tryptophan Hydroxylase Inhibitor on the Behavior and Brain Serotonin System in Danio rerio.

We studied the effect of reduced tryptophan hydroxylase (TPH) activity and short daylight exposure on the behavior and the 5-HT system of the brain in D. rerio. Male and female D. rerio were exposed for 30 days to standard (12:12 h light:dark) and short (4:20 h light:dark) photoperiods in the presence or absence of TPH inhibitor (p-chlorophenylalanine, pCPA, 5 mg/liter). On day 31, the fish behavior in the "novel tank diving" test, their sex and body weight were determined, and the levels of pCPA, 5-HT, and its metabolite 5-HIAA were measured by HPLC; the levels of the key genes encoding metabolism enzymes (Tph1a, Tph1b, Tph2, and Mao) and receptors of 5-HT (Htr1aa, Htr2aa) were assessed by real-time PCR with reverse transcription. The short daylight exposure caused masculinization of females, reduced body weight, and motor activity in the "novel tank diving" test, but did not affect the 5-HT system of the brain. Long-term pCPA treatment had no effect on sex and body weight, significantly reduced the 5-HIAA level, but increased Tph1a and Tph2 gene expression in the brain. No effects of the interaction of short daylight and pCPA exposure on the sex, body weight, behavior, and 5-HT system of the brain were found. Thus, a moderate decrease in TPH activity cannot potentiate the negative effects of short daylight exposure on the sex, body weight, behavior, and 5-HT system of D. rerio.

Estimations of the weather effects on brain functions using functional MRI: A cautionary note.

The influences of environmental factors such as weather on the human brain are still largely unknown. A few neuroimaging studies have demonstrated seasonal effects, but were limited by their cross-sectional design or sample sizes. Most importantly, the stability of the MRI scanner has not been taken into account, which may also be affected by environments. In the current study, we analyzed longitudinal resting-state functional MRI (fMRI) data from eight individuals, where they were scanned over months to years. We applied machine learning regression to use different resting-state parameters, including the amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), and functional connectivity matrix, to predict different weather and environmental parameters. For careful control, the raw EPI and the anatomical images were also used for predictions. We first found that daylight length and air temperatures could be reliably predicted with cross-validation using the resting-state parameters. However, similar prediction accuracies could also be achieved by using one frame of EPI image, and even higher accuracies could be achieved by using the segmented or raw anatomical images. Finally, the signals outside of the brain in the anatomical images and signals in phantom scans could also achieve higher prediction accuracies, suggesting that the predictability may be due to the baseline signals of the MRI scanner. After all, we did not identify detectable influences of weather on brain functions other than the influences on the baseline signals of MRI scanners. The results highlight the difficulty of studying long-term effects using MRI.

Daylight-PDT: everything under the sun.

5-Aminolevulinic acid-based photodynamic therapy (ALA-PDT) was first implemented over three decades ago and has since been mainly part of clinical practice for the management of pre-cancerous and cancerous skin lesions. Photodynamic therapy relies on the combination of a photosensitizer, light and oxygen to cause photo-oxidative damage of cellular components. 5-Aminolevulinic acid (ALA) is a natural precursor of the heme biosynthetic pathway, which when exogenously administered leads to the accumulation of the photoactivatable protoporphyrin IX. Although, effective and providing excellent cosmetic outcomes, its use has been restricted by the burning, stinging, and prickling sensation associated with treatment, as well as cutaneous adverse reactions that may be induced. Despite intense research in the realm of drug delivery, pain moderation, and light delivery, a novel protocol design using sunlight has led to some of the best results in terms of treatment response and patient satisfaction. Daylight PDT is the protocol of choice for the management of treatment of multiple or confluent actinic keratoses (AK) skin lesions. This review aims to revisit the photophysical, physicochemical and biological characteristics of ALA-PDT, and the underlying mechanisms resulting in daylight PDT efficiency and limitations.

Association of physical activity, sedentary behaviour, and daylight exposure with sleep in an ageing population: findings from the Whitehall accelerometer sub-study.

BACKGROUND: Ageing is accompanied by changes in sleep, while poor sleep is suggested as a risk factor for several health outcomes. Non-pharmacological approaches have been proposed to improve sleep in elderly; their impact remains to be investigated. The aim of this study was to examine the independent day-to-day associations of physical behaviours and daylight exposure with sleep characteristics among older adults. METHODS: Data were drawn from 3942 participants (age range: 60-83 years; 27% women) from the Whitehall II accelerometer sub-study. Day-to-day associations of objectively-assessed daytime physical behaviours (sedentary behaviour, light-intensity physical activity (LIPA), moderate-to-vigorous physical activity (MVPA), mean acceleration, physical activity chronotype) and daylight exposure (proportion of waking window with light exposure > 1000 lx and light chronotype) with sleep characteristics were examined using mixed models. RESULTS: A 10%-increase in proportion of the waking period spent sedentary was associated with 5.12-minute (4.31, 5.92) later sleep onset and 1.76-minute shorter sleep duration (95%confidence interval: 0.86, 2.66). Similar increases in LIPA and MVPA were associated with 6.69 (5.67, 7.71) and 4.15 (2.49, 5.81) earlier sleep onset respectively and around 2-minute longer sleep duration (2.02 (0.87, 3.17) and 2.23 (0.36, 4.11), respectively), although the association was attenuated for MVPA after adjustment for daylight exposure (1.11 (- 0.84, 3.06)). A 3-hour later physical activity chronotype was associated with a 4.79-minute later sleep onset (4.15, 5.43) and 2.73-minute shorter sleep duration (1.99, 3.47). A 10%-increase in proportion of waking period exposed to light> 1000 lx was associated with 1.36-minute longer sleep (0.69, 2.03), independently from mean acceleration. Associations found for sleep duration were also evident for duration of the sleep windows with slightly larger effect size (for example, 3.60 (2.37, 4.82) minutes for 10%-increase in LIPA), resulting in associations with sleep efficiency in the opposite direction (for example, - 0.29% (- 0.42, - 0.16) for 10%-increase in LIPA). Overall, associations were stronger for women than for men. CONCLUSIONS: In this study, higher levels of physical activity and daylight exposure were associated with slightly longer sleep in older adults. Given the small effect sizes of the associations, increased physical activity and daylight exposure might not be enough to improve sleep.

Saving light, losing lives: How daylight saving time impacts deaths from suicide and substance abuse.

This paper estimates the impact of Daylight Saving Time (DST) on deaths from suicide and substance abuse in the United States. Using Multiple Cause-of-Death Mortality Data from the National Vital Statistics System of the National Center for Health Statistics from 1979 to 1988, the effect is identified in two ways: a regression discontinuity design that exploits discrete time changes in the Spring and Fall; and a fixed effects model that uses a policy change and a switching mechanism that introduces random variation to DST's start and end dates. This is one of the first attempts to estimate the impact of DST on deaths due to suicide and substance abuse and the first to use either identification strategy. The results from both methods suggest that the sleep disruptions during the Spring transition cause the suicide rate to rise by 6.25 percent and the death rate from suicide and substance abuse combined to increase by 6.59 percent directly after the time change. There is no evidence for any change in these outcomes during the Fall transition. The contrasting results from Spring to Fall suggest the entire effect can be attributed to disruptions in sleep patterns rather than changes in ambient light exposure.

Fully home-based methyl aminolevulinate daylight photodynamic therapy for actinic keratosis of the face or scalp: A real life open study.

Methyl aminolevulinate daylight photodynamic therapy (MAL DL-PDT) is highly efficacious for the treatment of nonhyperkeratotic actinic keratosis (AK), even when partially performed at home. To evaluate the long-term effectiveness, safety, and patient-reported outcomes of MAL DL-PDT performed completely by the patient in real life conditions. An open prospective study was conducted in Spain among patients diagnosed with at least five AK lesions on the face or the scalp. Patients received instruction and information in infographic format to perform MAL DL-PDT at home. All had been treated with 30% urea daily for 7 days before the day of MAL DL-PDT. Meteorological conditions on the day of the treatment and adverse effects were recorded. Patients underwent follow-up, and a second session of home-based MAL DL-PDT if deemed necessary, 3, 6, and 12 months after the initial treatment session. The study population consisted of 22 patients (19 men and three women, mean [standard deviation, SD] age, 72.05 [6.96] years). A complete response was observed in 47.7% of AK lesions at 3 months (p < 0.001) and 65.9% (n = 199) at 12 months (p < 0.001). Olsen grade II lesions showed the highest rate of response (76.07% at 12 months). The mean (SD) actinic keratosis area and severity index score decreased significantly from 4.99 (2.43) at baseline to 2.33 (1.01) at 12 months (p = 0.0234). Adverse effects were mild and expected. A majority of patients were "satisfied" or "very satisfied" with the treatment instruction provided (90.9%) and the treatment outcome (72.7%). MAL DL-PDT can be applied at home like any other topical treatment for AK. Our results indicate good long-term effectiveness, a high level of patient satisfaction, and no significant side effects.

The effect of indoor daylight spectrum and intensity on viability of indoor pathogens on different surface materials.

Built environments play a key role in the transmission of infectious diseases. Ventilation rates, air temperature, and humidity affect airborne transmission while cleaning protocols, material properties and light exposure can influence viability of pathogens on surfaces. We investigated how indoor daylight intensity and spectrum through electrochromic (EC) windows can impact the growth rate and viability of indoor pathogens on different surface materials (polyvinyl chloride [PVC] fabric, polystyrene, and glass) compared to traditional blinds. Results showed that tinted EC windows let in higher energy, shorter wavelength daylight than those with clear window and blind. The growth rates of pathogenic bacteria and fungi were significantly lower in spaces with EC windows compared to blinds: nearly 100% growth rate reduction was observed when EC windows were in their clear state followed by 41%-100% reduction in bacterial growth rate and 26%-42% reduction in fungal growth rate when EC windows were in their darkest tint. Moreover, bacterial viabilities were significantly lower on PVC fabric when they were exposed to indoor light at EC-tinted window. These findings are deemed fundamental to the design of healthy modern buildings, especially those that encompass sick and vulnerable individuals.