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Wang W, Flament F, Wang H, Ye C, Jiang R, Houghton J, Liu W. Grading facial aging: Comparing the clinical assessments made by three dermatologists with those obtained by an AI-based scoring system that analyses selfie pictures. A focus on Chinese subjects of both genders. Int J Cosmet Sci 2024. [PMID: 39219096 DOI: 10.1111/ics.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/19/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE The objective of this study is to assess the correspondence, in live conditions, between clinical gradings of facial aging signs by three dermatologists and those afforded by an automatic AI-based algorithm that analyses smartphones' selfie images of Chinese subjects. METHODS In total, 125 Chinese subjects of both genders, aged 18-62y, took a selfie using their own smartphones and were immediately viewed by three dermatologists. The latter graded the severity of 15 facial signs in women and 9 in men, using the standardized values afforded by a Skin Aging Atlas referential dedicated to Asian skin. The data issued by both methodologies were then statistically compared. RESULTS The absolute gradings of the automatic system were found highly correlated with clinical assessments, with lower values in most cases. In women, large differences in absolute values were found on the gradings for size of isolated spot, cheek fold, spread macules, and texture of mouth contour women. Analysis of the Mean Absolute Errors (M.A.E) revealed that these rarely exceed 0.6 grading units in women and to a lesser extent in men. CONCLUSION The present study confirmed the value of the automatic system towards an extended use towards large human cohorts as a surrogate of clinical evaluations and allowed to detect the points where improvements must be brought to the system.
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Affiliation(s)
- Wenna Wang
- L'Oréal Research and Innovation, Shanghai, China
| | | | - Hequn Wang
- L'Oréal Research and Innovation, Shanghai, China
| | - Chengda Ye
- L'Oréal Research and Innovation, Shanghai, China
| | - Ruowei Jiang
- ModiFace - A L'Oréal Group Company, Toronto, Canada
| | | | - Wei Liu
- Department of Dermatology, The General Hospital of air Force PLA, Beijing, China
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Couteau C, Philippe A, Galharret JM, Metay E, Coiffard L. UV filters in everyday cosmetic products, a comparative study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:2976-2986. [PMID: 38079041 DOI: 10.1007/s11356-023-31330-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024]
Abstract
Today, UV filters are found as contaminants in a variety of biological fluids and environment, e.g. in vegetable crops and surface water. This is because UV filters are widely used in everyday products. In this context, we focused this study on cosmetic products, in order to assess the importance of this source of contamination. The study of 742 cosmetic products, excluding actual sunscreen products, but including hygiene, personal care and make-up products and perfumes revealed that the most common UV filters present are butyl methoxydibenzoylmethane (90 products or 12.1% of products tested), octyl methoxycinnamate (75 products or 10.1% of products tested), octocrylene (62 products or 8.3% of products tested), octyl salicylate (43 products or 5.8% of products tested) and titanium dioxide (33 products or 4.4% of products tested). Very few UV filters are found in the hygiene products (only in 12 shampoos/conditioners and in 2 shower gels) and deodorants and toothpastes are completely free of them. Conversely, make-up and perfumes are frequently formulated with at least one UV filter. Seventy-five of the two hundred and forty-four (or 30.7%) skincare products studied contained at least one UV filter. 49.1 of the makeup products studied and 74.3% of perfumes contained it.
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Affiliation(s)
- Céline Couteau
- Faculté de Pharmacie, Université de Nantes, 9 rue Bias, 44000, Nantes, France
| | - Anne Philippe
- Université de Nantes - Laboratoire de Mathématiques Jean Leray, UMR CNRS 6629, Faculté des Sciences et des Techniques, 2 rue de la Houssinière, BP 92208, 44322 cedex 3, Nantes, France
| | - Jean-Michel Galharret
- Université de Nantes - Laboratoire de Mathématiques Jean Leray, UMR CNRS 6629, Faculté des Sciences et des Techniques, 2 rue de la Houssinière, BP 92208, 44322 cedex 3, Nantes, France
| | - Emilie Metay
- Faculté de Pharmacie, Université de Nantes, 9 rue Bias, 44000, Nantes, France
| | - Laurence Coiffard
- Faculté de Pharmacie, Université de Nantes, 9 rue Bias, 44000, Nantes, France.
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Andrade LF, Hernandez LE, Mashoudy KD, Lalama MJ, Saaraswat M, Scheinkman RJ, Hu S. A Cost-Based Analysis of Anti-aging Products Across Four Major United States Retailers. Cureus 2023; 15:e46596. [PMID: 37933373 PMCID: PMC10625798 DOI: 10.7759/cureus.46596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Background In the field of aesthetic dermatology, there is currently very little data on affordability and cost analysis regarding cosmeceuticals as more demand from patients showing interest in cosmeceutical products to reduce and prevent aging continues to grow. Photoaging, a form of extrinsic aging from sun exposure, can be ameliorated by applying sunscreen and retinol products. Topical ascorbic acid and niacinamide have been shown to target the oxidative stress process that contributes to photoaging. These four products have been identified as the cosmeceutical ingredients with the most evidence-based data on photoaging prevention and treatment. Objective Given the demand for effective skin care, the paucity of data on cost differentiation, and the availability of cosmeceutical products, we analyzed the unit cost of four anti-aging products from major online and physical retailers in the United States. Such a cost comparison may facilitate more economically appropriate recommendations on skin care to consumers. Methods and materials We analyzed sunscreen, topical vitamin C (ascorbic acid), topical vitamin B3 (niacinamide), and topical vitamin A (retinol) products sold by four major United States retailers: Walmart, Ulta, Walgreens, and Amazon. The average cost in dollars per ounce (dollar/oz) was calculated for each product category at each retailer. Statistical analyses were done to determine statistical significance for each product category between retailers as well as between each category of product. Results Between the four retailers, Walmart offered the lowest cost per ounce for every product. In contrast, Amazon offered the highest cost per ounce for every product except for sunscreen. We also found that sunscreen products are less expensive per ounce as compared to retinol, ascorbic acid, and niacinamide products. Conclusion Dermatologists should be knowledgeable of product costs when providing patients with anti-aging product recommendations. Our study provides data on the financial cost by retail location of evidence-based anti-aging cosmeceuticals to better guide physicians in patient consulting and economical resource sharing.
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Affiliation(s)
- Luis F Andrade
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Loren E Hernandez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Kayla D Mashoudy
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Maria J Lalama
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Manya Saaraswat
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Ryan J Scheinkman
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Shasa Hu
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
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Young AR. The adverse consequences of not using sunscreens. Int J Cosmet Sci 2023; 45 Suppl 1:11-19. [PMID: 37799076 DOI: 10.1111/ics.12897] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/10/2023] [Indexed: 10/07/2023]
Abstract
The adverse effects of solar ultraviolet radiation (UVR) on normal skin are well established, especially in those with poorly melanized skin. Clinically, these effects may be classified as acute, such as erythema or chronic such as keratinocyte and melanocyte skin cancers. Apart from skin type genetics, clinical responses to solar UVR are dependent on geophysical (e.g., solar intensity) and behavioural factors. The latter are especially important because they may result in 'solar overload' with unwanted clinical consequences and ever greater burdens to healthcare systems. Correctly used, sunscreens can mitigate the acute and chronic effects of solar UVR exposure. Laboratory studies also show that sunscreens can inhibit the initial molecular and cellular events that are responsible for clinical outcomes. Despite public health campaigns, global trends continue to show increasing incidence of all types of skin cancer. Large-scale epidemiological studies have shown the benefits of sunscreen use in preventing skin cancer, though it is likely that sunscreen use has not been optimal in such studies. It is evident that without substantial changes in sun-seeking behaviour, sunscreen use is a very important part of the defence against the acute and chronic effects of solar exposure. Ideally, sunscreens should be able to provide the level of protection that reduces the risk of skin cancer in susceptible skin types to that observed in heavily melanized skin.
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Affiliation(s)
- Antony R Young
- St John's Institute of Dermatology, King's College London, London, UK
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Flament F, Saint-Leger D. Photoaging's portrait: The road map towards its photoprotection. Int J Cosmet Sci 2023; 45 Suppl 1:33-44. [PMID: 37638664 DOI: 10.1111/ics.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE To summarize key research published by the author's group, dealing with skin photoaging and its photoprotection. MATERIALS AND METHODS Two methodologies (standard photographs and selfies imaging) resulting from referential skin ageing atlases were applied on 2487 subjects of different ancestries, ages and gender. These aimed at first to best assess and grade the variable severities of some facial signs (texture/wrinkles, pigmentary spots, sagging and vascular disorders) that occur progressively during the photoaging process. Second, such methodologies were used to record the benefits brought by a photoprotective regimen (671 women and men). RESULTS In all studied ancestries, each facial sign show an increase severity along decades, at its own pace, some showing a linear like progression, whereas some plateau at early ages. These changes differed according to skin innate colour (phototype) and with individual behaviours vis-à-vis sun exposures, more so among European women than North-East Asian women. An effect of gender (less severe alterations) was observed on Chinese men, as compared to Chinese women. Pigmentary disorders were found hallmarks of photo-aged North-East Asian women. Globally, photoaging impact the apparent age of the different subjects. The counteracting effects of strong topical Photoprotective regimens were evidenced along a 6-month seasonality in Chinese and French women or 1-year period in Brazilian women with phototypes II to VI. Photoprotection led to a more even skin complexion among Indian subjects with pigment irregularities. CONCLUSION Two factors clearly hamper a better assessment of the efficiency of photoprotection of the sun-induced cutaneous ageing: short durations (months) of the studies with regard to the global fate of photoaging by decades and the number of studied subjects, limited to hundreds for practical reasons. The methodology based on the automatic analysis of facial signs through selfies images could theoretically bypass both factors, allowing thousands of subjects to be studied along years.
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Flament F, Mercurio DG, Catalan E, Bouhadanna E, Delaunay C, Miranda DF, Passeron T. Impact on facial skin aging signs of a 1-year standardized photoprotection over a classical skin care routine in skin phototypes II-VI individuals: A prospective randomized trial. J Eur Acad Dermatol Venereol 2023; 37:2090-2097. [PMID: 37247191 DOI: 10.1111/jdv.19230] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/11/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Data reflecting the impact of photoprotection on cutaneous aging are scarce and mostly limited to fair skin. OBJECTIVE To assess the effectiveness of a photoprotective product in counteracting the photoaging process in different skin phototypes over 1 year compared against a classical routine. MATERIALS AND METHODS Two hundred and ninety Brazilian women aged 30-65 years, with skin phototype II-VI were equally randomized in two groups. Group 1 kept on their routine whereas Group 2 applied, twice daily, a photoprotective product (SPF 60, PPD = 24.1) replacing the one they routinely used. Volunteers reported the duration of their daily sun-exposure. Standardized photographs taken at D0 and D365 were analysed by 15 dermatologists to assess eight wrinkles and pigmentation signs. RESULTS A global increase in severity was reported which was significant for Group 1. This increase was lower in Group 2 where only half the signs showed significant worsening. In Group 2 versus Group 1, the increase in forehead wrinkles, marionette lines, wrinkles created by ptosis and size of dark spot was significantly (p < 0.05) decreased by 30%-50%. CONCLUSION Daily application of a high photoprotective product significantly decreases the progression of skin aging signs after 1 year in skin phototypes II-VI.
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Affiliation(s)
- F Flament
- L'Oréal Research and Innovation, Clichy, France
| | - D G Mercurio
- L'Oréal Research and Innovation, Rio de Janeiro, Brazil
| | - E Catalan
- L'Oréal Research and Innovation, Clichy, France
| | | | - C Delaunay
- L'Oréal Research and Innovation, Clichy, France
| | | | - T Passeron
- Department of Dermatology, CHU Nice, Université Côte d'Azur, Nice, France
- INSERM, U1065, C3M, Université Côte d'Azur, Nice, France
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Fedok FG, Lighthall JG. Evaluation and Treatment Planning for the Aging Face Patient. Clin Plast Surg 2023; 50:367-380. [PMID: 37169403 DOI: 10.1016/j.cps.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Facial aging is a multifactorial process that occurs due to alterations in the skin, soft tissue, and bony skeleton. When considering treatments for the aging face and neck, a multifaceted approach targeting each of these areas should be considered. Although surgical intervention remains a key component to the holistic care of the aging face patient, a multitude of minimally invasive techniques is now available to optimize the care of the patient seeking rejuvenation. Proper patient evaluation and counseling on realistic expectations are critical and will be discussed here. A brief overview of common minimally invasive treatments will be presented.
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Affiliation(s)
- Fred G Fedok
- The Fedok Plastic Surgery and Laser Center, 113 East Fern Avenue, Foley, AL 36535, USA
| | - Jessyka G Lighthall
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, 500 University Drive H-091, Hershey, PA 17033, USA.
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Berry K, Hallock K, Lam C. Photoaging and Topical Rejuvenation. Clin Plast Surg 2023; 50:381-390. [PMID: 37169404 DOI: 10.1016/j.cps.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Photoaging is a complex process of skin changes associated with chronic ultraviolet exposure. Prevention with photoprotection and treatment with topical retinoids are the core components of a topical antiaging regimen. Other topicals such as hydroquinone, vitamin C, niacinamide, and alpha hydroxyl acid can be added based on specific concerns. However, caution must be used with some of these products as the stability and absorption are major considerations. A simple topical regimen will reduce irritability and enhance compliance.
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Affiliation(s)
- Katherine Berry
- Department of Dermatology, Penn State Health Hershey Medical Center, Hershey, PA, USA
| | - Katherine Hallock
- Department of Dermatology, Penn State Health Hershey Medical Center, Hershey, PA, USA
| | - Charlene Lam
- Department of Dermatology, Penn State Health Hershey Medical Center, Hershey, PA, USA.
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Fedok FG, Lighthall JG. Evaluation and Treatment Planning for the Aging Face Patient. Facial Plast Surg Clin North Am 2022; 30:277-290. [DOI: 10.1016/j.fsc.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Berry K, Hallock K, Lam C. Photoaging and Topical Rejuvenation. Facial Plast Surg Clin North Am 2022; 30:291-300. [DOI: 10.1016/j.fsc.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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11
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Bernerd F, Passeron T, Castiel I, Marionnet C. The Damaging Effects of Long UVA (UVA1) Rays: A Major Challenge to Preserve Skin Health and Integrity. Int J Mol Sci 2022; 23:ijms23158243. [PMID: 35897826 PMCID: PMC9368482 DOI: 10.3390/ijms23158243] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023] Open
Abstract
Within solar ultraviolet (UV) light, the longest UVA1 wavelengths, with significant and relatively constant levels all year round and large penetration properties, produce effects in all cutaneous layers. Their effects, mediated by numerous endogenous chromophores, primarily involve the generation of reactive oxygen species (ROS). The resulting oxidative stress is the major mode of action of UVA1, responsible for lipid peroxidation, protein carbonylation, DNA lesions and subsequent intracellular signaling cascades. These molecular changes lead to mutations, apoptosis, dermis remodeling, inflammatory reactions and abnormal immune responses. The altered biological functions contribute to clinical consequences such as hyperpigmentation, inflammation, photoimmunosuppression, sun allergies, photoaging and photocancers. Such harmful impacts have also been reported after the use of UVA1 phototherapy or tanning beds. Furthermore, other external aggressors, such as pollutants and visible light (Vis), were shown to induce independent, cumulative and synergistic effects with UVA1 rays. In this review, we synthetize the biological and clinical effects of UVA1 and the complementary effects of UVA1 with pollutants or Vis. The identified deleterious biological impact of UVA1 contributing to clinical consequences, combined with the predominance of UVA1 rays in solar UV radiation, constitute a solid rational for the need for a broad photoprotection, including UVA1 up to 400 nm.
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Affiliation(s)
- Françoise Bernerd
- L’Oréal Research and Innovation, 1 Avenue Eugène Schueller, 93600 Aulnay sous Bois, France;
- Correspondence: ; Tel.: +33-(0)1-48-68-95-95
| | - Thierry Passeron
- Department of Dermatology, CHU Nice, University Côte d’Azur, 151, Route de Ginestière, 06200 Nice, France;
- Research Center C3M, INSERM Unit 1065, University Côte d’Azur, 06200 Nice, France
| | - Isabelle Castiel
- L’Oréal Research and Innovation, 3 Rue Dora Maar, 93400 Saint-Ouen, France;
| | - Claire Marionnet
- L’Oréal Research and Innovation, 1 Avenue Eugène Schueller, 93600 Aulnay sous Bois, France;
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Consider using a broad-spectrum sunscreen daily to prevent photoaging. DRUGS & THERAPY PERSPECTIVES 2022. [DOI: 10.1007/s40267-022-00920-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Marionnet C, de Dormael R, Marat X, Roudot A, Gizard J, Planel E, Tornier C, Golebiewski C, Bastien P, Candau D, Bernerd F. Sunscreens with the New MCE Filter Cover the Whole UV Spectrum: Improved UVA1 Photoprotection In Vitro and in a Randomized Controlled Trial. JID INNOVATIONS 2022; 2:100070. [PMID: 35072138 PMCID: PMC8762479 DOI: 10.1016/j.xjidi.2021.100070] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 01/09/2023] Open
Abstract
Background UVA1 rays (340–400 nm) contribute to carcinogenesis, immunosuppression, hyperpigmentation, and aging. Current sunscreen formulas lack sufficient absorption in the 370–400 nm wavelengths range. Recently, a new UVA1 filter, Methoxypropylamino Cyclohexenylidene Ethoxyethylcyanoacetate (MCE) exhibiting a peak of absorption at 385 nm, was approved by the Scientific Committee on Consumer Safety for use in sunscreen products. These studies evaluated, in a three-dimensional skin model and in vivo, the protection afforded by state-of-the-art sunscreen formulations enriched with MCE. Trial design This study is a monocentric, double-blinded, randomized, and comparative trial. This study is registered at ClinicalTrials.gov with the identification number NCT04865094. Methods The efficacy of sunscreens with MCE was compared with that of reference formulas. In a three-dimensional skin model, histology, protein, and gene expression were analyzed. In the clinical trial, pigmentation was analyzed in 19 volunteers using colorimetric measurements and visual scoring. Results MCE addition in reference formulas enlarged the profile of absorption up to 400 nm; reduced UVA1-induced dermal and epidermal alterations at cellular, biochemical, and molecular levels; and decreased UVA1-induced pigmentation. Conclusions Addition of MCE absorber in sunscreen formulations leads to full coverage of UV spectrum and improved UVA1 photoprotection. The data support benefits in the long term on sun-induced consequences, especially those related to public health care issues.
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Guan LL, Lim HW, Mohammad TF. Sunscreens and Photoaging: A Review of Current Literature. Am J Clin Dermatol 2021; 22:819-828. [PMID: 34387824 PMCID: PMC8361399 DOI: 10.1007/s40257-021-00632-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 12/17/2022]
Abstract
Sunscreens have been on the market for many decades as a means of protection against ultraviolet-induced erythema. Over the years, evidence has also shown their efficacy in the prevention of photoaging, dyspigmentation, DNA damage, and photocarcinogenesis. In the USA, most broad-spectrum sunscreens provide protection against ultraviolet B (UVB) radiation and short-wavelength ultraviolet A (UVA) radiation. Evidence suggests that visible light and infrared light may play a role in photoaging and should be considered when choosing a sunscreen. Currently, there is a paucity of US FDA-approved filters that provide protection against long UVA (> 370 nm) and none against visible light. Additionally, various sunscreen additives such as antioxidants and photolyases have also been reported to protect against and possibly reverse signs of photoaging. This literature review evaluates the utility of sunscreen in protecting against photoaging and further explores the requirements for an ideal sunscreen.
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Affiliation(s)
- Linna L Guan
- Department of Dermatology, Henry Ford Health Systems, Henry Ford Medical Center-New Center One, 3031 W. Grand Boulevard, Suite 800, Detroit, MI, 48202, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health Systems, Henry Ford Medical Center-New Center One, 3031 W. Grand Boulevard, Suite 800, Detroit, MI, 48202, USA
| | - Tasneem F Mohammad
- Department of Dermatology, Henry Ford Health Systems, Henry Ford Medical Center-New Center One, 3031 W. Grand Boulevard, Suite 800, Detroit, MI, 48202, USA.
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Yanine Z, Dicker Jiménez V, Ortegón Pulido LF, Rueda Rugeles AJ, Buitrago-Medina DA. Photoaging factors in patients from two healthcare centers in Colombia. J Cosmet Dermatol 2021; 21:2984-2994. [PMID: 34633744 DOI: 10.1111/jocd.14501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/05/2021] [Accepted: 09/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Exposure to solar radiation has been documented as a direct cause of skin changes associated with aging, and its effects have been categorized as photoaging. OBJECTIVE To explore the clinical characteristics of photoaging and its relationship with external predisposing factors in a Colombian urban and rural population. METHODS We included 350 patients on outpatient consultation at Clínica Chía in Zipaquirá (rural) and Hospital Universitario Barrios Unidos in Bogotá (urban) in an observational, cross-sectional study with an analytical component included, between 2018 and 2019. A survey was conducted and photographs were taken. A group of experts determined the degree of photoaging. RESULTS The majority of respondents worked in closed environments (n = 222). The main sociodemographic variable associated was age (p = 0.000). Factors such as smoking, alcohol consumption, use of sunscreen, exercising, and sun exposure were also associated with scale progression (p < 0.05). Exercising (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.3-0.9) and being from Bogotá (OR 0.6, 95% CI 0.2-0.9) appeared as protective factors. Smoking (OR 1.6, 95% CI 1.0-2.6) was defined as a risk factor. CONCLUSIONS Changes related to photoaging and photocarcinogenesis are associated with sun exposure. However, there are environmental factors, such as smoking, alcohol consumption, sedentary lifestyle, woman's age at first delivery, and number of children, among others, that affect the degree of photoaging. It is necessary to explore these relationships in higher evidence level studies to define their causality.
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Affiliation(s)
- Zamira Yanine
- Universidad del Rosario - School of Medicine and Health Sciences, Bogotá, Colombia.,Hospital Universitario Mayor - Méderi, Bogotá, Colombia
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16
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Gilaberte Y, Mzumara TE, Manjolo SP, Kaseko N, Bagazgoitia L, Fuller LC, Soto M. Evaluation of the acceptance and efficacy of a bespoke sun protection package for persons with oculocutaneous albinism living in Malawi. Int J Dermatol 2021; 61:352-360. [PMID: 34490895 DOI: 10.1111/ijd.15793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 04/28/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Skin cancer is the main cause of death in persons with albinism (PWA) in Africa. Education would minimize sun damage. OBJECTIVE To evaluate the efficacy and acceptance of a photoprotection educative and sunscreen (Umozi Max) package designed for PWA in reducing sunburns and skin cancer. PATIENTS AND METHODS A multicenter, noncontrolled, before-and-after, interventional study was conducted in PWA > 12 years of age, from February to May, 2019, in Malawi. During the baseline and the follow-up visits (at 8 and 15 weeks), subjects received an educational program designed to PWA and use of Umozi Max. At every visit, photoprotection behavior and knowledge were checked and cutaneous lesions were recorded. Univariate and bivariate analysis were performed. RESULTS A total of 210 PWA were analyzed, 50% males, with a mean age of 24.5 (SD 11.29) years. The percentage of people using sun protective clothing increased from 80% to 100% and sunscreen from 81.9% to 99.5%. People avoiding the midday sun increased by 38.9% (P < 0.05). Participants that erroneously applied the sunscreen at night diminished from 40% to 4% (P < 0.001). Absent erythema on the face increased from 40% to 90% (P < 0.05). The percentage of patients with actinic keratoses (AK) on all locations significantly decreased during the study. All the participants preferred Umozi Max to previously used sunscreens. The satisfaction with the program was unanimous. CONCLUSION The educational program enhanced the use of all photoprotection measures, improved behaviors, and decreased the incidence of solar erythema and contributed to decreasing the incidence of new AKs.
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Affiliation(s)
- Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Zaragoza, Spain
| | | | - Sunganani P Manjolo
- Dermatovenereology officer, Dermatology department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Ndamiwe Kaseko
- Dermatovenereology officer, Dermatology department, Kamuzu Central Hospital, Lilongwe, Malawi
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17
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Passeron T, Lim HW, Goh CL, Kang HY, Ly F, Morita A, Ocampo Candiani J, Puig S, Schalka S, Wei L, Dréno B, Krutmann J. Photoprotection according to skin phototype and dermatoses: practical recommendations from an expert panel. J Eur Acad Dermatol Venereol 2021; 35:1460-1469. [PMID: 33764577 PMCID: PMC8252523 DOI: 10.1111/jdv.17242] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/10/2021] [Indexed: 12/14/2022]
Abstract
Increasing evidence on the impact of the different wavelengths of sunlight on the skin demonstrates the need for tailored recommendations of sunscreen according to skin phototype and dermatoses, which is now possible due to advances in the filters and formulations of sunscreens. A selective literature search was performed by an international expert panel, focusing on the type of sunscreen to recommend for photoaging, skin cancers, photodermatoses, pigmentary disorders and skin inflammatory disorders. Protection against ultraviolet (UV)B is especially important for light skin as there is a high risk of sunburn, DNA damage and skin cancers. Darker skin may be naturally better protected against UVB but is more prone to hyperpigmentation induced by visible light (VL) and UVA. Protection against UVA, VL and infrared A can be helpful for all skin phototypes as they penetrate deeply and cause photoaging. Long‐wave UVA1 plays a critical role in pigmentation, photoaging, skin cancer, DNA damage and photodermatoses. Adapting the formulation and texture of the sunscreen to the type of skin and dermatoses is also essential. Practical recommendations on the type of sunscreen to prescribe are provided to support the clinician in daily practice.
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Affiliation(s)
- T Passeron
- Department of Dermatology, Côte d'Azur University, Nice University Hospital Center, Nice, France.,INSERM U1065, C3M, Côte d'Azur University, Nice, France
| | - H W Lim
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - C-L Goh
- National Skin Centre, Singapore, Singapore
| | - H Y Kang
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
| | - F Ly
- Department of Dermatology, Cheikh Anta Diop Dakar University, EPS Institute of Social Hygiene, Dakar, Senegal
| | - A Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - J Ocampo Candiani
- Department of Dermatology, Medical Faculty University Hospital of Nuevo León, Monterrey, Mexico
| | - S Puig
- Melanoma Unit, Dermatology Department, Barcelona University Hospital Clinic, Barcelona, Spain
| | - S Schalka
- Medcin Skin Research Center and Biochemistry Department, Chemistry Institute of São Paulo University, São Paulo, Brazil
| | - L Wei
- Department of Dermatology, The General Hospital of Air Force PLA, Beijing, China
| | - B Dréno
- Department of Dermato-Oncology, CIC 1413, CRCINA, Nantes University Hospital Center, Nantes, France
| | - J Krutmann
- IUF Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany.,Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany
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18
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Krutmann J, Schalka S, Watson REB, Wei L, Morita A. Daily photoprotection to prevent photoaging. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 37:482-489. [PMID: 33896049 DOI: 10.1111/phpp.12688] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/10/2021] [Accepted: 04/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Extrinsic skin aging or photoaging was previously thought to be almost exclusively due to solar ultraviolet (UV) radiation. However, recent literature has described other contributing factors and clarification is thus required as to what extent and what type of daily photoprotection is needed to mitigate extrinsic skin aging. METHODS We reviewed the existing scientific evidence on daily photoprotection, and specific requirements at the product level, to prevent extrinsic skin aging. We critically reviewed the existing evidence on potential ecological and toxicological risks which might be associated with daily photoprotection. RESULTS Evidence shows that broad protection against the entire solar range of UVB, UVA, UVA1, visible light, and short infrared (IRA) is required to prevent extrinsic aging. Other exposome factors, such as air pollution and smoking, also contribute to skin aging. Daily broad-spectrum sunscreen photoprotection should thus contain antioxidant ingredients for additional benefits against UV, IRA, and pollution-induced oxidative stress as well as anti-aging active ingredients to provide clinical benefits against skin aging signs, such as wrinkles and dark spots. Broad-spectrum sunscreen containing pigments, such as iron oxide, may be required for melasma prevention. There is no conclusive clinical evidence that daily sunscreen use is unsafe or that it compromises vitamin D synthesis. CONCLUSION Daily use of broad-spectrum sunscreen containing antioxidant and anti-aging active ingredients can effectively reduce extrinsic aging.
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Affiliation(s)
- Jean Krutmann
- IUF Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany.,Medical faculty, Heinrich-Heine-University, Dusseldorf, Germany
| | - Sérgio Schalka
- Medcin Skin research Center and Biochemistry Department, Chemistry Institute of São Paulo University, São Paulo, Brazil
| | - Rachel Elizabeth Beatrice Watson
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Salford, UK.,Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Liu Wei
- Department of Dermatology, The General Hospital of Air Force PLA, Beijing, China
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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19
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Pedić L, Pondeljak N, Šitum M. Recent information on photoaging mechanisms and the preventive role of topical sunscreen products. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [DOI: 10.15570/actaapa.2020.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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Photoaging Reversibility in Asian Patients With Melasma Treated Using Picosecond Lasers With a Diffractive Lens Array: A 1-Year Prospective Observational Cohort Study. Dermatol Surg 2020; 47:e10-e14. [DOI: 10.1097/dss.0000000000002405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Sunscreens in the United States: Current Status and Future Outlook. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:355-379. [DOI: 10.1007/978-3-030-46227-7_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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22
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Memon MM, Manzoor M, Ashrafi MM, Kumar S, Ul Haq Z, Irfan S, Navid Z, Khan MA, Shahid I, Nisar M, Shaikh S, Hassan SN, Motiani V, Khan MS. Prevalence and Predictors of the Use of Sunscreen Amongst Medical Students: A Multi-center Cross-sectional Study. Cureus 2019; 11:e4926. [PMID: 31431832 PMCID: PMC6695233 DOI: 10.7759/cureus.4926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Sun exposure is a primary preventable risk factor for skin cancer. Sunscreen has been shown to reduce the risk of certain skin cancers such as squamous cell carcinoma and melanoma. We aimed to assess the prevalence and predictors of sunscreen use among medical students in Karachi. Methods A multi-center cross-sectional study was conducted among 578 students from multiple medical universities in Karachi, Pakistan. The levels of use of sunscreen were recorded using a comprehensive questionnaire consisting of 29 questions. Descriptive statistics were used and p-values less than 0.05 calculated using the chi-square test were considered significant. Results A majority (n=441, 73.9%) of the participants in this study were female students. Sunscreen use was prevalent in 415 (69.5%) participants. Female students were more aware of the risk of skin cancer from extended sun exposure (n=186, 72.4%). Sunscreen use was significantly associated with gender (p<0.001) and the propensity to get sunburned easily (p=0.001). Few (n=19, 5.0%) students reported being well-versed regarding skin cancer and its risk factors. Most participants were aware of the use of sunscreen for sunburn prevention (n=473, 79.2%), though knowledge of the additional benefits of sunscreen, such as the prevention of skin cancer (n=257, 43.0%) and aging (n=199, 33.3%), was lacking. Conclusion There is an evident lack of knowledge of the importance of sunscreen protection among medical students, particularly regarding the prevention of skin cancer and skin aging. However, an overall positive attitude was observed regarding the use of sunscreen among female students. Medical students are an imperative part of our future healthcare system and should be adequately informed on sunscreen benefits and skin cancer prevention.
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Affiliation(s)
| | | | | | - Sahlish Kumar
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Zaiyn Ul Haq
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Simra Irfan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Zunaira Navid
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Muhammad A Khan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Izza Shahid
- Internal Medicine, Ziauddin University Hospital, Karachi, PAK
| | - Maheen Nisar
- Biochemistry, Ziauddin University Hospital, Karachi, PAK
| | - Shehryar Shaikh
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Samran N Hassan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Vanita Motiani
- Internal Medicine, Ziauddin University Hospital, Karachi, PAK
| | - Maaz S Khan
- Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
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23
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Bais F, Luca RM, Bornman JF, Williamson CE, Sulzberger B, Austin AT, Wilson SR, Andrady AL, Bernhard G, McKenzie RL, Aucamp PJ, Madronich S, Neale RE, Yazar S, Young AR, de Gruijl FR, Norval M, Takizawa Y, Barnes PW, Robson TM, Robinson SA, Ballaré CL, Flint SD, Neale PJ, Hylander S, Rose KC, Wängberg SÅ, Häder DP, Worrest RC, Zepp RG, Paul ND, Cory RM, Solomon KR, Longstreth J, Pandey KK, Redhwi HH, Torikai A, Heikkilä AM. Environmental effects of ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2017. Photochem Photobiol Sci 2018; 17:127-179. [PMID: 29404558 PMCID: PMC6155474 DOI: 10.1039/c7pp90043k] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022]
Abstract
The Environmental Effects Assessment Panel (EEAP) is one of three Panels of experts that inform the Parties to the Montreal Protocol. The EEAP focuses on the effects of UV radiation on human health, terrestrial and aquatic ecosystems, air quality, and materials, as well as on the interactive effects of UV radiation and global climate change. When considering the effects of climate change, it has become clear that processes resulting in changes in stratospheric ozone are more complex than previously held. Because of the Montreal Protocol, there are now indications of the beginnings of a recovery of stratospheric ozone, although the time required to reach levels like those before the 1960s is still uncertain, particularly as the effects of stratospheric ozone on climate change and vice versa, are not yet fully understood. Some regions will likely receive enhanced levels of UV radiation, while other areas will likely experience a reduction in UV radiation as ozone- and climate-driven changes affect the amounts of UV radiation reaching the Earth's surface. Like the other Panels, the EEAP produces detailed Quadrennial Reports every four years; the most recent was published as a series of seven papers in 2015 (Photochem. Photobiol. Sci., 2015, 14, 1-184). In the years in between, the EEAP produces less detailed and shorter Update Reports of recent and relevant scientific findings. The most recent of these was for 2016 (Photochem. Photobiol. Sci., 2017, 16, 107-145). The present 2017 Update Report assesses some of the highlights and new insights about the interactive nature of the direct and indirect effects of UV radiation, atmospheric processes, and climate change. A full 2018 Quadrennial Assessment, will be made available in 2018/2019.
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Affiliation(s)
- F. Bais
- Aristotle Univ. of Thessaloniki, Laboratory of Atmospheric Physics, Thessaloniki, Greece
| | - R. M. Luca
- National Centre for Epidemiology and Population Health, Australian National Univ., Canberra, Australia
| | - J. F. Bornman
- Curtin Univ., Curtin Business School, Perth, Australia
| | | | - B. Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - A. T. Austin
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. R. Wilson
- School of Chemistry, Centre for Atmospheric Chemistry, Univ. of Wollongong, Wollongong, Australia
| | - A. L. Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State Univ., Raleigh, NC, USA
| | - G. Bernhard
- Biospherical Instruments Inc., San Diego, CA, USA
| | | | - P. J. Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - S. Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - R. E. Neale
- Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, Australia
| | - S. Yazar
- Univ. of Western Australia, Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, Australia
| | | | - F. R. de Gruijl
- Department of Dermatology, Leiden Univ. Medical Centre, Leiden, The Netherlands
| | - M. Norval
- Univ. of Edinburgh Medical School, UK
| | - Y. Takizawa
- Akita Univ. School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - P. W. Barnes
- Department of Biological Sciences and Environment Program, Loyola Univ., New Orleans, USA
| | - T. M. Robson
- Research Programme in Organismal and Evolutionary Biology, Viikki Plant Science Centre, Univ. of Helsinki, Finland
| | - S. A. Robinson
- Centre for Sustainable Ecosystem Solutions, School of Biological Sciences, Univ. of Wollongong, Wollongong, NSW 2522, Australia
| | - C. L. Ballaré
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. D. Flint
- Dept of Forest, Rangeland and Fire Sciences, Univ. of Idaho, Moscow, ID, USA
| | - P. J. Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - S. Hylander
- Centre for Ecology and Evolution in Microbial model Systems, Linnaeus Univ., Kalmar, Sweden
| | - K. C. Rose
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - S.-Å. Wängberg
- Dept Marine Sciences, Univ. of Gothenburg, Göteborg, Sweden
| | - D.-P. Häder
- Friedrich-Alexander Univ. Erlangen-Nürnberg, Dept of Biology, Möhrendorf, Germany
| | - R. C. Worrest
- CIESIN, Columbia Univ., New Hartford, Connecticut, USA
| | - R. G. Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - N. D. Paul
- Lanter Environment Centre, Lanter Univ., LA1 4YQ, UK
| | - R. M. Cory
- Earth and Environmental Sciences, Univ. of Michigan, Ann Arbor, MI, USA
| | - K. R. Solomon
- Centre for Toxicology, School of Environmental Sciences, Univ. of Guelph, Guelph, ON, Canada
| | - J. Longstreth
- The Institute for Global Risk Research, Bethesda, MD, USA
| | - K. K. Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - H. H. Redhwi
- Chemical Engineering Dept, King Fahd Univ. of Petroleum and Minerals, Dhahran, Saudi Arabia
| | - A. Torikai
- Materials Life Society of Japan, Kayabacho Chuo-ku, Tokyo, Japan
| | - A. M. Heikkilä
- Finnish Meteorological Institute R&D/Climate Research, Helsinki, Finland
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