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Pellacani G, Lim HW, Stockfleth E, Sibaud V, Brugués AO, Saint Aroman M. Photoprotection: Current developments and controversies. J Eur Acad Dermatol Venereol 2024; 38 Suppl 5:12-20. [PMID: 38924160 DOI: 10.1111/jdv.19677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/16/2023] [Indexed: 06/28/2024]
Abstract
This review aimed at summarizing some of the key points that were discussed during the photoprotection session at the International Forum of Dermatology in 2022. This international conference was designed to address prominent topics of clinical dermatology in a holistic way, allowing to articulate multiple viewpoints. Therefore, this review does not claim to be exhaustive, but is instead intended to give an overview of recent developments and ongoing controversies in the field of photoprotection. Cumulative ultraviolet radiation (UVR) exposure is the major aetiological factor in the development of photoageing, photoimunosuppression and photocarcinogenesis. UVA (320-400 nm) penetrates into the dermis and damages DNA and other intracellular and acellular targets primarily by generating reactive oxygen species (ROS). It is the major contributor to photoageing, characterized by fine and coarse wrinkles, dyspigmentation and loss of elasticity. UVB (290-320 nm) is responsible for sunburns through direct damage to DNA by the formation of 6-4 cyclobutane pyrimidine dimers (CPDs) and pyrimidine 6-4 pyrimidone photoproducts. Both UVA and UVB exposure increase the risk of basal cell carcinoma, squamous cell carcinoma and melanoma. In recent years, visible light (VL; 400-700 nm) has also been implicated in the exacerbation of conditions aggravated by sun exposure such as hyperpigmentation and melasma. Photoprotection is a critical health strategy to reduce the deleterious effects of UVR and VL. Comprehensive photoprotection strategies include staying in the shade when outdoors, wearing photoprotective clothing including a wide-brimmed hat, and sunglasses, and the use of sunscreen. Due to the absorption of UV filters, the safety of sunscreens has been questioned. Newer sunscreens are becoming available with filters with absorption even beyond the UV spectrum, offering enhanced protection compared with older products. Prevention of photocarcinogenesis, sun-induced or sunlight-exacerbated hyperpigmentary conditions and drug-induced photosensitivity is an important reason for adopting comprehensive photoprotection strategies.
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Affiliation(s)
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Eggert Stockfleth
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Vincent Sibaud
- Department of Oncodermatology, Claudius Regaud Institute and University Cancer Institute Toulouse Oncopole, Toulouse, France
| | - Ariadna Ortiz Brugués
- Department of Oncodermatology, Claudius Regaud Institute and University Cancer Institute Toulouse Oncopole, Toulouse, France
- Laboratoires Dermatologiques Avène, Pierre Fabre Dermo-Cosmétique, Les Cauquillous, Lavaur, France
| | - Markéta Saint Aroman
- Medical Direction Dermo-Cosmétique & Personal Care, Pierre Fabre Group, Toulouse, France
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Artosi F, Costanza G, Di Prete M, Garofalo V, Lozzi F, Dika E, Cosio T, Diluvio L, Shumak RG, Lambiase S, Di Raimondo C, Campa S, Piscitelli P, Miani A, Bianchi L, Campione E. Epidemiological and clinical analysis of exposure-related factors in non-melanoma skin cancer: A retrospective cohort study. ENVIRONMENTAL RESEARCH 2024; 247:118117. [PMID: 38218521 DOI: 10.1016/j.envres.2024.118117] [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: 11/26/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The incidence of non-melanoma skin cancers (NMSCs) increased over last decades, probably due to environmental concerns or to the increase of frail patients with age related comorbidities. Currently, the relationship of increasing global skin cancer rates with increased ultraviolet radiations (UVRs) resulting from stratospheric ozone depletion, global warming, and air pollution from fossil-fuel combustion. AIMS We conducted a retrospective epidemiological study including 546 NMSC patients managed at the Dermatology Unit of the Tor Vergata Hospital to highlight different trends of sun exposure or different comorbidities. METHODS Descriptive and inferential statistical analyses were performed to evidence differences between continous variable and Spearman rank test for dicotomical variables. Charlson Comorbidity Index was calculated to obtain the 10-years survival rate in order to identify the mean comorbidity burden of our patients. RESULTS Considering patients with comorbidities (73.81%), actinic keratoses (AKs) was the most frequent lesion. In patients with a history of previous melanoma, basal cell carcinoma (BCC) was predominant (ANOVA test, p < 0.05) with a statistically significant correlation (rho = 0.453; p < 0.01). Squamous cell carcinoma (SCC) showed a higher rate in arterial hypertension patients, followed by the chronic heart failure and hematologic neoplasms (60%, 29.7% and 32.1%, respectively) groups. Men were more affected than women, representing 61.54% of patients. Chronic sun exposure is directly correlated with SCC rho = 0.561; p < 0.01), whereas BCC correlated with a history of sunburns (rho = 0.312; p < 0.05). CONCLUSIONS History of photo-exposition had an important role on NMSC development especially for work or recreational reasons. Sex, age, and presence of comorbidities influenced different NMSC types. BCC was more frequent in younger patients, associated with melanoma and sunburns. The presence of SCC is associated with older patients and the hypertension group. AKs were diagnosed predominantly in oldest men, with a chronic sun-exposure history, and hematologic neoplasms group.
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Affiliation(s)
- Fabio Artosi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Gaetana Costanza
- Unit of Virology, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Monia Di Prete
- Dermatopathology Laboratory, Istituti Fisioterapici Ospitalieri, Istituto San Gallicano, via Fermo Ognibene 23, 00144, Rome, Italy.
| | - Virginia Garofalo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy
| | - Flavia Lozzi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Emi Dika
- Dermatology, IRCCS Policlinico Sant'Orsola, via Massarenti 9, 40138, Bologna, Italy.
| | - Terenzio Cosio
- PhD Course Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Laura Diluvio
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Sara Lambiase
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Cosimo Di Raimondo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Serena Campa
- Italian Society of Environmental Medicine, SIMA, Italy.
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine, SIMA, Italy; University of Salento, Lecce, Italy.
| | - Alessandro Miani
- Italian Society of Environmental Medicine, SIMA, Italy; Department of Environmental Sciences and Policies, University of Milan, Milan, Italy.
| | - Luca Bianchi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Elena Campione
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
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Eggink MC, Hsieh TY, Simon F. Sustainable ENT: international collaboration is key. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00043-7. [PMID: 38580491 DOI: 10.1016/j.anorl.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 04/07/2024]
Affiliation(s)
- M C Eggink
- Department of Otorhinolaryngology, Head and Neck Surgery, AmsterdamUMC, Amsterdam, The Netherlands; YO-IFOS Sustainability Committee: "Young Otorhinolaryngologists for Sustainability".
| | - T-Y Hsieh
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America; YO-IFOS Sustainability Committee: "Young Otorhinolaryngologists for Sustainability"
| | - F Simon
- Department of Paediatric Otolaryngology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants-Malades, Paris, France; YO-IFOS Executive Board
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Ghorbani R, Hosseinzadeh S, Azari A, Taghipour N, Soleimani M, Rahimpour A, Abbaszadeh HA. The Current Status and Future Direction of Extracellular Nano-vesicles in the Alleviation of Skin Disorders. Curr Stem Cell Res Ther 2024; 19:351-366. [PMID: 37073662 DOI: 10.2174/1574888x18666230418121053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 04/20/2023]
Abstract
Exosomes are extracellular vesicles (EVs) that originate from endocytic membranes. The transfer of biomolecules and biological compounds such as enzymes, proteins, RNA, lipids, and cellular waste disposal through exosomes plays an essential function in cell-cell communication and regulation of pathological and physiological processes in skin disease. The skin is one of the vital organs that makes up about 8% of the total body mass. This organ consists of three layers, epidermis, dermis, and hypodermis that cover the outer surface of the body. Heterogeneity and endogeneity of exosomes is an advantage that distinguishes them from nanoparticles and liposomes and leads to their widespread usage in the remedy of dermal diseases. The biocompatible nature of these extracellular vesicles has attracted the attention of many health researchers. In this review article, we will first discuss the biogenesis of exosomes, their contents, separation methods, and the advantages and disadvantages of exosomes. Then we will highlight recent developments related to the therapeutic applications of exosomes in the treatment of common skin disorders like atopic dermatitis, alopecia, epidermolysis bullosa, keloid, melanoma, psoriasis, and systemic sclerosis.
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Affiliation(s)
- Raziyeh Ghorbani
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Simzar Hosseinzadeh
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezo Azari
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Taghipour
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Soleimani
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Rahimpour
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hojjat Allah Abbaszadeh
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Hearing Disorders Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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DeGrave AJ, Cai ZR, Janizek JD, Daneshjou R, Lee SI. Auditing the inference processes of medical-image classifiers by leveraging generative AI and the expertise of physicians. Nat Biomed Eng 2023:10.1038/s41551-023-01160-9. [PMID: 38155295 DOI: 10.1038/s41551-023-01160-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 12/30/2023]
Abstract
The inferences of most machine-learning models powering medical artificial intelligence are difficult to interpret. Here we report a general framework for model auditing that combines insights from medical experts with a highly expressive form of explainable artificial intelligence. Specifically, we leveraged the expertise of dermatologists for the clinical task of differentiating melanomas from melanoma 'lookalikes' on the basis of dermoscopic and clinical images of the skin, and the power of generative models to render 'counterfactual' images to understand the 'reasoning' processes of five medical-image classifiers. By altering image attributes to produce analogous images that elicit a different prediction by the classifiers, and by asking physicians to identify medically meaningful features in the images, the counterfactual images revealed that the classifiers rely both on features used by human dermatologists, such as lesional pigmentation patterns, and on undesirable features, such as background skin texture and colour balance. The framework can be applied to any specialized medical domain to make the powerful inference processes of machine-learning models medically understandable.
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Affiliation(s)
- Alex J DeGrave
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, WA, USA
- Medical Scientist Training Program, University of Washington, Seattle, WA, USA
| | - Zhuo Ran Cai
- Program for Clinical Research and Technology, Department of Dermatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Joseph D Janizek
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, WA, USA
- Medical Scientist Training Program, University of Washington, Seattle, WA, USA
| | - Roxana Daneshjou
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA.
| | - Su-In Lee
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, WA, USA.
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Ezzedine K, Bergqvist C, Baissac C, Cullell NP, Aroman MS, Taïeb C, Lim HW. Use of multiple correspondence analysis to explore associations between caregivers and sun protective habits during summer vacations. Clin Exp Dermatol 2023; 49:26-34. [PMID: 37539734 DOI: 10.1093/ced/llad260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/21/2023] [Accepted: 07/29/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Childhood exposure to ultraviolet radiation (UVR) plays an important role in the development of keratinocyte carcinomas and melanomas. Therefore, sun protective measures ought to be implemented during early childhood. Young children are largely dependent upon adult care providers in order to achieve proper sun protection. OBJECTIVES To develop effective photoprotection in children, it is necessary to understand caregivers' attitudes and knowledge about UVR exposure. This study aimed to explore the variables associated with sun protective behaviour in parents and grandparents during summer vacations. METHODS A multinational, cross-sectional study was conducted using a web-based online survey with a representative sample of parents and grandparents of children aged ≤ 12 years, who cared for their children/grandchildren for at least 2 weeks during the summer of 2021, in five countries (France, Germany, Spain, Italy and the USA). Multiple correspondence analysis (MCA) was used to explore in an unbiased way the possible relationships among all the variables and to identify specific profiles. RESULTS A total of 6190 adult participants responded to the questionnaire: 5104 parents (average age 42.0 years, 54.3% women) and 1086 grandparents (average age 64.2 years, 55.5% women). MCA allowed discrimination of two groups of respondents based on their answers: a profile with 'unprotected sun exposure habits' vs. those with 'protective sun exposure habits'. Parents fell in closer proximity to the 'unprotected sun exposure habits', and 'sunburn reported in youngest child'. Grandparents adopted more cautious behaviours than parents. Nevertheless, grandparents fell in proximity to 'having exposed the grandchild to the sun between 11 h and 17.00 h', 'not using an umbrella' and 'not using sunglasses'. CONCLUSIONS Although grandparents appear to adopt more cautious behaviours than parents, many gaps in proper sun protection behaviour were observed in both groups of caregivers.
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Affiliation(s)
- Khaled Ezzedine
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, UPEC, Créteil, France
- EA 7379 EpidermE, Université Paris-Est Créteil (UPEC), Créteil, France
| | - Christina Bergqvist
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, UPEC, Créteil, France
| | - Catherine Baissac
- Patient Centricity Department, Pharma, Dermocosmetics Care & Personal Care, Pierre Fabre, Toulouse, France
| | - Nuria Perez Cullell
- Patients & Consumers Division, Dermocosmetics Care & Personal Care, Pierre Fabre, Toulouse, France
| | - Marketa Saint Aroman
- Patients & Consumers Division, Dermocosmetics Care & Personal Care, Pierre Fabre, Toulouse, France
| | - Charles Taïeb
- Emma, Patient Priority Department, European Market Maintenance Assessment, Fontenay sous-bois, France
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health, Detroit, MI, USA
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Manne S, Wu Y, Buller D, Heckman C, Devine K, Frederick S, Solleder J, Schaefer A, Lu SE. The Effects of a Parent-Focused Social Media Intervention on Child Sun Safety: Pilot and Feasibility Study. JMIR Form Res 2023; 7:e48402. [PMID: 38064250 PMCID: PMC10746961 DOI: 10.2196/48402] [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: 04/21/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Middle childhood (ages 8-12 years) is a critical period for forming behavioral habits and reducing the risk for the development of skin cancer later in life. During this time, children develop more autonomy and spend more unsupervised time away from their parents. Professional agencies recommend that all children engage in regular sun protection behaviors and avoid the sun during peak daytime hours. Unfortunately, in middle childhood, child sun protection often declines and UV radiation exposure increases. Effective parenting involves balancing ways to encourage the child's increasing independence while providing practical assistance to ensure sun protection is implemented. OBJECTIVE The goal was to evaluate the feasibility, acceptability, and preliminary effects of Sun Safe Families, a Facebook group intervention for parents of children between 8 and 12 years of age. METHODS The team developed Facebook messages targeting parent knowledge, normative influences, sun safety barriers, planning and goal setting, confidence in implementing sun safety, communication, forming habits, and managing sun safety in risky situations. A total of 92 parents were enrolled, and the groups ran for 6 weeks. Feasibility was measured by enrollment and retention rates. Acceptability was measured by engagement in the Facebook groups. Satisfaction was assessed by a treatment evaluation. At pre- and post-intervention, parents completed measures of child sun protection, UV radiation exposure, sunburn, sun safety knowledge, child risk, barriers, sun protection self-efficacy, planning, sun safe habits, norms for child sun safety, and communication about sun safety. RESULTS Enrollment (64.3%, 92/143) and retention (94.6%, 87/92) were good. On average, participants viewed 67.6% (56.8/84) of posts, "liked" 16.4% (13.77/84) of posts, commented on 14.8% (12.43/84) of posts, and voted on 46% (6.4/14) of polls. Satisfaction was excellent. From pre- to post-intervention, there were significant increases in child sun protection, sun exposure, and sunburn (P<.01; moderate effect sizes), as well as statistically significant increases in planning and self-efficacy (P<.05) and family norms and parent communication (P<.01). CONCLUSIONS This study demonstrated high survey retention, acceptability, and satisfaction with the intervention. There were promising preliminary effects on child sun protection behaviors and parent sun protection attitudes and communication with their child. Replication with a larger sample size and a comparison condition is warranted.
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Affiliation(s)
- Sharon Manne
- Behavioral Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Yelena Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Carolyn Heckman
- Behavioral Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Katie Devine
- Behavioral Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Sara Frederick
- Behavioral Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Justin Solleder
- Behavioral Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Alexis Schaefer
- Behavioral Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Shou-En Lu
- Rutgers School of Public Health, New Brunswick, NJ, United States
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Mathes S, Lindwedel KS, Nilsen LT, Kaiser I, Pfahlberg AB, Gefeller O. Global Tanning Bed Advertising: A Comparison of Legal Regulations on Three Continents. Cancers (Basel) 2023; 15:4362. [PMID: 37686637 PMCID: PMC10486637 DOI: 10.3390/cancers15174362] [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: 08/12/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Artificial ultraviolet radiation from tanning beds has been classified as carcinogenic by the International Agency for Research on Cancer in 2009. Several countries have subsequently introduced comprehensive legislation regulating commercial indoor tanning. Specific aspects of these regulations address tanning bed advertising and information requirements for tanning bed customers, which have been previously neglected in international comparisons of indoor tanning regulations. We performed a systematic search regarding legislation on these aspects in 131 legislative units across three continents (North America, Australia/New Zealand, Europe). The legal restrictions found varied widely in type and content. In 49 legislative units we identified total (n = 8) or partial legal bans (n = 41) on advertising for indoor tanning, while 64 legislative units enacted 5regulations that necessitate the dissemination of different types of specific health information to tanning bed customers. Nearly 40% of the legislative units of the study region lacked any legislation on these issues altogether. The heterogenous results emphasize the need for an international dialogue between health authorities and governments to harmonize the regulatory framework for tanning bed advertising and information requirements to a level better protecting the public from skin cancer. Our comprehensive international comparison can serve as a starting point for such a harmonization process that may ultimately protect the public worldwide from misleading tanning bed advertising.
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Affiliation(s)
- Sonja Mathes
- Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany;
| | - Karla S. Lindwedel
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
| | - Lill Tove Nilsen
- Section for Environmental Monitoring and Radon- and UV-Protection, Norwegian Radiation and Nuclears Safety Authority, NO-1332 Østeras, Norway;
| | - Isabelle Kaiser
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
| | - Annette B. Pfahlberg
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
| | - Olaf Gefeller
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
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DeGrave AJ, Cai ZR, Janizek JD, Daneshjou R, Lee SI. Dissection of medical AI reasoning processes via physician and generative-AI collaboration. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.12.23289878. [PMID: 37292705 PMCID: PMC10246034 DOI: 10.1101/2023.05.12.23289878] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Despite the proliferation and clinical deployment of artificial intelligence (AI)-based medical software devices, most remain black boxes that are uninterpretable to key stakeholders including patients, physicians, and even the developers of the devices. Here, we present a general model auditing framework that combines insights from medical experts with a highly expressive form of explainable AI that leverages generative models, to understand the reasoning processes of AI devices. We then apply this framework to generate the first thorough, medically interpretable picture of the reasoning processes of machine-learning-based medical image AI. In our synergistic framework, a generative model first renders "counterfactual" medical images, which in essence visually represent the reasoning process of a medical AI device, and then physicians translate these counterfactual images to medically meaningful features. As our use case, we audit five high-profile AI devices in dermatology, an area of particular interest since dermatology AI devices are beginning to achieve deployment globally. We reveal how dermatology AI devices rely both on features used by human dermatologists, such as lesional pigmentation patterns, as well as multiple, previously unreported, potentially undesirable features, such as background skin texture and image color balance. Our study also sets a precedent for the rigorous application of explainable AI to understand AI in any specialized domain and provides a means for practitioners, clinicians, and regulators to uncloak AI's powerful but previously enigmatic reasoning processes in a medically understandable way.
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Affiliation(s)
- Alex J DeGrave
- Paul G. Allen School of Computer Science and Engineering, University of Washington
- Medical Scientist Training Program, University of Washington
| | - Zhuo Ran Cai
- Program for Clinical Research and Technology, Stanford University
| | - Joseph D Janizek
- Paul G. Allen School of Computer Science and Engineering, University of Washington
- Medical Scientist Training Program, University of Washington
| | - Roxana Daneshjou
- Department of Dermatology, Stanford School of Medicine
- Department of Biomedical Data Science, Stanford School of Medicine
| | - Su-In Lee
- Paul G. Allen School of Computer Science and Engineering, University of Washington
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Lim JZ, Misra SL, Gokul A, Hadden PW, Cavadino A, McGhee CNJ. Conjunctival Melanoma in Aotearoa-New Zealand: A 21-Year Analysis of Incidence and Survival. Asia Pac J Ophthalmol (Phila) 2023; 12:273-278. [PMID: 37042461 DOI: 10.1097/apo.0000000000000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/06/2023] [Indexed: 04/13/2023] Open
Abstract
PURPOSE Conjunctival melanoma (CM) is a rare and aggressive malignancy. Global studies demonstrate increased burden of disease in countries with high rates of cutaneous melanoma. There are currently no reports on CM incidence, trends, or survival within Aotearoa-New Zealand (NZ), a country with the highest global rates of cutaneous melanoma, which this study aims to address. DESIGN This was a retrospective review using the national cancer registry. METHODS Data on histologically confirmed CM diagnosed between January 1, 2000, and December 31, 2020, were obtained from the NZ Cancer Registry. Cases were identified using the International Classification of Disease, 10th edition (ICD-10) codes. Primary outcome measures were age-standardized incidence, trends, and survival. RESULTS A total of 68 CM cases were identified. There was a preponderance for females (n=40, 58.8%) and CM predominantly affected European patients (n=63, 92.6%). Median follow-up was 5.0 years [interquartile range (IQR)=2.4-9.9 y] and the median age at diagnosis was 68.5 years (IQR=57.0-79.0 y), with non-Europeans presenting at a significantly younger age [-17.3 y (95% CI: -31.3 to -3.2), P =0.019] than Europeans. The annual age-adjusted incidence(±SD) was 0.6±0.2 cases per million population per year with a stable incidence trend over 21 years. All-cause mortality was found in 28 cases (41.2%) and the median time to death was 3.76 years (IQR=2.1-5.7 y). Five-year all-cause survival and disease-specific survival was 69% and 90%, respectively. CONCLUSIONS This is the first report on CM incidence, trends, and mortality in NZ. The CM burden is in line with European and North American data, despite NZ having the highest rate of cutaneous melanoma. The incidence remained stable over 2 decades.
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Affiliation(s)
- Joevy Z Lim
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, Aotearoa-New Zealand
- Department of Ophthalmology, Auckland District Health Board, Aotearoa-New Zealand
| | - Stuti L Misra
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, Aotearoa-New Zealand
| | - Akilesh Gokul
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, Aotearoa-New Zealand
| | - Peter W Hadden
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, Aotearoa-New Zealand
- Department of Ophthalmology, Auckland District Health Board, Aotearoa-New Zealand
| | - Alana Cavadino
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, Aotearoa-New Zealand
| | - Charles N J McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, Aotearoa-New Zealand
- Department of Ophthalmology, Auckland District Health Board, Aotearoa-New Zealand
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Krishnamoorthy S, Allabasha N, Mani MK, Sarkar AK. Effect of β-cyclodextrin on benzophenones and its impact on UVR filtration of cotton fabric through ‘guest absorber—host enhancer’ mechanism. J INCL PHENOM MACRO 2023. [DOI: 10.1007/s10847-023-01184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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12
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Stump TK, Fastner S, Jo Y, Chipman J, Haaland B, Nagelhout ES, Wankier AP, Lensink R, Zhu A, Parsons B, Grossman D, Wu YP. Objectively-Assessed Ultraviolet Radiation Exposure and Sunburn Occurrence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5234. [PMID: 37047850 PMCID: PMC10094127 DOI: 10.3390/ijerph20075234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Ultraviolet radiation (UVR) exposure is the primary modifiable risk factor for melanoma. Wearable UVR sensors provide a means of quantifying UVR exposure objectively and with a lower burden than self-report measures used in most research. The purpose of this study was to evaluate the relationship between detected UVR exposure and reported sunburn occurrence. In this study, a UVR monitoring device was worn by 97 parent-child dyads during waking hours for 14 days to measure instantaneous and accumulated UVR exposure. The results showed that the participants' total UVR exposure was associated with reported sunburn after adjusting for Fitzpatrick skin type and geographic location. It was observed that one standard erythemal dose (SED) increase in the participants' daily total UVR exposure was associated with reported sunburn (an odds ratio (OR) of 1.26 with a 95% CI of 1.13 and 1.41, and p < 0.001 for parents and an OR of 1.28 with a 95% CI of 1.12 and 1.47, and p < 0.001 for children). A one-SED increase in the participants' UVR exposure from 10 am to 4 pm was also associated with reported sunburn (an OR of 1.31 with a 95% CI of 1.15 and 1.49, and p < 0.001 for parents and an OR of 1.33 with a 95% CI of 1.12 and 1.59, and p = 0.001 for children). We found that elevated UVR exposure recordings measured by the UVR sensor were associated with reported sunburn occurrence. Future directions for wearable UVR sensors may include their use as an intervention tool to support in-the-moment sunburn prevention.
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Affiliation(s)
- Tammy K. Stump
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Suzanne Fastner
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yeonjung Jo
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Elizabeth S. Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Ali P. Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Riley Lensink
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Angela Zhu
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84113, USA
| | - Bridget Parsons
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yelena P. Wu
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
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13
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Scott JJ, Johnston RS, Darby J, Blane S, Strickland M, McNoe BM. A novel skin cancer prevention strategy: Preservice teachers' perceptions of a sun safety intervention and experiences in schools. Health Promot J Austr 2023; 34:255-263. [PMID: 35833309 PMCID: PMC10084111 DOI: 10.1002/hpja.638] [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: 04/06/2022] [Accepted: 06/20/2022] [Indexed: 01/27/2023] Open
Abstract
ISSUE ADDRESSED Teachers play a vital role in developing children's sun protection routines however upskilling preservice teachers (PSTs) while at university has not yet been trialled as a targeted skin cancer prevention strategy. Hence, this study investigated PSTs perceptions and experiences of sun safety following a brief pilot intervention and placement in primary schools in Western Australia. METHODS This study used a triangulation mixed methods design. Participants (n = 161) completed a post intervention survey which was analysed quantitatively. A random sub-sample was invited to participate in focus groups (three groups, n = 21) and one-on-one interviews (n = 4). This data was transcribed and uploaded in NVIVO software for thematic analysis. RESULTS Participants felt the intervention increased their awareness of the dangers of overexposure to ultraviolet radiation (UVR) with many feeling more knowledgeable, skilled and confident to teach sun safety in school settings. Most reported clear sun safety messages in their placement schools. However, only 34.4% reported they had been briefed on the school's sun safety procedures. There was consensus among PSTs that sun protection in primary schools needs to be improved to maximise the protection of children from harmful UVR overexposure. Participants supported a need for consistent sun protection messaging across primary schools with greater emphasis on education rather than compliance management to sun protection. CONCLUSION Enhancing existing teacher education programs to include more rigorous curriculum content and pedagogical approaches to sun protection education is a novel skin cancer prevention strategy and could feasibly support PSTs self-efficacy to effectively deliver sun safety curriculum in Australian schools.
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Affiliation(s)
- Joseph J Scott
- School of Education and Tertiary Access, University of Sunshine Coast, QLD, Australia.,School of Education, Edith Cowan University, WA, Australia
| | - Robyn S Johnston
- Telethon Kids Institute and University of Western Australia, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, WA, Australia
| | - Jill Darby
- School of Medical and Health Sciences, Edith Cowan University, WA, Australia
| | - Sally Blane
- Cancer Council Western Australia, WA, Australia
| | | | - Bronwen M McNoe
- Social and Behavioural Research Unit, University of Otago, New Zealand
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14
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Raymond-Lezman JR, Riskin S. Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults. Cureus 2023; 15:e34934. [PMID: 36938200 PMCID: PMC10016731 DOI: 10.7759/cureus.34934] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/16/2023] Open
Abstract
Skin cancer is the most common cancer diagnosis worldwide. Many factors are involved in the development of skin cancers, but ultraviolet (UV) light exposure is the most modifiable. Our lifetime cumulative UV exposure may be a result of poor sun protection practices in childhood and adolescence. Modifying the attitudes and behaviors of children can be done in the classroom, at recreational activities, and at home. A review of the literature was conducted using Embase and PubMed to examine the relationship between attitudes and behaviors as they relate to sun protection strategies. Well-developed, standardized sun protection educational programs are needed to instruct children and adolescents. Individualized counseling from physicians or online programs is needed to help parents increase sun-safe standards for their children. Many young women utilize indoor tanning beds frequently, but many instructional programs increased their tanning bed usage. Time should be allotted at schools, sports practices, camps, and other outdoor activities for sunscreen reapplication. Many parents and children report the media is their primary source of information about sun safety. Media outlets may positively change attitudes and behaviors when reporting about sun safety. Parents and children need individualized programs or counseling to reduce ultraviolet (UV) exposure and increase sun protection. At-risk populations need tailored instruction, but few strategies have worked to decrease UV exposure.
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Affiliation(s)
- Jonathan R Raymond-Lezman
- Department of Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Suzanne Riskin
- Department of Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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15
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Schanknecht E, Bachari A, Nassar N, Piva T, Mantri N. Phytochemical Constituents and Derivatives of Cannabis sativa; Bridging the Gap in Melanoma Treatment. Int J Mol Sci 2023; 24:ijms24010859. [PMID: 36614303 PMCID: PMC9820847 DOI: 10.3390/ijms24010859] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Melanoma is deadly, physically impairing, and has ongoing treatment deficiencies. Current treatment regimens include surgery, targeted kinase inhibitors, immunotherapy, and combined approaches. Each of these treatments face pitfalls, with diminutive five-year survival in patients with advanced metastatic invasion of lymph and secondary organ tissues. Polyphenolic compounds, including cannabinoids, terpenoids, and flavonoids; both natural and synthetic, have emerging evidence of nutraceutical, cosmetic and pharmacological potential, including specific anti-cancer, anti-inflammatory, and palliative utility. Cannabis sativa is a wellspring of medicinal compounds whose direct and adjunctive application may offer considerable relief for melanoma suffers worldwide. This review aims to address the diverse applications of C. sativa's biocompounds in the scope of melanoma and suggest it as a strong candidate for ongoing pharmacological evaluation.
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Affiliation(s)
- Ellen Schanknecht
- The Pangenomics Lab, School of Science, RMIT University, Bundoora, VIC 3083, Australia
| | - Ava Bachari
- The Pangenomics Lab, School of Science, RMIT University, Bundoora, VIC 3083, Australia
| | - Nazim Nassar
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Terrence Piva
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Nitin Mantri
- The Pangenomics Lab, School of Science, RMIT University, Bundoora, VIC 3083, Australia
- UWA Institute of Agriculture, The University of Western Australia, Perth, WA 6009, Australia
- Correspondence:
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16
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Lergenmuller S, Rueegg CS, Perrier F, Robsahm TE, Green AC, Lund E, Ghiasvand R, Veierød MB. Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women. JAMA Dermatol 2022; 158:1367-1377. [PMID: 36197657 PMCID: PMC9535508 DOI: 10.1001/jamadermatol.2022.4053] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/31/2022] [Indexed: 01/13/2023]
Abstract
Importance To our knowledge, no study has prospectively investigated sunburn patterns over age periods from childhood to adulthood and their associations with skin cancer risk. Objective To identify lifetime trajectories of sunburns and compare the association between these trajectories and subsequent risk of cutaneous melanoma and squamous cell carcinoma (cSCC). Design, Setting, and Participants This population-based cohort study included participants from the Norwegian Women and Cancer Study, established in 1991, with follow-up through 2018. Baseline questionnaires were issued from 1991 to 2007, with follow-up questionnaires every 5 to 7 years. Data analysis was performed from March 16, 2021, to December 4, 2021. Exposures Participants reported pigmentation factors, sunbathing vacations, and indoor tanning. Annual frequencies of sunburns were reported for childhood, adolescence, and adulthood. Main Outcomes and Measures Information on cancer diagnoses, emigration, and death were obtained through linkage to the Cancer Registry of Norway using the unique personal identification number of Norwegian citizens. Results Of the 172 472 women (age range, 31-70 years) who returned questionnaires, 169 768 received questions about sunburns at study inclusion. Five classes (stable low, low-moderate-low, low to high, high to low, and stable high) of individual lifetime sunburn trajectories with similar shapes were estimated in 3 samples up to 39 years (n = 159 773), up to 49 years (n = 153 297), and up to 59 years (n = 119 170). Mean follow-up ranged from 14.3 to 19.5 years in the 3 samples, during which 1252 to 1774 women were diagnosed with incident primary melanoma and 739 to 871 women with incident primary cSCC. With hazard ratios (HRs) and 95% CIs estimated using a Cox proportional hazards model, the stable high and high to low trajectories showed statistically significant increased melanoma and cSCC risks compared with the stable low trajectory across all samples (≤39 years for stable high and high to low trajectories: melanoma: HR, 1.50 [95% CI, 1.28-1.75] and HR, 1.44 [95% CI, 1.20-1.73]; cSCC: HR, 1.51 [95% CI, 1.22-1.87] and HR, 1.47 [95% CI, 1.14-1.91]). Other trajectories showed increased risk, though generally weaker and mainly estimates that were not statistically significant. There was no statistically significant heterogeneity between melanoma and cSCC estimates. Conclusion and Relevance This cohort study showed that high sunburn frequency throughout life was associated with increased melanoma and cSCC risk. Furthermore, sunburns in childhood are especially important for subsequent risk of these skin cancers. Avoiding sunburns throughout life, in particular in childhood, is therefore crucial.
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Affiliation(s)
- Simon Lergenmuller
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Now with Department of Clinical and Registry-Based Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Corina S. Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Flavie Perrier
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E. Robsahm
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Adele C. Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Cancer Research UK Manchester and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England, United Kingdom
| | - Eiliv Lund
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
- Department of Public Health, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Marit B. Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Gao Y, Hou Q, Guo R, Ying J, Xiong J, Jiang H. Effect of Sun exposure-induced ferroptosis mechanisms on pathology and potential biological processes of primary melanoma by microarray data analysis. Front Genet 2022; 13:998792. [PMID: 36226170 PMCID: PMC9548870 DOI: 10.3389/fgene.2022.998792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: Sunlight exposure is an important environmental factor in the pathogenesis of skin cutaneous melanoma (SKCM). Ultraviolet (UV) from sunlight can cause excessive intracellular production of reactive oxygen species (ROS), resulting in damage from oxidative stress to cells. As a major iron-rich and ROS-producing organelle, mitochondria are considered as an important place for cell ferroptosis. Thus, the pathology and potential biological process of UV exposure-induced ferroptosis in the development of SKCM has aroused our strong interest.Methods: Gene expression profile datasets of melanoma cell line datasets (GSE31909) and UV-irradiated mitochondria dataset (GSE3632) were downloaded from the Gene Expression Omnibus (GEO) database, and ferroptosis-related genes were obtained from the FerrDb v2 database. After identifying the common differentially expressed genes (DEGs), comprehensive analyzes were performed, including functional annotation, protein-protein interaction (PPI) network construction, hub gene identification, and gene and tissue protein expression levels, survival analysis, and immune cell infiltration analysis.Results: A total of 14 common DEGs was identified for subsequent analyses. Seven DEGs, including PSMB4, CRELD2, CDKN2A, TIMP1, NDRG1, ATF3 and JUND, have consistent performance in mRNA and protein expression in normal skin and SKCM tissues can be regarded as a good biomarker with SKCM diagnostic effectiveness. Functional enrichment analysis results indicate that HIF-1 signaling pathway and angiogenesis involved in the pathogenesis and development of SKCM. Induction of ferroptosis in tumor cells by enhancing the function of CD8+ T cells is expected to be an effective intervention to promote tumor therapy.Conclusion: Our study reveals the pathogenesis and potential biological processes of UV exposure-induced ferroptosis in the development of SKCM, which may provide potential immunotherapy targets for SKCM treatment via tumor cell ferroptosis mechanisms.
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Affiliation(s)
| | | | | | | | | | - Hua Jiang
- *Correspondence: Jiachao Xiong, ; Hua Jiang,
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18
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Buja A, Rugge M, Damiani G, Zorzi M, De Toni C, Vecchiato A, Del Fiore P, Spina R, Baldo V, Brazzale AR, Rossi CR, Mocellin S. Sex Differences in Cutaneous Melanoma: Incidence, Clinicopathological Profile, Survival, and Costs. J Womens Health (Larchmt) 2022; 31:1012-1019. [PMID: 35076310 PMCID: PMC9299528 DOI: 10.1089/jwh.2021.0223] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: This study aims to provide a comprehensive overview of sex-related characteristics of cutaneous malignant melanoma (CMM), with special reference to its incidence, clinicopathological profile, overall survival, and treatment-related costs. Methods: This retrospective cohort study included all 1,279 CMM patients who were registered in 2015 in the Veneto Cancer Registry (a population-based registry including all 4,900,000 regional residents). The by-sex comparisons included tumor stage and site, histological subtype, and other clinical-pathological variables. A Cox regression analysis was used to test the association between sex and survival, adjusting for the main covariates. Treatment costs were calculated by linking patients with several administrative regional databases. Results: Age-specific incidence rates were significantly higher for men among people >50 years old. For men, the trunk was the most common primary site (59.3%), whereas for women the lower limbs (32.1%) were the most common primary site, followed by the trunk (31.8%), which was lower than for men (p < 0.001). At presentation, the frequency of early stage CMM was higher among women, who also featured a significantly lower risk of death (p = 0.016), after adjusting for covariates. Men also incurred higher costs for melanoma treatment in the first year after their diagnosis. Conclusions: Among younger adults, CMM was more common in women, whereas among older adults, it was more common in men. Sex also influences patients' histopathological characteristics at diagnosis. Women had better overall survival after adjusting for demographic, pathological, and clinical profiles. The costs of treatment were also lower for women with CMM.
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Affiliation(s)
- Alessandra Buja
- Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, Health Care Services and Health Promotion Evaluation, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - Massimo Rugge
- Veneto Tumor Registry, Azienda Zero, Padua, Italy
- Department of Medicine-DIMED, Pathology and Cytopathology Unit, University of Padua, Padua, Italy
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- PhD Program in Pharmacological Sciences, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Azienda Zero, Padua, Italy
| | - Chiara De Toni
- Departament of Statistical Sciences, University of Padua, Padua, Italy
| | - Antonella Vecchiato
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, IOV-IRCCS, Padua, Italy
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, IOV-IRCCS, Padua, Italy
| | - Romina Spina
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, IOV-IRCCS, Padua, Italy
| | - Vincenzo Baldo
- Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, Health Care Services and Health Promotion Evaluation, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | | | - Carlo Riccardo Rossi
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy
| | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy
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Revisiting the melanomagenic pathways and current therapeutic approaches. Mol Biol Rep 2022; 49:9651-9671. [DOI: 10.1007/s11033-022-07412-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 03/22/2022] [Indexed: 01/10/2023]
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Pauley K, Khan A, Kohlmann W, Jeter J. Considerations for Germline Testing in Melanoma: Updates in Behavioral Change and Pancreatic Surveillance for Carriers of CDKN2A Pathogenic Variants. Front Oncol 2022; 12:837057. [PMID: 35372037 PMCID: PMC8967159 DOI: 10.3389/fonc.2022.837057] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/23/2022] [Indexed: 01/13/2023] Open
Abstract
The largest proportion of hereditary melanoma cases are due to pathogenic variants (PVs) in the CDKN2A/p16 gene, which account for 20%-40% of familial melanomas and confer up to a 30%-70% lifetime risk for melanoma in individuals with these variants. In addition, PVs in the CDKN2A gene also increase risk for pancreatic cancer (~5-24% lifetime risk). Individuals with PVs in the CDKN2A gene also tend to have an earlier onset of cancer. Despite these known risks, uptake of germline testing has been limited in the past, largely due to perceptions of limited benefit for patients. Prevention recommendations have been developed for individuals with CDKN2A PVs as well the providers who care for them. On the patient level, behavioral modifications regarding melanoma prevention such as wearing sunscreen, limiting prolonged sun exposure and practicing general sun safety can help reduce risks. Germline testing can provide motivation for some individuals to adhere to these lifestyle changes. On the provider level, pancreatic cancer surveillance for individuals with CDKN2A PVs has been increasingly endorsed by expert consensus, although the efficacy of these surveillance methods remains under study. This review summarizes the updated surveillance guidelines for individuals with CDKN2A PVs and explores the impact of genetic counseling and testing in influencing behavioral changes in these individuals.
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Affiliation(s)
- Kristen Pauley
- Family Cancer Assessment Clinic, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Ambreen Khan
- Family Cancer Assessment Clinic, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Wendy Kohlmann
- Family Cancer Assessment Clinic, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Joanne Jeter
- Department of Internal Medicine, Huntsman Cancer Institute, Salt Lake City, UT, United States
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Epidemiology of melanoma: the importance of correctly reporting to the cancer registries. Eur J Cancer Prev 2022; 31:385-387. [PMID: 35307715 DOI: 10.1097/cej.0000000000000747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In Italy, few epidemiologic studies have been conducted by tracing melanoma reports directly in the electronic registers of the operating units of pathologic anatomy. The Cancer Registers of the Italian regions receive only partial and incomplete data on the diagnoses of melanoma, for this reason, the incidences are usually underestimated. Our work offers a precise picture of the epidemiologic situation of melanoma in a homogenous sample of patients residing in a geographic area traditionally considered to have a high incidence of melanoma.
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Rinonce HT, Sastri DJ, Trisnawati F, Kameswari B, Ferronika P, Irianiwati. The frequency and clinicopathological significance of NRAS mutations in primary cutaneous nodular melanoma in Indonesia. Cancer Rep (Hoboken) 2022; 5:e1454. [PMID: 34110110 PMCID: PMC8789608 DOI: 10.1002/cnr2.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Melanoma is a lethal skin malignancy with a high risk of metastasis, which prompts a need for research on treatment targets and prognostic factors. Recent studies show that the presence of neuroblastoma RAS viral oncogene homolog (NRAS) mutation can influence cell growth in melanomas. The NRAS mutation, which stimulates the mitogen-activated protein kinase (MAPK) signaling pathway, is associated with a lower survival rate. However, evidence from Indonesia population is still very rare. Further understanding of the role of NRAS mutations in Indonesian melanoma cases will be crucial in developing new management strategies for melanoma patients with NRAS mutations. AIMS To explore the frequency of NRAS mutations and their clinicopathological associations in patients with primary nodular cutaneous melanoma in Central Java and Yogyakarta, Indonesia. METHODS AND RESULTS Fifty-one paraffin-embedded tissue samples were collected from primary nodular skin melanoma cases between 2011 and 2019 from the two largest referral hospitals in Yogyakarta and Central Java, Indonesia. The NRAS mutation status was evaluated using qualitative real-time polymerase chain reaction (qRT-PCR). The association of NRAS mutation was analyzed with the following: age, gender, location, lymph node metastasis, ulceration, mitotic index, tumor-infiltrating lymphocytes (TILs), necrosis, tumor thickness, lymphovascular invasion (LVI), and tumor size. NRAS mutations were detected in 10 (19.6%) samples and predominantly observed (60%) in exon 2 (G12). These mutations were significantly correlated with lymph node metastases (p = .000); however, they were not associated with other variables analyzed in this study. CONCLUSIONS The prevalence of NRAS mutations in primary nodular cutaneous melanoma cases from Indonesia is consistent with previous studies and is significantly associated with increased lymph node metastases. However, the predominant mutation detected in exon 2 (G12) is different from previous studies conducted in other countries. This suggests that melanoma cases in Javanese people have different characteristics from other ethnicities.
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Affiliation(s)
- Hanggoro Tri Rinonce
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Deflen Jumatul Sastri
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Fita Trisnawati
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Bidari Kameswari
- Department of Anatomical Pathologydr. Soeradji Tirtonegoro HospitalKlatenCentral JavaIndonesia
| | - Paranita Ferronika
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
| | - Irianiwati
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and NursingUniversitas Gadjah Mada/ Dr. Sardjito HospitalSlemanYogyakartaIndonesia
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Site-Specific Vesicular Drug Delivery System for Skin Cancer: A Novel Approach for Targeting. Gels 2021; 7:gels7040218. [PMID: 34842689 PMCID: PMC8628733 DOI: 10.3390/gels7040218] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 12/21/2022] Open
Abstract
Skin cancer, one of the most prevalent cancers worldwide, has demonstrated an alarming increase in prevalence and mortality. Hence, it is a public health issue and a high burden of disease, contributing to the economic burden in its treatment. There are multiple treatment options available for skin cancer, ranging from chemotherapy to surgery. However, these conventional treatment modalities possess several limitations, urging the need for the development of an effective and safe treatment for skin cancer that could provide targeted drug delivery and site-specific tumor penetration and minimize unwanted systemic toxicity. Therefore, it is vital to understand the critical biological barriers involved in skin cancer therapeutics for the optimal development of the formulations. Various nanocarriers for targeted delivery of chemotherapeutic drugs have been developed and extensively studied to overcome the limitations faced by topical conventional dosage forms. A site-specific vesicular drug delivery system appears to be an attractive strategy in topical drug delivery for the treatment of skin malignancies. In this review, vesicular drug delivery systems, including liposomes, niosomes, ethosomes, and transfersomes in developing novel drug delivery for skin cancer therapeutics, are discussed. Firstly, the prevalence statistics, current treatments, and limitations of convention dosage form for skin cancer treatment are discussed. Then, the common type of nanocarriers involved in the research for skin cancer treatment are summarized. Lastly, the utilization of vesicular drug delivery systems in delivering chemotherapeutics is reviewed and discussed, along with their beneficial aspects over other nanocarriers, safety concerns, and clinical aspects against skin cancer treatment.
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Sun Exposure in Pediatric Age: Perspective of Caregivers. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111019. [PMID: 34828732 PMCID: PMC8625385 DOI: 10.3390/children8111019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/22/2021] [Accepted: 11/04/2021] [Indexed: 11/21/2022]
Abstract
Excessive sun exposure during childhood increases the risk of skin cancer. This study characterized the knowledge and attitudes of caregivers regarding exposure and sun protection of children and adolescents. One hundred and ninety-eight caregivers (38.5 ± 8.0 years) who resorted to the consultations of a Pediatrics Service or a Family Health Unit answered a questionnaire. The age of children/adolescents was 6.5 ± 5.1 years. On average, caregivers presented a high level of knowledge regarding exposure and sun protection. One hundred and twenty-six caregivers indicated that they obtained more information about sun protection on social communication, and 66% considered the information provided by healthcare professionals to be enough. One-hundred and fifteen caregivers reported that the child/adolescent was more exposed to the sun after 4 a.m., and 88% reported applying sunscreen on the beach/pool and outdoor activities. Fifty-seven percent of caregivers renewed sunscreen application on the child/adolescent every 2 h, and 94% applied a sun protection factor ≥ 50 in the child/adolescent. There was a significant association (p < 0.001) between education level and caregivers’ self-knowledge about sun protection (the higher the education, the higher the knowledge), and between the knowledge of the hour of sun exposure avoidance and the time when the child/adolescent was more exposed to the sun. This study shows that caregivers are highly knowledgeable about exposure and sun protection in children/adolescents, and their attitudes follow the general recommendations.
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Results of a Primary Skin-Cancer-Prevention Campaign in Early Childhood on Sun-Related Knowledge and Attitudes in Southern Hungary. Cancers (Basel) 2021; 13:cancers13153873. [PMID: 34359770 PMCID: PMC8345575 DOI: 10.3390/cancers13153873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/17/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Primary skin-cancer-prevention campaigns among young children are important as this is the age when individuals are developing behaviors. Our aim was to evaluate sun-protection knowledge and behavior among caregivers in daycare centers and kindergartens and to determine if educational lectures are positively influential. In daycare centers, we discovered that measures of sun protection (e.g., hat, sunscreen, and shaded areas) are more likely to be available when compared to kindergartens. Knowledge regarding sun safety has improved following our initial presentation, however, not significantly. Sun safety policies did not exist in any of the facilities, presenting an urgent need for their implementation. Abstract Avoidance of ultraviolet (UV) exposure in early childhood is important for reducing the lifetime risk of developing skin cancer. The goal of the present prospective, multicenter pilot study was to assess the sun-protection practices in kindergartens and daycare centers and to evaluate sun protection knowledge and behavior among caregivers employed in the surveyed facilities. The study consisted of two parts. A baseline questionnaire was completed by the caregivers in relation to knowledge regarding basic sun protection and sun protection practices of the participating facilities. Afterward, a thirty-minute presentation was hosted in reference to this topic. Six months following the presentation, a follow-up questionnaire was distributed among the caregivers, evaluating the attitude-related and behavioral changes towards children. A total of 153 caregivers from five daycare centers (children between 6 months and 3 years of age) and sixteen kindergartens (children between 3 and 7 years of age) willfully participated in our study. According to our results, the main source of information regarding sun protection originated from different types of media. We found that staying in shaded areas and the use of protective clothing were not frequent in the facilities. Following our presentation regarding skin types and sunscreen use, protective measures improved, but not significantly (p = 0.222). The majority (92.31%) of caregivers distributed the information throughout their environment and also to parents. Sun protection knowledge is necessary; however, motivation among caregivers and parents and involvement of children is also relevant. Hence, a continuous, repetitive educational program regarding sun-smart behavior is deemed essential.
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Cluster Randomized Trial: Sun Protection Intervention 'Clever in Sun and Shade for Preschools'-Effectiveness and Dissemination. CHILDREN-BASEL 2021; 8:children8080651. [PMID: 34438542 PMCID: PMC8391804 DOI: 10.3390/children8080651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 11/22/2022]
Abstract
Skin cancer is one of the most common types of cancer and UV radiation is one of the main risk factors. Therefore, sun protection, especially in childhood, is strongly recommended. We examined the effectiveness of the ‘Clever in Sun and Shade for Preschools’ program (CLEVER) in promoting sun protection behavior among preschool staff (trial registration: DRKS00023468) and describe its dissemination. Within a cluster randomized trial with 24 preschools (n = 273 staff members) stating a high need for sun protection measures, an educational workshop for preschool staff and a project kit with materials applicable in preschool groups was provided. Staff members of preschools taking part in CLEVER report significantly stronger sun protection behavior to avoid the sun (effect size [ES] 0.70, 95% confidence interval [CI] 0.04 0.71, p < 0.05) and less perceived impediments to avoid the sun (ES −0.56, CI −0.82 −0.17, p < 0.01) after 12 months as well as higher self-efficacy to avoid the sun (ES 1.09, CI 0.39 1.07, p < 0.001) and to use sunscreen (ES 0.71, CI 0.03 0.88, p < 0.05) after 1 month. Compared to the control group, there was no significant effect on sunscreen use and further psychosocial outcomes. The effectiveness of CLEVER may be underrated due to a high drop-out rate. Within three years, an enhanced free-of-charge program kit, including a media-based workshop and materials, had reached over 4000 preschools, i.e., 7.1% of all daycare centers in Germany. The results show that CLEVER can strengthen sun protection, offer high-quality information at low cost, and is easily disseminable.
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Vanos JK, Rykaczewski K, Middel A, Vecellio DJ, Brown RD, Gillespie TJ. Improved methods for estimating mean radiant temperature in hot and sunny outdoor settings. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:967-983. [PMID: 33909138 DOI: 10.1007/s00484-021-02131-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/01/2021] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
Thermal comfort research has utilized various sensors and models to estimate the mean radiant temperature (MRT) experienced by a human, including the standard black globe thermometer (SGT), acrylic globe thermometers (AGT), and cylindrical radiation thermometers (CRT). Rather than directly measuring radiation, a temperature is measured in the center of these low-cost sensors that can be related to MRT after theoretically accounting for convection. However, these sensors have not been systematically tested under long-term hot and clear conditions. Further, under variable weather conditions, many issues can arise due to slow response times, shape, inaccuracies in material properties and assumptions, and color (albedo, emissivity) inconsistencies. Here, we assess the performance of MRT produced by various heat transfer models, with and without new average surface temperature ([Formula: see text]) correction factors, using five instruments-the SGT (15 cm, black), tan and black CRTs, gray and black 38 mm AGTs-compared to 3D integral radiation measurements. Measurements were taken on an unobscured roof throughout summer-to-early-fall months in Tempe, Arizona, examining 58 full-sun days. Deviations without correcting for asymmetrical surface heating-found to be the main cause of errors-reached ± 15-20 °C MRT. By accounting for asymmetric heating through [Formula: see text] calculations, new corrective algorithms were derived for the low-cost sensor models. Results show significant improvements in the estimated MRT error for each sensor (i.e., ∆MRTmodel - IRM) when applying the [Formula: see text] corrections. The tan MRTCRT improved from 1.9 ± 6.2 to -0.1 ± 4.4 °C, while the gray AGT and SGT showed improvements from -1.6 ± 7.2 to -0.4 ± 6.3 °C and - 6.6 ± 6.4 to - 0.03 ± 5.7 °C, respectively. The new corrections also eliminated dependence on other meteorological factors (zenith, wind speed). From these results, we provide three simple equations for CRT, AGT, and SGT correction for future research use under warm-hot and clear conditions. This study is the most comprehensive empirical assessment of various low-cost instruments with broad applicability in urban climate and biometeorological research.
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Affiliation(s)
- Jennifer K Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA.
| | - Konrad Rykaczewski
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Ariane Middel
- School of Arts, Media and Engineering, Herberger Institute for Design and the Arts, Arizona State University, Tempe, AZ, USA
| | - Daniel J Vecellio
- Department of Geography, Texas A&M University, College Station, TX, USA
| | - Robert D Brown
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Terry J Gillespie
- School of Environmental Sciences, University of Guelph, Guelph, Ontario, Canada
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Abstract
Malignant melanoma is a neoplasm originating in the melanocytes in the skin. Although malignant melanoma is the third most common cutaneous cancer, it is recognized as the main cause of skin cancer-related mortality, and its incidence is rising. The natural history of malignant melanoma involves an inconsistent and insidious skin cancer with great metastatic potential. Increased ultra-violet (UV) skin exposure is undoubtedly the greatest risk factor for developing cutaneous melanoma; however, a plethora of risk factors are now recognized as causative. Moreover, modern oncology now considers melanoma proliferation a complex, multifactorial process with a combination of genetic, epigenetic, and environmental factors all known to be contributory to tumorgenesis. Herein, we wish to outline the epidemiological, molecular, and biological processes responsible for driving malignant melanoma proliferation.
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Affiliation(s)
| | - Nicola Miller
- Surgery, National University of Ireland Galway, Galway, IRL
| | - Niall M McInerney
- Plastic, Aesthetic, and Reconstructive Surgery, Galway University Hospitals, Galway, IRL
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Dulskas A, Cerkauskaite D, Vincerževskiene I, Urbonas V. Trends in Incidence and Mortality of Skin Melanoma in Lithuania 1991-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084165. [PMID: 33920754 PMCID: PMC8071109 DOI: 10.3390/ijerph18084165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 01/12/2023]
Abstract
Background. We aimed to investigate age-specific and sex-specific incidence trends of melanoma in Lithuania from 1991 to 2015. Methods. Analysis was based on data from the population-based Lithuanian Cancer Registry database for 1991–2015, and 6024 cases of skin melanoma were identified. Age-adjusted rates (ASRs) by sex and age group were calculated. Adjustment for ASRs was done using the old European standard population, where a total of three age groups were considered: 0–39, 40–59 and 60+. Additionally, the annual percent change (APC) was calculated, and 95% confidence intervals for APC were calculated. Results. Between 1991 and 2015, the overall melanoma rates increased by an annual percent change (APC) of 3.9% in men (95% CI, 3.6–4.1%) and 2.3% in women (95% CI, 2.1–2.5%). The highest incidences of new cutaneous melanoma cases were observed between old adults (60+) of both sexes, while the lowest incidence rates were observed in the young adult group (up to 39 years old), with the lowest APC (1.6% in males and 0.4% in females). The overall number of melanoma deaths during 1991 and 2015 increased from 64 to 103 deaths per year, and the age-standardized rate (ASR) increased 1.3 times (from 1.8 to 2.4). Conclusions. The incidence and mortality of skin melanoma seem to be increased in all age groups. These trends indicate that skin protection behavior is not sufficient in our population and more efforts need to be taken in order to decrease incidence and mortality rates.
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Affiliation(s)
- Audrius Dulskas
- Department of Abdominal and General Surgery and Oncology, National Cancer Institute, 1 Santariskiu Str., LT-08406 Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, M. K. Ciurlionio Str. 21, LT-03101 Vilnius, Lithuania
- Correspondence: ; Tel.: +37-067520094
| | - Dovile Cerkauskaite
- Faculty of Medicine, Lithuanian University of Health Sciences, 9 A. Mickeviciaus Str., LT-44307 Kaunas, Lithuania;
| | - Ieva Vincerževskiene
- Laboratory of Clinical Oncology, National Cancer Institute, LT-08406 Vilnius, Lithuania; (I.V.); (V.U.)
| | - Vincas Urbonas
- Laboratory of Clinical Oncology, National Cancer Institute, LT-08406 Vilnius, Lithuania; (I.V.); (V.U.)
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Thoonen K, van Osch L, Drittij R, de Vries H, Schneider F. A Qualitative Exploration of Parental Perceptions Regarding Children's Sun Exposure, Sun Protection, and Sunburn. Front Public Health 2021; 9:596253. [PMID: 33681123 PMCID: PMC7930008 DOI: 10.3389/fpubh.2021.596253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/21/2021] [Indexed: 11/13/2022] Open
Abstract
Sun protection among children is of utmost importance since sunburn in early life is a major risk factor for skin cancer development. Because parents play a vital role in enhancing sun safety among children, this study explored parental perceptions concerning sun exposure, sun protection behaviors, and sunburn in children. Additionally, the context in which children experience sunburn in order to assist the development, optimization, and targeting of sun safety interventions for parents is revealed. A qualitative study design, using a semi-structured interview guide addressing several themes (e.g., sun exposure, sun protection, and sunburn experiences), was used. Data were collected in the Netherlands in the fall of 2019. Parents were recruited via purposive sampling at schools, youth services centers, and social media. Execution, transcription, and coding of the interviews was done by two researchers, using the qualitative analyzing program Nvivo (interrater reliability of d = 0.84). In total, 26 interviews were performed (n = 17 mothers, n = 17 daughters, aged between 4 and 11 years). Parental perceptions and recall of their child's lifetime sunburn were frequent, even though all parents reported using at least one sun protection measure during sun exposure situations and parents seemed often unaware of their child's sunburn. Moreover, parents reported an overreliance on sunscreen, often failing to adequately protect their children's skin. Water-related activities, a lack of shade, and misconceptions regarding UV-index were often related to sunburn. In addition, unexpected sun exposure or longer exposure duration than initially planned were reported as challenging situations. The majority of parents had positive perceptions regarding tanned skin for both themselves as for children. This study provides directions for skin cancer prevention efforts targeted at both parents and their children. Since a lack of knowledge regarding sufficient sun protection measures and sunburn occurrence in various situations was reported, educational efforts are warranted. Additionally, focusing on clothing, shade-seeking, and adequate sunscreen use is recommended to increase children's sun safety. By intervening in the physical environment as well (e.g., providing shady areas), sun protection barriers can be reduced. Lastly, the general positive attitude toward tanned skin evident in this study is certainly worthy of attention in future interventions.
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Affiliation(s)
- Karlijn Thoonen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Liesbeth van Osch
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Rowan Drittij
- Faculty of Health, Medicine and Life Sciences, Health Sciences Master, Health Education and Promotion, Maastricht University, Maastricht, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Francine Schneider
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Huang X, Chalmers AN. Review of Wearable and Portable Sensors for Monitoring Personal Solar UV Exposure. Ann Biomed Eng 2021; 49:964-978. [PMID: 33432511 DOI: 10.1007/s10439-020-02710-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/12/2020] [Indexed: 12/16/2022]
Abstract
Sunlight is one of the main environmental resources that keeps all the organisms alive on earth. The ultraviolet (UV) radiation from the sun is essential for vitamin D synthesis in the human body, which is crucial for bone and muscle health. In addition, sun exposure also helps to reduce the risk of some cardiovascular diseases and cancers. However, excessive UV exposure can lead to adverse effects, including some eye diseases, premature aging, sunburn and skin cancers. The solar UV irradiance itself depends on many environmental factors. In fact, the UV index reported in weather forecasts is an estimation under cloudless conditions. Personal UV exposure also depends on one's outdoor activities and habits. Furthermore, the UV intake depends on the skin sensitivity. Therefore, there is a need for research into monitoring the optimal daily UV exposure for health benefits, without developing potential health risks. To facilitate the monitoring of solar UV intensity and cumulative dose, a variety of UV sensors have been developed in the past few decades and many are commercially available. Examples of sensors being marketed are: portable UV dosimeter, wearable UV radiometer, personal UV monitor, and handheld Solarmeter®. Some of the UV sensors can be worn as personal health monitors, which promote solar exposure protection. The paper provides a comprehensive review of the wearable and portable UV sensors for monitoring personal UV exposure, including a discussion of their unique advantages and limitations. Proposals are also presented for possible future research into reliable and practical UV sensors for personal UV exposure monitoring.
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Affiliation(s)
- Xiyong Huang
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, 1010, New Zealand.
| | - Andrew N Chalmers
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, 1010, New Zealand
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Correa L, de Carvalho Meirelles G, Balestrin L, de Souza PO, Moreira JCF, Schuh RS, Bidone J, von Poser GL, Teixeira HF. In vitro protective effect of topical nanoemulgels containing Brazilian red propolis benzophenones against UV-induced skin damage. Photochem Photobiol Sci 2020; 19:1460-1469. [PMID: 33026028 DOI: 10.1039/d0pp00243g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The overexposure of the skin to ultraviolet (UV) radiation may lead to oxidative stress, resulting in severe damage. The prevention of skin injuries through the topical application of natural compounds rich in antioxidants, such as propolis extracts, has shown promising results. In Brazil, the "red propolis" extract has stood out due to its complex constitution, based mainly on polyprenylated benzophenones (BZP). However, although the use of red propolis extracts has been shown to be encouraging, their addition in topical formulations is limited by the low solubility of BZP. For this reason, this study aimed to develop topical nanoemulgels containing Brazilian red propolis (BRP) extract to increase the potential of topical application, and the evaluation of skin protection against UVA/UVB radiation damage by means of protein carbonylation, protein thiol content and TBARS assays. The nanoemulgels were obtained by adding gelling polymer to nanoemulsions that were previously prepared by spontaneous emulsification. In this sense, a nanoemulgel containing BRP extract-loaded nanoemulsions (H-NE) and a nanoemulgel containing BRP extract-loaded nanoemulsions with DOTAP (H-NE/DT) were prepared. The physicochemical characterization of nanoemulgels showed monodisperse populations of 200-300 nm. The H-NE zeta potential was -38 mV, while that of H-NE/DT was +36 mV. BZP content in the formulations was around 0.86 mg g-1. These parameters remained stable for 90 days under cold storage. H/NE and H-NE/DT presented a non-Newtonian pseudoplastic rheological behavior. Permeation/retention studies, through porcine ear skin, showed the highest BZP retention (18.11 μg cm-2 after 8 h) for H-NE/DT, which also demonstrated, in an in vitro study, the highest ability to protect skin against oxidative damage after UVA/UVB radiation exposure. The results concerning the antioxidant activity revealed that formulations containing the BRP n-hexane extract were the most promising in combating oxidative stress, probable due to the presence of polyprenylated BZP. Altogether, the outcomes of this study suggest that nanoemulgels have suitable characteristics for topical application, and may be an alternative for the prevention of oxidative skin damage caused by UVA/UVB radiation.
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Affiliation(s)
- Lucíria Correa
- Programa de Pós-graduação em Ciências Farmacêuticas da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000, Brazil.
| | - Gabriela de Carvalho Meirelles
- Programa de Pós-graduação em Ciências Farmacêuticas da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000, Brazil.
| | - Lucélia Balestrin
- Programa de Pós-graduação em Ciências Farmacêuticas da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000, Brazil.
| | - Priscila Oliveira de Souza
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90035-003, Brazil
| | - José Cláudio Fonseca Moreira
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90035-003, Brazil
| | - Roselena Silvestri Schuh
- Programa de Pós-graduação em Ciências Farmacêuticas da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000, Brazil.
| | - Juliana Bidone
- Centro de Ciências Químicas, Farmacêuticas e de Alimentos da Universidade Federal de Pelotas, Pelotas, RS 96160-000, Brazil
| | - Gilsane Lino von Poser
- Programa de Pós-graduação em Ciências Farmacêuticas da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000, Brazil.
| | - Helder Ferreira Teixeira
- Programa de Pós-graduação em Ciências Farmacêuticas da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000, Brazil.
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Wong A, Frøslev T, Dearing L, Forbes H, Mulick A, Mansfield K, Silverwood R, Kjærsgaard A, Sørensen H, Smeeth L, Lewin A, Schmidt S, Langan S. The association between partner bereavement and melanoma: cohort studies in the U.K. and Denmark. Br J Dermatol 2020; 183:673-683. [PMID: 32128788 PMCID: PMC7587014 DOI: 10.1111/bjd.18889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Psychological stress is commonly cited as a risk factor for melanoma, but clinical evidence is limited. OBJECTIVES This study aimed to evaluate the association between partner bereavement and (i) first-time melanoma diagnosis and (ii) mortality in patients with melanoma. METHODS We conducted two cohort studies using data from the U.K. Clinical Practice Research Datalink (1997-2017) and Danish nationwide registries (1997-2016). In study 1, we compared the risk of first melanoma diagnosis in bereaved vs. matched nonbereaved people using stratified Cox regression. In study 2 we estimated hazard ratios (HRs) for death from melanoma in bereaved compared with nonbereaved individuals with melanoma using Cox regression. We estimated HRs separately for the U.K. and for Denmark, and then pooled the data to perform a random-effects meta-analysis. RESULTS In study 1, the pooled adjusted HR for the association between partner bereavement and melanoma diagnosis was 0·88 [95% confidence interval (CI) 0·84-0·92] across the entire follow-up period. In study 2, we observed increased melanoma-specific mortality in people experiencing partner bereavement across the entire follow-up period (HR 1·17, 95% CI 1·06-1·30), with the peak occurring during the first year of follow-up (HR 1·31, 95% CI 1·07-1·60). CONCLUSIONS We found decreased risk of melanoma diagnosis, but increased mortality associated with partner bereavement. These findings may be partly explained by delayed detection resulting from the loss of a partner who could notice skin changes. Stress may play a role in melanoma progression. Our findings indicate the need for a low threshold for skin examination in individuals whose partners have died. What is already known about this topic? Psychological stress has been proposed as a risk factor for the development and progression of cancer, including melanoma, but evidence is conflicting. Clinical evidence is limited by small sample sizes, potential recall bias associated with self-report, and heterogeneous stress definitions. What does this study add? We found a decreased risk of melanoma diagnosis, but increased mortality associated with partner bereavement. While stress might play a role in the progression of melanoma, an alternative explanation is that bereaved people no longer have a close person to help notice skin changes, leading to delayed melanoma detection. Linked Comment: Talaganis et al. Br J Dermatol 2020; 183:607-608.
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Affiliation(s)
- A.Y.S. Wong
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - T. Frøslev
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - L. Dearing
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - H.J. Forbes
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research UKLondonU.K
| | - A. Mulick
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - K.E. Mansfield
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - R.J. Silverwood
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Centre for Longitudinal StudiesDepartment of Social ScienceUniversity College LondonLondonU.K
| | - A. Kjærsgaard
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - H.T. Sørensen
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
| | - L. Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research UKLondonU.K
| | - A. Lewin
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
| | - S.A.J. Schmidt
- Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark
- Department of DermatologyAarhus University HospitalAarhusDenmark
| | - S.M. Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLondonU.K
- Health Data Research UKLondonU.K
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Horsham C, Antrobus J, Olsen CM, Ford H, Abernethy D, Hacker E. Testing Wearable UV Sensors to Improve Sun Protection in Young Adults at an Outdoor Festival: Field Study. JMIR Mhealth Uhealth 2020; 8:e21243. [PMID: 32936083 PMCID: PMC7531871 DOI: 10.2196/21243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022] Open
Abstract
Background Australia and New Zealand have the highest skin cancer incidence rates worldwide, and sun exposure is the main risk factor for developing skin cancer. Sun exposure during childhood and adolescence is a critical factor in developing skin cancer later in life. Objective This study aims to test the effectiveness of wearable UV sensors to increase sun protection habits (SPH) and prevent sunburn in adolescents. Methods During the weeklong school leavers outdoor festival (November 2019) at the Gold Coast, Australia, registered attendees aged 15-19 years were recruited into the field study. Participants were provided with a wearable UV sensor and free sunscreen. The primary outcome was sun exposure practices using the SPH index. Secondary outcomes were self-reported sunburns, sunscreen use, and satisfaction with the wearable UV sensor. Results A total of 663 participants were enrolled in the study, and complete data were available for 188 participants (188/663, 28.4% response rate). Participants provided with a wearable UV sensor significantly improved their use of sunglasses (P=.004) and sunscreen use both on the face (P<.001) and on other parts of the body (P=.005). However, the use of long-sleeve shirts (P<.001) and the use of a hat (P<.001) decreased. During the study period, 31.4% (59/188) of the participants reported receiving one or more sunburns. Satisfaction with the wearable UV sensor was high, with 73.4% (138/188) of participants reporting the UV sensor was helpful to remind them to use sun protection. Conclusions Devices that target health behaviors when outdoors, such as wearable UV sensors, may improve use of sunscreen and sunglasses in adolescents.
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Affiliation(s)
- Caitlin Horsham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Jodie Antrobus
- Preventive Health Branch, Queensland Health, Queensland Government, Brisbane, Australia
| | - Catherine M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Helen Ford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - David Abernethy
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Elke Hacker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Efimenko M, Ignatev A, Koshechkin K. Review of medical image recognition technologies to detect melanomas using neural networks. BMC Bioinformatics 2020; 21:270. [PMID: 32921304 PMCID: PMC7488698 DOI: 10.1186/s12859-020-03615-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Melanoma is one of the most aggressive types of cancer that has become a world-class problem. According to the World Health Organization estimates, 132,000 cases of the disease and 66,000 deaths from malignant melanoma and other forms of skin cancer are reported annually worldwide ( https://apps.who.int/gho/data/?theme=main ) and those numbers continue to grow. In our opinion, due to the increasing incidence of the disease, it is necessary to find new, easy to use and sensitive methods for the early diagnosis of melanoma in a large number of people around the world. Over the last decade, neural networks show highly sensitive, specific, and accurate results. OBJECTIVE This study presents a review of PubMed papers including requests «melanoma neural network» and «melanoma neural network dermatoscopy». We review recent researches and discuss their opportunities acceptable in clinical practice. METHODS We searched the PubMed database for systematic reviews and original research papers on the requests «melanoma neural network» and «melanoma neural network dermatoscopy» published in English. Only papers that reported results, progress and outcomes are included in this review. RESULTS We found 11 papers that match our requests that observed convolutional and deep-learning neural networks combined with fuzzy clustering or World Cup Optimization algorithms in analyzing dermatoscopic images. All of them require an ABCD (asymmetry, border, color, and differential structures) algorithm and its derivates (in combination with ABCD algorithm or separately). Also, they require a large dataset of dermatoscopic images and optimized estimation parameters to provide high specificity, accuracy and sensitivity. CONCLUSIONS According to the analyzed papers, neural networks show higher specificity, accuracy and sensitivity than dermatologists. Neural networks are able to evaluate features that might be unavailable to the naked human eye. Despite that, we need more datasets to confirm those statements. Nowadays machine learning becomes a helpful tool in early diagnosing skin diseases, especially melanoma.
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Affiliation(s)
- Mila Efimenko
- Digital Health Institute, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Alexander Ignatev
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - Konstantin Koshechkin
- Digital Health Institute, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.
- Information Technology Department, Federal State Budgetary Institution Scientific Centre for Expert Evaluation of Medicinal Products of the Ministry of Health of the Russian Federation, Moscow, Russia.
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Brożyna AA, Hoffman RM, Slominski AT. Relevance of Vitamin D in Melanoma Development, Progression and Therapy. Anticancer Res 2020; 40:473-489. [PMID: 31892603 PMCID: PMC6948187 DOI: 10.21873/anticanres.13976] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/22/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022]
Abstract
Melanoma is one of the most lethal types of skin cancer, with a poor prognosis once the disease enters metastasis. The efficacy of currently available treatment schemes for advanced melanomas is low, expensive, and burdened by significant side-effects. Therefore, there is a need to develop new treatment options. Skin cells are able to activate vitamin D via classical and non-classical pathways. Vitamin D derivatives have anticancer properties which promote differentiation and inhibit proliferation. The role of systemic vitamin D in patients with melanoma is unclear as epidemiological studies are not definitive. In contrast, experimental data have clearly shown that vitamin D and its derivatives have anti-melanoma properties. Furthermore, molecular and clinicopathological studies have demonstrated a correlation between defects in vitamin D signaling and progression of melanoma and disease outcome. Therefore, adequate vitamin D signaling can play a role in the treatment of melanoma.
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Affiliation(s)
- Anna A Brożyna
- Department of Human Biology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Toruń, Poland
| | | | - Andrzej T Slominski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, U.S.A. .,Comprehensive Cancer Center, Cancer Chemoprevention Program, University of Alabama at Birmingham, Birmingham, AL, U.S.A.,VA Medical Center, Birmingham, AL, U.S.A
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Yako-Suketomo H, Katanoda K, Kawamura Y, Katayama K, Yuasa M, Horinouchi H, Saito K. Children's Knowledge of Cancer Prevention and Perceptions of Cancer Patients: Comparison Before and After Cancer Education with the Presence of Visiting Lecturer -Guided Class. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1059-1066. [PMID: 30069808 DOI: 10.1007/s13187-018-1408-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The purpose of this study was to investigate the effect of the presence of visiting lecturer-guided class on children's knowledge of cancer prevention and perceptions of cancer patients, conducting surveys before and after the cancer education classes at local elementary schools that are pioneering cancer education. We implemented self-administered questionnaire surveys with 571 sixth-grade children at nine elementary schools receiving cancer education in the Tokyo metropolitan area from September 2013 to February 2014. The surveys were conducted twice in each classroom: 1 week before the cancer education class and 1 week after. The questionnaire items included participants' gender, cancer prevention information, and perceptions of cancer patients with the following description: "looks pitiful," "always depressed," "bedridden and hospitalized," "excessive smoking and drinking," "looks thin and pale," "no visible change despite cancer," and "always bright and cheerful." Children who had not attended the cancer education day, or had not completed both the pre- and post-test, were excluded from the analysis. Regardless of whether there visiting lecturer-guided class was provided, the possibility of improving children's knowledge of cancer prevention was demonstrated. On the other hand, in the post-class surveys, compared to the group with visiting lecturer-guided class, the group without it had a significantly lower percentage of persons selecting "Looks pitiful" (76.2%/63.5%, p = 0.002) and significantly higher percentages for "Too much smoking and drinking," and "Looks thin and pale" (50.2%/63.5%, p = 0.002; 18.8%/31.1%, p = 0.001). Therefore, study is needed into cancer education coordinated with relevant institutions in order to more effectively utilize visiting lecturers and the like.
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Affiliation(s)
- Hiroko Yako-Suketomo
- Japan Women's College of Physical Education, 8-19-1 Kitakarasuyama, Setagaya, Tokyo, 157-8565, Japan.
| | | | - Yoko Kawamura
- Shizuoka University of Art and Culture, Hamamatsu, Shizuoka, Japan
| | - Kayoko Katayama
- Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan
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Abstract
The incidence of melanoma continues to increase worldwide. In the United States, melanoma is the fifth most common cancer in men and the sixth most common cancer in women. The risk factors contributing to melanoma have largely remained unchanged, but there is a new focus on modifiable risk factors including sun exposure and ultraviolet light. A large public initiative supported by the Centers for Disease Control focuses on educating the public on the risks of sun exposure and indoor tanning. Early detection and resection of melanoma lesions is necessary to prevent metastasis and reduce medical costs.
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Affiliation(s)
- Stephanie Carr
- General Surgery, Marshfield Medical Center, 1000 North Oak Avenue, Marshfield, WI 54449, USA
| | - Christy Smith
- General Surgery, Marshfield Medical Center, 1000 North Oak Avenue, Marshfield, WI 54449, USA
| | - Jessica Wernberg
- General Surgery, Marshfield Medical Center, 1000 North Oak Avenue, Marshfield, WI 54449, USA.
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Wu YP, Parsons BG, Mooney R, Aspinwall LG, Cloyes K, Hay JL, Kohlmann W, Grossman D, Leachman SA. Barriers and Facilitators to Melanoma Prevention and Control Behaviors Among At-Risk Children. J Community Health 2019; 43:993-1001. [PMID: 29623503 DOI: 10.1007/s10900-018-0516-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Melanoma prevention is essential for children who are at elevated risk for the disease due to family history. However, children who carry a familial risk for the disease do not optimally adhere to recommended melanoma preventive behaviors. The current study sought to identify perceived barriers to and facilitators of children's engagement in melanoma preventive behaviors among children at elevated risk for melanoma due to family history of the disease (i.e., having a parent with a history of melanoma) from both parents' and childrens' perspectives. Qualitative methods were employed and consisted of separate focus group discussions with children (ages 8-17 years, n = 37) and their parents (n = 39). Focus group transcripts were coded using content analysis. Parents and children reported a number of barriers and facilitators, including on the individual (e.g., knowledge and awareness, preferences), social (e.g., peer influences, family modeling and communication), and contextual (e.g., healthcare provider communication) levels. The identified categories of barriers and facilitators both confirm and extend the literature documenting the reasons children who are at elevated risk for melanoma do not engage in melanoma prevention and control behaviors. Programs aiming to decrease melanoma risk among children of melanoma survivors could help families address their barriers to preventive behavior implementation and build on facilitators. Melanoma survivors and their children could benefit from support on their interactions with healthcare providers, schools, peers, and other caregivers about melanoma prevention.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA. .,Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Bridget G Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Ryan Mooney
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Kristin Cloyes
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Wendy Kohlmann
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
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Thoonen K, Schneider F, Candel M, de Vries H, van Osch L. Childhood sun safety at different ages: relations between parental sun protection behavior towards their child and children's own sun protection behavior. BMC Public Health 2019; 19:1044. [PMID: 31382940 PMCID: PMC6683475 DOI: 10.1186/s12889-019-7382-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sunburns during childhood are strongly associated with development of melanoma in later life. While parents play an important role in children's sun protection, insight in possible shifts in behavioral responsibility from parents towards their children and the possible effect of children's sex is important for targeting sun safety interventions throughout childhood and adolescence. METHODS This cross-sectional survey study was conducted among a representative sample of Dutch parents (N = 1053) of children aged between 4 and 13 years old. Questionnaires measured both parental and children's own sun safety behavior during planned (e.g. going to the beach) and incidental (e.g. bycicling) sun exposure situations. Analyses of variance were used to test for age group differences and linear regression models were computed to detect behavioral shifts in executive behavior. RESULTS Parents applied all sun safety behaviors (i.e. sunscreen use, wearing UV-protective clothing and seeking shade) more often on younger children, except for supportive behavior (facilitating children's own sun safety behavior), which remained relatively stable over the years. Older children and girls were more likely to execute sun safety behaviors themselves. A behavioral shift was found in wearing UV-protective clothing during planned situations among 11 year old children. For other behaviors, shifts were predicted after the age of 13. CONCLUSIONS Older children execute sun safety behaviors more often than younger children, although they still largely depend on their parents' protection. Specific attention for boys in the primary school years, and for both boys and girls in the years adjacent to adolescence is warranted in skin cancer prevention interventions.
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Affiliation(s)
- Karlijn Thoonen
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands.
| | - Francine Schneider
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Math Candel
- Department of Methodology and Statistics School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Hein de Vries
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Liesbeth van Osch
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands
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Huang X, Protheroe MD, Al-Jumaily AM, Chalmers AN, Paul SP, Fu X. Simulation of UV power absorbed by follicular stem cells during sun exposure and possible implications for melanoma development. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:628-635. [PMID: 31044982 DOI: 10.1364/josaa.36.000628] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
The incidence of melanoma in children is extremely rare. However, there is convincing evidence supporting a higher risk of developing melanoma in individuals who have experienced excessive sun exposure during their childhood. A possible explanation for this phenomenon is that prior to puberty, the melanocyte stem cells in the bulge region of hair follicles are much shallower in the dermis, resulting in their increased vulnerability to sun exposure. To validate this hypothesis, a Monte Carlo simulation of light transport is applied to quantify the dose of solar UV power absorbed in the stem-cell layers at different depths in both child and adult skins. The simulated results suggest that the stem cells in vellus hair follicles would absorb over 250 times higher UV photons than those in the terminal hair follicles. Due to the thinner epidermis in child skin, the stem cells in vellus hair follicles absorb about 1.9 and 3.2 times greater ultraviolet A and ultraviolet B, respectively, than those in adult skin. These findings provide a possible explanation to why children are particularly vulnerable to sun exposure.
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Kimlin MG, Youlden DR, Brodie AM, DiSipio T, Youl P, Nair-Shalliker V, Baade PD. Risk of Second Primary Cancer in Survivors of In Situ Melanoma. J Invest Dermatol 2019; 139:842-847. [PMID: 30423330 DOI: 10.1016/j.jid.2018.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/16/2018] [Accepted: 11/04/2018] [Indexed: 01/12/2023]
Abstract
Survivors of invasive melanoma have an increased risk of developing second primary cancers; however, similar risks associated with in situ melanoma have not been established. We evaluated 39,872 survivors of first primary in situ melanoma diagnosed from 1982 through 2012 in Queensland, Australia. Relative risk of second nonmelanoma primary cancers was estimated from standardized incidence ratios with 95% confidence intervals. A total of 4,823 (12%) in situ melanoma survivors developed a second primary cancer. A small increased risk (6%) compared with the general population was found. In those younger than 50 years, risk was increased by 14% for all cancers combined. In situ melanoma survivors had significantly increased risks of developing lip, thyroid, pancreatic, and brain cancers and decreased risks of head and neck, and lung cancers. Male in situ melanoma survivors had a significantly increased risk of prostate cancer; female survivors had an increased risk of thyroid cancer and lymphoid leukemia. Findings indicate that in situ melanoma may predict the diagnosis of certain second primary cancers. This altered risk may be due to biological, behavioral, or genetic factors or increased medical surveillance, and it requires further investigation, particularly among people younger than 50 years.
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Affiliation(s)
- Michael G Kimlin
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia; Cancer Council Queensland, Spring Hill, Queensland, Australia.
| | - Danny R Youlden
- Cancer Council Queensland, Spring Hill, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Alison M Brodie
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Tracey DiSipio
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Philippa Youl
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Visalini Nair-Shalliker
- Cancer Council New South Wales, Woolloomooloo, New South Wales, Australia; The University of Sydney, Sydney, Australia
| | - Peter D Baade
- Cancer Council Queensland, Spring Hill, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Mathematical Sciences, Queensland University of Technology, Queensland, Australia
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Size Matters: The Functional Role of the CEACAM1 Isoform Signature and Its Impact for NK Cell-Mediated Killing in Melanoma. Cancers (Basel) 2019; 11:cancers11030356. [PMID: 30871206 PMCID: PMC6468645 DOI: 10.3390/cancers11030356] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/21/2019] [Accepted: 03/09/2019] [Indexed: 12/22/2022] Open
Abstract
Malignant melanoma is the most aggressive and treatment resistant type of skin cancer. It is characterized by continuously rising incidence and high mortality rate due to its high metastatic potential. Various types of cell adhesion molecules have been implicated in tumor progression in melanoma. One of these, the carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1), is a multi-functional receptor protein potentially expressed in epithelia, endothelia, and leukocytes. CEACAM1 often appears in four isoforms differing in the length of their extracellular and intracellular domains. Both the CEACAM1 expression in general, and the ratio of the expressed CEACAM1 splice variants appear very dynamic. They depend on both the cell activation stage and the cell growth phase. Interestingly, normal melanocytes are negative for CEACAM1, while melanomas often show high expression. As a cell–cell communication molecule, CEACAM1 mediates the direct interaction between tumor and immune cells. In the tumor cell this interaction leads to functional inhibitions, and indirectly to decreased cancer cell immunogenicity by down-regulation of ligands of the NKG2D receptor. On natural killer (NK) cells it inhibits NKG2D-mediated cytolysis and signaling. This review focuses on novel mechanistic insights into CEACAM1 isoforms for NK cell-mediated immune escape mechanisms in melanoma, and their clinical relevance in patients suffering from malignant melanoma.
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Olsen H, Kennedy E. Safety of School Playgrounds: Field Analysis From a Randomized Sample. J Sch Nurs 2019; 36:369-375. [PMID: 30722719 DOI: 10.1177/1059840519827364] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research supports recess, however, playground injuries are prevalent with more than 200,000 cases per year requiring medical attention. School playgrounds are among the leading location for injury. The purpose was to identify the safety and risk factors of playground environments and impact attenuation characteristics of surfacing materials. Results demonstrated 46% playground spaces protected students from traffic. Results found 75% of playgrounds were exposed to full sun, and unitary surface materials were up to 49°F warmer than the air temperature. There was an increase in the probability of risk whether equipment height was over 9 ft for loose fill surfacing materials or over 6 ft for unitary surfaces. Loose strings or ropes looped over equipment were found on 23% of playgrounds. This study provides discussion and data pertaining to numerous aspects of playground safety. Strategies for school nurses are shared to shape policies and education for playground safety practices.
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Affiliation(s)
- Heather Olsen
- Department of Allied Health, Recreation, and Community Services, College of Education, 2313University of Northern Iowa, Cedar Falls, IA, USA
| | - Eric Kennedy
- Department of Allied Health, Recreation, and Community Services, College of Education, 2313University of Northern Iowa, Cedar Falls, IA, USA
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Antoniadis D, Katsoulas N, Kittas C. Simulation of schoolyard's microclimate and human thermal comfort under Mediterranean climate conditions: effects of trees and green structures. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:2025-2036. [PMID: 30225542 DOI: 10.1007/s00484-018-1612-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/19/2018] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
The present study explores the effects on microclimate parameters and on heat stress conditions of the bioclimatic redevelopment of an urban schoolyard based mainly on inserting shading canopies and replacing hard surfaces with green cover. This included the use of the recent version of the microclimate model ENVI-met (V4), first validated using experimental data and then later applied to different case studies in schoolgrounds of Volos, a coastal city in central Greece under Mediterranean type climate. The simulation of the existing yard condition showed that the values of the biometorological index PET (physiologically equivalent temperature, in °C), were within the range of the thermal sensation class of extreme heat stress (> 41 °C) from early morning, while at midday 80.5% of the yard area was within the range of the above class. With the implementation of the redesign proposal, 69.9% of the yard area was improved by two or three PET scale classes, helping to improve the microclimate in 82% of the total area of the courtyard. Tree canopies reduced the direct incident radiation more than 90%, reduced Tmrt and PET index up to 31 °C and 19 °C, respectively, and the surface ground temperatures of wet grass and hard surfaces more than 20 °C and 14 °C, respectively.
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Affiliation(s)
- D Antoniadis
- Department of Agriculture Crop Production and Rural Environment, University of Thessaly, Fytokou Str., 38446, Volos, Greece
| | - N Katsoulas
- Department of Agriculture Crop Production and Rural Environment, University of Thessaly, Fytokou Str., 38446, Volos, Greece.
| | - C Kittas
- Department of Agriculture Crop Production and Rural Environment, University of Thessaly, Fytokou Str., 38446, Volos, Greece
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Nguyen NT, Fisher DE. MITF and UV responses in skin: From pigmentation to addiction. Pigment Cell Melanoma Res 2018; 32:224-236. [PMID: 30019545 DOI: 10.1111/pcmr.12726] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/21/2018] [Accepted: 06/25/2018] [Indexed: 12/15/2022]
Abstract
Ultraviolet radiation (UVR) has numerous effects on skin, including DNA damage, tanning, vitamin D synthesis, carcinogenesis, and immunomodulation. Keratinocytes containing damaged DNA secrete both α-melanocyte-stimulating hormone (α-MSH), which stimulates pigment production by melanocytes, and the opioid β-endorphin, which can trigger addiction-like responses to UVR. The pigmentation (tanning) response is an adaptation that provides some delayed protection against further DNA damage and carcinogenesis, while the opioid response may be an evolutionary adaptation for promoting sun-seeking behavior to prevent vitamin D deficiency. Here, we review the pigmentation response to UVR, driven by melanocytic microphthalmia-associated transcription factor (MITF), and evidence for UVR-induced melanomagenesis and addiction. We also discuss potential applications of a novel approach to generate protective pigmentation in the absence of UVR (sunless tanning) using a topical small-molecule inhibitor of the salt-inducible kinase (SIK) family.
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Affiliation(s)
- Nhu T Nguyen
- Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - David E Fisher
- Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
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Dhana A, Yen H, Li T, Holmes MD, Qureshi AA, Cho E. Intake of folate and other nutrients related to one-carbon metabolism and risk of cutaneous melanoma among US women and men. Cancer Epidemiol 2018; 55:176-183. [PMID: 29990794 PMCID: PMC6097627 DOI: 10.1016/j.canep.2018.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 06/11/2018] [Accepted: 06/18/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nutrients involved in one-carbon metabolism - folate, vitamins B6 and B12, methionine, choline, and betaine - have been inversely associated with multiple cancer sites and may be related to skin cancer. However, there is a lack of research on the association between intake of these nutrients and cutaneous melanoma risk. The aim of this study was to examine the associations between intake of one-carbon metabolism nutrients and cutaneous melanoma risk in two large prospective cohorts. METHODS The cohorts included 75,311 white women and 48,523 white men. Nutrient intake was assessed repeatedly by food frequency questionnaires and self-reported supplement use. We used Cox proportional hazards regression to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) and then pooled HRs using a random-effects model. RESULTS Over 24-26 years of follow-up, we documented 1328 melanoma cases (648 men and 680 women). Higher intake of folate from food only, but not total folate, was associated with increased melanoma risk (pooled HR for top versus bottom quintile: 1.36; 95% CI: 1.13-1.64; P for trend = 0.001). The association was significant in men, but attenuated in women. Higher intake of vitamins B6 and B12, choline, betaine, and methionine were not associated with melanoma risk, although there was modest increasing trend of risk for vitamin B6 from food only (pooled HR for top versus bottom quintile: 1.18; 95% CI: 0.99-1.41; P for trend = 0.03). CONCLUSIONS We found some evidence that higher intake of folate from food only was associated with a modest increased risk of cutaneous melanoma. However, since other factors related to dietary folate intake may account for the observed association, our findings warrant further investigation.
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Affiliation(s)
- Ashar Dhana
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Hsi Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tricia Li
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Michelle D Holmes
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Abrar A Qureshi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Eunyoung Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
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Wu YP, Aspinwall LG, Nagelhout E, Kohlmann W, Kaphingst KA, Homburger S, Perkins RD, Grossman D, Harding G, Cassidy P, Leachman SA. Development of an Educational Program Integrating Concepts of Genetic Risk and Preventive Strategies for Children with a Family History of Melanoma. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:774-781. [PMID: 27889875 PMCID: PMC5446308 DOI: 10.1007/s13187-016-1144-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Efforts to prevent melanoma, especially for those at elevated risk for the disease, should ideally begin during childhood. However, there are few preventive interventions targeting children who are at higher risk for melanoma due to a family history of the disease. Further, there are no educational interventions that aim to help these at-risk children understand their risk for melanoma and the ways in which preventive behaviors, such as sun protection, can mitigate their risk. The current paper describes a multidisciplinary team's process for creating a developmentally appropriate educational intervention about melanoma risk and prevention for children ages 8-17 years who have a family history of melanoma. Drawing from the fields of dermatology, health behavior change and education, genetic risk communication, science education, and graphic arts, the multimedia intervention created covers key learning points relevant to understanding melanoma, the role of DNA damage in melanoma development, inherited risk factors for melanoma, environmental factors causing DNA damage, and methods for preventing DNA damage, such as sun protective behaviors. Lessons learned during the development of the educational intervention, particularly relevant to multidisciplinary team interactions, are discussed. Implications for future testing and refinement of the novel educational content are also reviewed.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4142, Salt Lake City, UT, 84112, USA.
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112, USA
| | - Elizabeth Nagelhout
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Wendy Kohlmann
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4142, Salt Lake City, UT, 84112, USA
| | - Kimberly A Kaphingst
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4142, Salt Lake City, UT, 84112, USA
- Department of Communication, University of Utah, 255 S Central Campus Drive, Room 2400, Salt Lake City, UT, 84112, USA
| | - Sheila Homburger
- Genetic Science Learning Center, University of Utah, 515 100 S, Salt Lake City, UT, 84102, USA
| | - Ryan D Perkins
- Genetic Science Learning Center, University of Utah, 515 100 S, Salt Lake City, UT, 84102, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4142, Salt Lake City, UT, 84112, USA
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
| | - Garrett Harding
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4142, Salt Lake City, UT, 84112, USA
| | - Pamela Cassidy
- Department of Dermatology and Knight Cancer Institute, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR, 97239, USA
| | - Sancy A Leachman
- Department of Dermatology and Knight Cancer Institute, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR, 97239, USA
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Lima SR, Stocco MB, Rondelli LA, Silva GS, Lopes RS, Furlan FH, Colodel EM, Pescador CA. Neoplasmas cutâneos em cães: 656 casos (2007-2014) em Cuiabá, MT. PESQUISA VETERINÁRIA BRASILEIRA 2018. [DOI: 10.1590/1678-5150-pvb-5534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO: Os neoplasmas cutâneos em cães apresentam elevada e relevante prevalência em todo o Brasil. Sendo assim, objetivou-se determinar a frequência e algumas características epidemiológicas dos neoplasmas cutâneos em cães diagnosticados no Laboratório de Patologia da Universidade Federal de Mato Grosso (LPV-UFMT), Cuiabá, entre os anos de 2007 a 2014. Foram revisados os protocolos de necropsias e biopsias do LPV-UFMT, de cães com neoplasmas cutâneos. Dados referentes à idade, sexo, raça dos cães afetados, localização anatômica, tamanho, diagnóstico histomorfológico e comportamento biológico foram coletados e analisados através de uma análise estatística descritiva. Adicionalmente o teste χ2, foi utilizado para associações entre comportamento biológico e tamanho da massa. Dos 3566 exames realizados, 656 (18,4%) foram diagnosticados como tumores cutâneos sendo cães adultos e idosos das raças Pit Bull, Boxer e Poodle os mais acometidos. Dentre os 11 padrões morfológicos mais diagnosticados o mastocitoma, carcinoma de células escamosas (CCE) e os tumores de origem vascular foram os mais frequentemente relatados. Em relação ao sítio anatômico, a cabeça foi a mais acometida. A maioria dos tumores benignos apresentaram menos de 1cm de diâmetro e os malignos de 3 a 5cm. O aumento de neoplasmas em adultos e idosos pode estar relacionado ao somatório de danos causados por agentes carcinogênicos e o comprometimento imunológico.
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Hubbard G, Kyle RG, Neal RD, Marmara V, Wang Z, Dombrowski SU. Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer: quasi-experimental trial of an adolescent psycho-educational intervention. BMC Public Health 2018; 18:666. [PMID: 29843654 PMCID: PMC5975556 DOI: 10.1186/s12889-018-5570-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 05/16/2018] [Indexed: 12/15/2022] Open
Abstract
Background Skin cancer rates are increasing. Interventions to increase adolescent sunscreen use and skin self-examination (SSE) are required. Methods Quasi-experimental design; 1 control and 4 intervention group schools in Scotland, UK. Participants were 15–16 year old students on the school register. The intervention was a theoretically-informed (Common-Sense Model and Health Action Process Approach) 50-min presentation, delivered by a skin cancer specialist nurse and young adult skin cancer survivor, to students in a classroom, supplemented by a home-based assignment. Outcome variables were sunscreen use intention, SSE intention/behaviour, planning, illness perceptions and skin cancer communication behaviour, measured 2 weeks pre- and 4 weeks post- intervention using self-completed pen and paper survey. School attendance records were used to record intervention up-take; students self-reported completion of the home-based assignment. Pearson’s chi-square test, analysis of variance, and non-parametric Wilcoxon Signed Ranks Test were used to measure outcomes and associations between variables. Focus groups elicited students’ (n = 29) views on the intervention. Qualitative data were analysed thematically. Results Five of 37 invited schools participated. 639 (81%) students in intervention schools received the intervention; 33.8% completed the home-based assignment. 627 (69.6%) of students on the school register in intervention and control schools completed a questionnaire at baseline; data for 455 (72.6%) students were available at baseline and follow-up. Focus groups identified four themes – personal experiences of skin cancer, distaste for sunscreen, relevance of SSE in adolescence, and skin cancer conversations. Statistically significant (p < 0.05) changes were observed for sunscreen use, SSE, planning, and talk about skin cancer in intervention schools but not the control. Significant associations were found between sunscreen use, planning and 2 illness perceptions (identity and consequence) and between SSE, planning and 3 illness perceptions (timeline, causes, control). Conclusions It is feasible to promote sunscreen use and SSE in the context of an adolescent school-based psychoeducation intention. Further research is required to improve study uptake, intervention adherence and effectiveness. Trial registration ISRCTN11141528 Electronic supplementary material The online version of this article (10.1186/s12889-018-5570-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gill Hubbard
- School of Health, Social Care and Life Sciences, Centre for Health Sciences, University of the Highlands and Islands (UHI), Old Perth Road, Inverness, IV2 3JH, Scotland.
| | - Richard G Kyle
- School of Health and Social Care, Edinburgh Napier University, Sighthill Court, Edinburgh, EH11 4BN, UK
| | - Richard D Neal
- Academic Unit of Primary Care, Institute of Health Sciences, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Vincent Marmara
- Department of Management, Faculty of Economics, Management and Accountancy, University of Malta, Humanities B (FEMA), Msida, MSD, 2080, Malta
| | - Ziyan Wang
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, FK10 4LA, Stirling, Scotland
| | - Stephan U Dombrowski
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, FK10 4LA, Stirling, Scotland
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