Claimed Effects, Outcome Variables and Methods of Measurement for Health Claims Proposed Under European Community Regulation 1924/2006 in the Framework of Maintenance of Skin Function

Cell Cultures as a Versatile Tool in the Research and Treatment of Autoimmune Connective Tissue Diseases

Cell cultures are an important part of the research and treatment of autoimmune connective tissue diseases. By culturing the various cell types involved in ACTDs, researchers are able to broaden the knowledge about these diseases that, in the near future, may lead to finding cures. Fibroblast cultures and chondrocyte cultures allow scientists to study the behavior, physiology and intracellular interactions of these cells. This helps in understanding the underlying mechanisms of ACTDs, including inflammation, immune dysregulation and tissue damage. Through the analysis of gene expression patterns, surface proteins and cytokine profiles in peripheral blood mononuclear cell cultures and endothelial cell cultures researchers can identify potential biomarkers that can help in diagnosing, monitoring disease activity and predicting patient's response to treatment. Moreover, cell culturing of mesenchymal stem cells and skin modelling in ACTD research and treatment help to evaluate the effects of potential drugs or therapeutics on specific cell types relevant to the disease. Culturing cells in 3D allows us to assess safety, efficacy and the mechanisms of action, thereby aiding in the screening of potential drug candidates and the development of novel therapies. Nowadays, personalized medicine is increasingly mentioned as a future way of dealing with complex diseases such as ACTD. By culturing cells from individual patients and studying patient-specific cells, researchers can gain insights into the unique characteristics of the patient's disease, identify personalized treatment targets, and develop tailored therapeutic strategies for better outcomes. Cell culturing can help in the evaluation of the effects of these therapies on patient-specific cell populations, as well as in predicting overall treatment response. By analyzing changes in response or behavior of patient-derived cells to a treatment, researchers can assess the response effectiveness to specific therapies, thus enabling more informed treatment decisions. This literature review was created as a form of guidance for researchers and clinicians, and it was written with the use of the NCBI database.

Effectiveness of weak wiping pressure during bed baths in hospitalized older adults: A single-blind randomized crossover trial

This study evaluated the effectiveness of weak wiping pressure on skin barrier function and patient satisfaction in comparison to ordinary pressure in hospitalized older adults. Forty-seven participants in a general hospital were blindly and randomly assigned a sequence of two bed baths: wiping three times with weak pressure (12-14 mmHg) and ordinary pressure (23-25 mmHg). Transepidermal water loss and stratum corneum hydration were measured before and after the intervention, and patient satisfaction was assessed using a Likert scale. Ordinary pressure significantly decreased skin barrier function compared to weak pressure; however, neither of the pressures caused discomfort. Weak pressure was more effective than ordinary pressure in preventing skin disorders and providing satisfaction. Subgroup cluster analysis showed that ordinary pressure was likely to impair the skin barrier function in older adults with diabetes/dyslipidemia and renal dysfunction. The application of weak pressure during bed baths, especially for these patients, is recommended.

Reliability and validity of the Japanese version of the overall dry skin score in older patients

BACKGROUND

Dry skin is the most common skin problem, especially in the elderly. However, there is no effective instrument to assess dry skin in Japan. This study aimed to evaluate the reliability and validity of the Japanese version of the overall dry skin score (ODS-J), the gold standard for dry skin assessment.

MATERIALS AND METHODS

A cross-sectional study was conducted on 47 patients aged > 65 years. Images of skin on their limbs were captured using a digital camera; both upper and lower limbs were assessed (n = 4/patient). One dermatologist; two wound, ostomy, and continence nurses; and three nursing researchers independently evaluated the images using the ODS-J to assess the intraclass correlation coefficient (ICC) for inter-rater reliability. Stratum corneum hydration (SCH) and transepidermal water loss (TEWL) were the external criteria used to verify concurrent and known-groups validity.

RESULTS

In total, 182 sites at which the SCH and TEWL could be measured were evaluated for the ODS-J. The ICC for inter-rater reliability of the six raters was 0.939 (p < 0.001). A higher ODS-J was associated with lower SCH (ρ = -0.374; p < 0.001) and lower TEWL (ρ = -0.287; p < 0.001) values. The ODS-J for the lower legs was significantly higher than that of the forearms (p < 0.001).

CONCLUSIONS

The ODS-J showed good inter-rater reliability, concurrent validity, and known-groups validity. It can be used by clinical nurses in Japan to observe patients' skin and is an effective indicator for the evaluation of skin care.

Nutrition to Optimise Human Health-How to Obtain Physiological Substantiation?

Demonstrating in an unambiguous manner that a diet, let alone a single product, 'optimizes' health, presents an enormous challenge. The least complicated is when the starting situation is clearly suboptimal, like with nutritional deficiencies, malnutrition, unfavourable lifestyle, or due to disease or ageing. Here, desired improvements and intervention strategies may to some extent be clear. However, even then situations require approaches that take into account interactions between nutrients and other factors, complex dose-effect relationships etc. More challenging is to substantiate that a diet or a specific product optimizes health in the general population, which comes down to achieve perceived, 'non-medical' or future health benefits in predominantly healthy persons. Presumed underlying mechanisms involve effects of non-nutritional components with subtle and slowly occurring physiological effects that may be difficult to translate into measurable outcomes. Most promising strategies combine classical physiological concepts with those of 'multi-omics' and systems biology. Resilience-the ability to maintain or regain homeostasis in response to stressors-is often used as proxy for a particular health domain. Next to this, quantifying health requires personalized strategies, measurements preferably carried out remotely, real-time and in a normal living environment, and experimental designs other than randomized controlled trials (RCTs), for example N-of-1 trials.

Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review

Aim

To evaluate the effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults.

Design

A systematic review based on the PRISMA guidelines.

Methods

We searched for quantitative studies published between 2004–2020, using the PubMed, MEDLINE and CINAHL. The remaining 25 studies were appraised by the JBI tool.

Results

Only four of the included studies were of high quality. Studies of above moderate quality demonstrated that disposable towels were as effective as cotton towels for skin lesions and bacterial removal. Applying a hot towel maintained the skin barrier function and provided warmth; cotton towels were effective for cleaning even with weak pressure, and post‐bed bath moisturizer treatment contributed to skin integrity.

Conclusion

Although various methods have been examined, the available evidence is inadequate for establishing best practices. It is necessary to verify empirical research with rigorous methodology involving elderly inpatients and to develop instruments that measure patients' comfort.

Claimed Effects, Outcome Variables and Methods of Measurement for Health Claims on Foods Related to Vision Proposed Under Regulation (EC) 1924/2006

Adequate visual function has a strong impact on the quality of life of people. Several foods and food components have been hypothesized to play a role in the maintenance of normal visual function and in the prevention of eye diseases. Some of these foods/food components have been the object of a request of authorization for use of health claims under Articles 13(5) or 14 of the Regulation (EC) 1924/2006. Most of these requests have received a negative opinion from the European Food Safety Authority (EFSA) due to the choice of inappropriate outcome variables (OVs) and/or methods of measurement (MMs) applied in the studies used to substantiate the claims. This manuscript refers to the collection, collation and critical analysis of OVs and MMs related to vision. Guidance document and requests for authorization of health claims were used to collect OVs and MMs related to vision. A literature review was performed to critically analyse OVs and MMs, with the aim of defining their appropriateness in the context of a specific claimed effect related to vision. The results highlight the importance of adequate choices of OVs and MMs for an effective substantiation of claims related to visual function.