Several factors are known contribute to hair cortisol concentration (HCC) in adults. However, there is less research on determinants of HCC in children and adolescents. HCC is a valuable tool for ...medical research pertaining to the hypothalamic-pituitary-adrenal (HPA) axis. This review aims to assess the extent to which established determinants of HCC in adults have been consistently reported in children (birth – 18 years) and to identify determinants of HCC specific to this age group.
Eligible studies were identified, selected and appraised as per PRISMA-P guidelines and as detailed in our systematic review protocol, registered on PROSPERO (registration number CRD42017056220). In view of contrasting methods and measures, a meta-analysis could not be done but a qualitative synthesis was performed.
Thirty-six studies were included in the analysis. Higher HCC is associated with male sex and anthropometry, particularly increased body mass index and waist circumference. There is preliminary evidence to suggest that socio-economic status is inversely related to child HCC, particularly with reference to caregiver education and income. Of note, most of the studies analysing socio-economic variables were performed in relatively equal societies. Hair wash frequency and use of hair products and treatments do not affect HCC when proximal segments of hair are used. There is conflicting evidence regarding the relationship between HCC and age in children and adolescents. Further investigation is required to better delineate if and how the following are associated with HCC in children: hair colour, hair type, exposure to trauma and stressors, psychiatric illness, atopic illness, steroid use (including topical and inhaled steroids) and perinatal variables.
Sex and anthropometry are potential confounders and should be considered for adjustment in hair cortisol research. Hair wash frequency and use of hair products and treatments are not important confounders when proximal hair segments are used. A better understanding of HCC in children in relation to exposure to trauma and stressors is required before it can be used as a biomarker, particularly in terms of vulnerable developmental stages, definition and measurement of stress, and temporal relationship to stressors. Age, SES and other correlates also warrant further investigation.
Curly hair is reported to contain higher lipid content than straight hair, which may influence incorporation of lipid soluble drugs. The use of race to describe hair curl variation (Asian, Caucasian ...and African) is unscientific yet common in medical literature (including reports of drug levels in hair). This study investigated the reliability of a geometric classification of hair (based on 3 measurements: the curve diameter, curl index and number of waves).
After ethical approval and informed consent, proximal virgin (6cm) hair sampled from the vertex of scalp in 48 healthy volunteers were evaluated. Three raters each scored hairs from 48 volunteers at two occasions each for the 8 and 6-group classifications. One rater applied the 6-group classification to 80 additional volunteers in order to further confirm the reliability of this system. The Kappa statistic was used to assess intra and inter rater agreement.
Each rater classified 480 hairs on each occasion. No rater classified any volunteer's 10 hairs into the same group; the most frequently occurring group was used for analysis. The inter-rater agreement was poor for the 8-groups (k = 0.418) but improved for the 6-groups (k = 0.671). The intra-rater agreement also improved (k = 0.444 to 0.648 versus 0.599 to 0.836) for 6-groups; that for the one evaluator for all volunteers was good (k = 0.754).
Although small, this is the first study to test the reliability of a geometric classification. The 6-group method is more reliable. However, a digital classification system is likely to reduce operator error. A reliable objective classification of human hair curl is long overdue, particularly with the increasing use of hair as a testing substrate for treatment compliance in Medicine.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Zinc plays a central role in skin integrity via barrier and immune mechanisms and may also be relevant in the pathogenesis of atopic dermatitis (AD). However, little is known about the relationship ...between zinc and AD. We performed a systematic review to determine (i) the association between zinc levels or zinc deficiency and AD and (ii) the efficacy of oral zinc supplementation in the treatment of AD. We searched PubMed, Scopus, Web of Science and article references for observational studies on zinc levels or zinc deficiency in participants with AD vs. controls and for randomized control trials (RCTs) on zinc supplementation in AD. For observational studies, we calculated pooled standardized mean differences (SMDs) or odds ratios (ORs) along with 95% confidence intervals (CIs) using a random effects model. We included 14 observational studies and two RCTs. The pooled SMD demonstrated significantly lower serum (SMD 0.66, 95% CI 0.21–1.10, P = 0.004), hair (SMD 0.95, 95% CI 0.38–1.52, P = 0.001) and erythrocyte (SMD 0.95, 95% CI 0.38–1.52, P = 0.001) zinc levels in participants with AD compared to controls. Pooled unadjusted data from three studies showed a non‐significant increased odds of AD in those with zinc deficiency compared with those without zinc deficiency (OR = 1.50, 95% CI 0.71–3.16, P = 0.28). One RCT of oral zinc supplementation among AD patients with zinc deficiency showed improvement in extent and severity of AD, while another RCT among all AD patients showed no significant improvement. All the studies were of low or moderate quality. We conclude that low serum, hair and erythrocyte zinc levels are associated with AD. However, the poor quality of included studies makes interpretation of these results problematic. High‐quality observational studies are needed to confirm the association between low zinc levels and AD, and RCTs are required to evaluate the merit of zinc supplementation for the treatment or prevention of AD.
Summary
Background Anecdotal reports suggest that certain scalp disorders are common in Africans and may be associated with hairstyles.
Objectives This study of 874 African adults in Cape Town was ...performed to test this hypothesis.
Methods A questionnaire was administered and scalp examinations performed, after ethics approval.
Results Participants included 30·9% men and 69·1% women (median age 36·1 years, range 18–99). Most men had natural hair: 91·7% vs. 24·3% women. The majority of men had recent haircuts (< 4 weeks): 74·8% vs. 9·9% women. The overall prevalence of acne (folliculitis) keloidalis nuchae (AKN) was 3·5%: higher in men than women (10·5% vs. 0·3%). AKN prevalence was not associated with whether clippers or blades were used. However, it was associated with haircut symptoms. Haircut‐associated symptoms, i.e. at least one episode of transient pimples (or crusts) and bleeding (however small) were reported in 37% and 18·9% of men, respectively. The latter may have implications for disease transmission. Most women (58·7%) had chemically treated hair (49·2% relaxed and 9·6% permed hair) vs. 2·3% men. The prevalences of traction alopecia (TA) and central centrifugal cicatricial alopecia (CCCA) were 22·6% and 1·9%: higher in women (31·7% vs. 2·2% and 2·7% vs. 0%, respectively). CCCA was highest in women > 50 years (6·7% vs. 1·2%). TA prevalence was highest if the usual hairstyle was extensions attached to relaxed hair (48%).
Conclusion We found associations between specific scalp diseases, hairstyles, gender, and age. These associations need further study, better to elucidate determinants and to improve disease prevention and treatment.
The need to cope with the continuously growing number of connected users and the increased demand for mobile broadband services in the Internet of Things has led to the notion of introducing the fog ...computing paradigm in fifth generation (5G) mobile networks in the form of fog radio access network (F-RAN). The F-RAN approach emphasises bringing the computation capability to the edge of the network so as to reduce network bottlenecks and improve latency. However, despite the potential, the management of computational resources remains a challenge in F-RAN architectures. Thus, this paper aims to overcome the shortcomings of conventional approaches to computational resource allocation in F-RANs. Reinforcement learning (RL) is presented as a method for dynamic and autonomous resource allocation, and an algorithm is proposed based on Q-learning. RL has several benefits in resource allocation problems and simulations carried out show that it outperforms reactive methods. Furthermore, the results show that the proposed algorithm improves latency and thus has the potential to have a major impact in 5G applications, particularly the Internet of Things.
Dear Editor, Hereditary Fibrosing Poikiloderma with Tendon Contractures, Myopathy and Pulmonary Fibrosis (POIKTMP MIM 615704) is a recently described autosomal dominant disorder due to missense ...mutations in the FAM111B gene. Key features are early-onset poikiloderma, muscle contractures in particular of the triceps surae, diffuse progressive fatty myopathy, pulmonary fibrosis in adulthood and exocrine pancreatic insufficiency. Dermatological manifestations seem to be constant and early however, a precise description is lacking.
HIV-positive children have lagged adults on retention in HIV care and viral suppression. To address this gap, Eswatini's Ministry of Health started a pilot family-centered HIV care model (FCCM) ...targeting HIV-positive children under 20 years old and their families.
We conducted semi-structured in-depth interviews with 25 caregivers and 17 healthcare workers (HCWs) to assess acceptability of FCCM in four pilot FCCM health facilities in Hhohho region of Eswatini. Thematic analysis with inductive and deductive codes was used to identify salient themes.
Caregivers and HCWs reported FCCM benefits including strengthening the family bond, encouragement for family members to disclose their HIV status and supporting each other in taking antiretroviral drugs. Caregivers reported that they spent fewer days in clinic, experienced shorter waiting times, and received better counseling services in FCCM compared to the standard-of-care services. FCCM implementation challenges included difficulty for families to attend clinic visits together (e.g., due to scheduling conflicts with weekend Teen Support Club meetings and weekday FCCM appointments). Both HCWs and caregivers mentioned difficulty in sharing sensitive health information in the presence of other family members. HCWs also had challenges with supporting caregivers to disclose HIV status to children and managing the larger group during clinic visits.
FCCM for HIV-positive children was acceptable to both caregivers and HCWs, and they supported scaling-up FCCM implementation nationally. However, special considerations should be made to address the challenges experienced by participants in attending clinic visits together as a family in order to achieve the full benefits of FCCM for HIV positive children.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Extreme floods have become frequent in the urban Palmiet River due to exacerbating climate change. Therefore, the current study aimed to explore a short-term recovery of macroinvertebrate communities ...following a flash flood in the Palmiet River, KwaZulu-Natal, South Africa. Different biotopes, i.e. stones, gravel sand and mud, and vegetation were sampled after the March-April heavy rain in 2018. Ephemeroptera, Odonatan, and Hemipteran have shown similar trends across weeks at all sites. Plecoptera and Coleoptera started recovering at week four However, the total abundance and taxa richness had significantly recovered during the fourth week at site 2 and 3, and fifth week at site 1. Communities have shown no significant difference for each site from weeks six to eight (ANOVA, p > 0.5), which implies that climax on macroinvertebrate communities was reached at week six. Hydrologic regime change has not influenced water quality parameters across all weeks (ANOVA, p > 0.5) and this was also reflected on the average score per taxon (ASPT), which has shown no significant difference (ANOVA, p > 0.5) across weeks at all sites. These findings provide a baseline for future studies on flood effect on urban streams and supplement the understanding of the effects of sudden hydrologic regime changes on macroinvertebrate communities.
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