This literature review explores atopic dermatitis and its management, with a focus on phototherapy as a treatment modality. The primary objectives are to elucidate the pathophysiological mechanisms, clinical manifestations, diagnostic criteria, and epidemiology of atopic dermatitis. Additionally, it seeks to explain phototherapy mechanisms, different modalities, and other therapeutic approaches. In this review, we comprehensively examine atopic dermatitis by synthesizing findings from diverse sources over the past 20 years. We investigate the epidemiology, pathophysiology, clinical manifestations, diagnostic criteria, and role of phototherapy in treatment. We conduct thematic analysis, compare phototherapy modalities, consider contextual factors, and integrate patient perspectives while upholding ethical considerations. Limitations include potential publication bias, language barriers, temporal constraints, subjectivity, and limited generalizability. Atopic dermatitis has a complex pathogenesis and can be managed with diverse modalities. Phototherapy emerges as an effective and safe treatment, particularly when other therapies prove ineffective.

Background: Touchscreens are usually microbially contaminated and can therefore act as fomites inside and outside healthcare environments. Due to the increasing use of such touchscreens and the growing awareness of infection risks, approaches that allow safe and automatic disinfection are desired. Ultraviolet (UV) irradiation, with its known antimicrobial efficacy, could achieve this goal, but should be executed with limited touchscreen degradation, disinfection duration, and energy consumption. It should also pose as little harm as possible to humans even in case of failure. Materials and methods: A literature search was performed first to identify the microorganisms most commonly found on touchscreens. Then, the 90% reduction doses (D90 doses) for the different relevant microorganisms and UV spectral ranges were determined from the literature, and irradiation doses are suggested that should reduce most of these important microorganisms by 5 log-levels. Results: The most frequent microorganisms are staphylococci, bacilli, micrococci, enterococci, pseudomonads and E. coli with small differences between hospital and community environments, if antibiotic resistance properties are ignored. The determined irradiation doses for a 5 log-reduction of the most frequent microorganisms are about 40 mJ/cm2, 80 J/cm2, 500 J/cm2 and 50 mJ/cm2 for the UV spectral ranges UVC, UVB, UVA and far-UVC, respectively. These doses are also sufficient to inactivate all nosocomial ESKAPE pathogens on touchscreens by at least 99.999%. Conclusion: Disinfection is achievable in all UV spectral ranges, with UVC being the most effective, enabling automatic disinfection within a minute or less. The much higher doses required in the UVB and UVA spectral range result in much longer disinfection durations, with the advantage of a reduced risk to humans. For all kinds of UV irradiation, the doses should be limited to reasonable values to avoid irradiating an already more or less sterile surface and to prevent degradation of touchscreen devices.
Hintergrund: Touchscreens weisen meist mikrobielle Kontaminationen auf, die innerhalb und außerhalb von Gesundheitseinrichtungen zu Infektionen führen können. Aufgrund des zunehmenden Einsatzes von Touchscreens und des wachsenden Hygiene-Bewusstseins werden Ansätze gesucht, die eine sichere und möglichst automatische Desinfektion ermöglichen. Ultraviolette (UV) Bestrahlung mit ihrer bekannten antimikrobiellen Wirkung könnte dieses Desinfektionsziel erreichen, doch sollte dies mit einer sinnvollen Begrenzung der Touchscreen-Degradation, der Desinfektionsdauer und des Energieverbrauchs erfolgen und auch im Fehlerfall Menschen möglichst wenig schädigen. Material und Methoden: Zunächst wird eine Literaturrecherche durchgeführt, um die am häufigsten auf Touchscreens vorkommenden Mikroorganismen zu identifizieren. Dann werden die 90%- Reduktionsdosen (D90-Dosen) für die verschiedenen Mikroorganismen und UV-Spektralbereiche aus der Literatur ermittelt und Bestrahlungsdosen vorgeschlagen, die die meisten der relevanten Mikroorganismen um 5 Log-Stufen reduzieren. Ergebnisse: Die am häufigsten gefundenen Mikroorganismen sind Staphylokokken, Bazillen, Mikrokokken, Enterokokken, Pseudomonaden und E. coli mit geringen Unterschieden zwischen Gesundheitseinrichtungen und nicht-medizinischen Umgebungen, wenn Antibiotikaresistenzen nicht betrachtet werden. Die ermittelten Bestrahlungsdosen für eine 5 Log-Reduktion der häufigsten Mikroorganismen liegen bei etwa 40 mJ/cm2, 80 J/cm2, 500 J/cm2 und 50 mJ/cm2 für die UV-Spektralbereiche UVC, UVB, UVA bzw. Far-UVC. Diese Dosen reichen auch aus, um alle nosokomialen ESKAPE-Erreger auf Touchscreens um mindestens 99,999% zu inaktivieren.Schlussfolgerung: Eine Desinfektion ist in allen UV-Spektralbereichen möglich, wobei UVC am wirksamsten ist und eine automatische Desinfektion innerhalb einer Minute oder weniger ermöglicht. Die viel höheren benötigten Dosen im UVB- und UVA-Spektralbereich führen zu einer deutlich längeren Desinfektionsdauer mit dem Vorteil eines geringeren Risikos für den Menschen. Bei allen Arten der UV-Bestrahlung sollten die Dosen auf vernünftige Werte begrenzt werden, um die Bestrahlung einer bereits mehr oder weniger sterilen Oberfläche zu vermeiden und um die Degradation von Touchscreen-Geräten zu minimieren.

UNASSIGNED: Clinical scores for sepsis have been primarily developed for, and applied in High-Income Countries. This systematic review and meta-analysis examined the performance of the quick Sequential Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SIRS), Modified Early Warning Score (MEWS), and Universal Vital Assessment (UVA) scores for diagnosis and prediction of mortality in patients with suspected infection in Low-and-Middle-Income Countries.
UNASSIGNED: PubMed, Science Direct, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched until May 18, 2021. Studies reporting the performance of at least one of the above-mentioned scores for predicting mortality in patients of 15 years of age and older with suspected infection or sepsis were eligible. The Quality Assessment of Diagnostic Accuracy Studies tool was used for risk-of-bias assessment. PRISMA guidelines were followed (PROSPERO registration: CRD42020153906). The bivariate random-effects regression model was used to pool the individual sensitivities, specificities and areas-under-the-curve (AUC).
UNASSIGNED: Twenty-four articles (of 5669 identified) with 27,237 patients were eligible for inclusion. qSOFA pooled sensitivity was 0·70 (95% confidence interval [CI] 0·60-0·78), specificity 0·73 (95% CI 0·67-0·79), and AUC 0·77 (95% CI 0·72-0·82). SIRS pooled sensitivity, specificity and AUC were 0·88 (95% CI 0·79 -0·93), 0·34 (95% CI 0·25-0·44), and 0·69 (95% CI 0·50-0·83), respectively. MEWS pooled sensitivity, specificity and AUC were 0·70 (95% CI 0·57 -0·81), 0·61 (95% CI 0·42-0·77), and 0·72 (95% CI 0·64-0·77), respectively. UVA pooled sensitivity, specificity and AUC were 0·49 (95% CI 0·33 -0·65), 0·91(95% CI 0·84-0·96), and 0·76 (95% CI 0·44-0·93), respectively. Significant heterogeneity was observed in the pooled analysis.
UNASSIGNED: Individual score performances ranged from poor to acceptable. Future studies should combine selected or modified elements of different scores.
UNASSIGNED: Partially funded by the UK National Institute for Health Research (NIHR) (17/63/42).

The effects of ultraviolet (UV) radiation on life on Earth have continuously been the subject of research. Over-exposure to UV radiation is harmful, but small amounts of exposure are required for good health. It is, therefore, crucial for humans to optimise their own UV exposure and not exceed UV levels that are sufficient for essential biological functions. Exceeding those levels may increase risk of developing health problems including skin cancer and cataracts. Smartphones have been previously investigated for their ability to detect UV radiation with or without additional devices that monitor personal UV exposure, in order to maintain safe exposure times by individuals. This review presents a comprehensive overview of the current state of smartphones\' use in UV radiation monitoring and prediction. There are four main methods for UV radiation detection or prediction involving the use smartphones, depending on the requirements of the user: devoted software applications developed for smartphones to predict UV Index (UVI), wearable and non-wearable devices that can be used with smartphones to provide real-time UVI, and the use of smartphone image sensors to detect UV radiation. The latter method has been a growing area of research over the last decade. Built-in smartphone image sensors have been investigated for UV radiation detection and the quantification of related atmospheric factors (including aerosols, ozone, clouds and volcanic plumes). The overall practicalities, limitations and challenges are reviewed, specifically in regard to public education. The ubiquitous nature of smartphones can provide an interactive tool when considering public education on the effects and individual monitoring of UV radiation exposure, although social and geographic areas with low socio-economic factors could challenge the usefulness of smartphones. Overall, the review shows that smartphones provide multiple opportunities in different forms to educate users on personal health with respect to UV radiation.

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OBJECTIVE: To review the literature on current applications of corneal Collagen Cross-Linking (CXL).
METHODS: A review of publications on corneal cross-linking was conducted. This included systemic reviews, randomized controlled clinical trials, cohort studies, case-controlled studies and case series. A summary of the publications is tabulated.
RESULTS: The original indication of riboflavin - Ultraviolet-A (UVA) induced corneal collagen cross-linking is to arrest the progression of keratoconus. Studies show that it is effective in arresting the progression of keratoconus and post-LASIK ectasia with the standard Dresden protocol (epithelium-off). There are also improvements in visual, keratometric and topographic measurements over time. Severe complications of cross-linking are rare. The epithelium-on techniques have less efficacy than the Dresden protocol. Accelerated protocols have variable results, with some studies reporting comparable outcomes to the Dresden protocol while other studies reporting less efficacious outcomes. Cross-linking combined with refractive procedures provide better visual outcome but long term studies are warranted. Cross-linking for the treatment of infective keratitis is a promising new treatment modality. Initial studies show that it is more effective for superficial rather than deep infections and for bacterial rather than fungal infections.
CONCLUSIONS: Corneal cross-linking is a procedure with an expanding list of indications from the treatment of corneal ectasias to infective keratitis. While the standard Dresden protocol is established as the gold standard treatment for progressive keratoconus, the more recent protocols may require further refinements, investigative and long-term studies.