Novel Education Modules Addressing the Underrepresentation of Skin of Color in Dermatology Training

Background Representative images of pathology in patients with skin of color are lacking in most medical education resources. This particularly affects training in dermatology, which relies heavily on the use of images to teach pattern recognition. The presentation of skin pathology can vary greatly among different skin tones, and this lack of representation of dark skin phototypes challenges providers’ abilities to provide quality care to patients of color. In Botswana and other countries in sub-Saharan Africa, this challenge is further compounded by limited resources and access to dermatologists. There is a need for improved and accessible educational resources to train medical students and local medical providers in basic skin lesion description and diagnosis. Objectives We examined whether online Perceptual and Adaptive Learning Modules (PALMs) composed of representative dark skin images could efficiently train University of Botswana medical students to more accurately describe and diagnose common skin conditions in their community. Methods Year 4 and 5 medical students voluntarily completed PALMs that teach skin morphology, configuration, and distribution terminology and diagnosis of the most common dermatologic conditions in their community. Pre-tests, post-tests and delayed-tests assessed knowledge acquisition and retention. Results PALMs training produced statistically significant ( P < .0001) improvements in accuracy and fluency with large effect sizes (1.5, 3.7) and good retention after a 12.5-21-week median delay. Limitations were a self-selected group of students, a single institution, slow internet connections, and high drop-out rates. Conclusions Overall, population-specific PALMs are a useful tool for efficient development of pattern recognition in skin disease description and diagnosis.

Manually scanned single fiber optical coherence tomography for skin cancer characterization

Optical coherence tomography (OCT) is a cross-sectional imaging modality based on low coherence light interferometry. Within dermatology, it has found applications for in vivo diagnostic imaging purposes, as well as to guide Mohs micrographic surgery (MMS), due to its ability to visualize skin morphology up to several millimeters in depth. However, standard OCT probes have a large footprint and capture an extended area of the skin, making it difficult to precisely pinpoint clinically relevant location being imaged. Mohs surgeons stand to benefit from a handheld in vivo imaging device that can accurately trace surgical margins. In this study, we demonstrate the use of a single fiber OCT (sfOCT) instrument. Our imaging system features a miniature common path single fiber probe, and a novel speckle decorrelation technique that generates distortion free 2D images from manual scanning.By manually moving the single-fiber probe across the region of interest, the user can perform a lateral OCT scan while visualizing the location of the probe during data acquisition. Using the sfOCT, we have identified normal skin morphology, qualitatively correlated features of basal cell carcinoma and squamous cell carcinoma with histopathology, and quantified the disruption of the dermo-epidermal junction OCT pattern in skin tumors—each demonstrating the potential of utilizing sfOCT to differentiate tumor from normal skin. Using this imaging tool, a Mohs surgeon can enhance determination of surgical margins for the first stage of MMS, potentially decreasing the time and number of stages required for complete tumor removal.

Macrophage depletion induces edema through release of matrix-degrading proteases and proteoglycan deposition

Colony-stimulating factor 1 receptor (CSF1R) blockade abates tumor-associated macrophage (TAM) infiltrates and provides marked clinical benefits in diffuse-type tenosynovial giant cell tumors. However, facial edema is a common adverse event associated with TAM elimination in patients. In this study, we examined molecular and cellular events associated with edema formation in mice and human patients with cancer treated with a CSF1R blocking antibody. Extended antibody treatment of mice caused marked body weight gain, an indicator of enhanced body fluid retention. This was associated with an increase of extracellular matrix–remodeling metalloproteinases (MMPs), namely MMP2 and MMP3, and enhanced deposition of hyaluronan (HA) and proteoglycans, leading to skin thickening. Discontinuation of anti-CSF1R treatment or blockade of MMP activity restored unaltered body weight and normal skin morphology in the mice. In patients, edema developed at doses well below the established optimal biological dose for emactuzumab, a CSF1R dimerization inhibitor. Patients who developed edema in response to emactuzumab had elevated HA in peripheral blood. Our findings indicate that an early increase of peripheral HA can serve as a pharmacodynamic marker for edema development and suggest potential interventions based on MMP inhibition for relieving periorbital edema in patients treated with CSF1R inhibitors.

Soft Biomimetic Optical Tactile Sensing with the TacTip: A Review

<div>Reproducing the capabilities of the human sense of touch in machines is an important step in enabling robot manipulation to have the ease of human dexterity. A combination of robotic technologies will be needed, including soft robotics, biomimetics and the high-resolution sensing offered by optical tactile sensors. This combination is considered here as a SoftBOT (Soft Biomimetic Optical Tactile) sensor. This article reviews the BRL TacTip as a prototypical example of such a sensor. Topics include the relation between artificial skin morphology and the transduction principles of human touch, the nature and benefits of tactile shear sensing, 3D printing for fabrication and integration into robot hands, the application of AI to tactile perception and control, and the recent step-change in capabilities due to deep learning. This review consolidates those advances from the past decade to indicate a path for robots to reach human-like dexterity.</div><div><br></div>

Soft Biomimetic Optical Tactile Sensing with the TacTip: A Review

<div>Reproducing the capabilities of the human sense of touch in machines is an important step in enabling robot manipulation to have the ease of human dexterity. A combination of robotic technologies will be needed, including soft robotics, biomimetics and the high-resolution sensing offered by optical tactile sensors. This combination is considered here as a SoftBOT (Soft Biomimetic Optical Tactile) sensor. This article reviews the BRL TacTip as a prototypical example of such a sensor. Topics include the relation between artificial skin morphology and the transduction principles of human touch, the nature and benefits of tactile shear sensing, 3D printing for fabrication and integration into robot hands, the application of AI to tactile perception and control, and the recent step-change in capabilities due to deep learning. This review consolidates those advances from the past decade to indicate a path for robots to reach human-like dexterity.</div><div><br></div>

Design of In Vitro Hair Follicles for Different Applications in the Treatment of Alopecia—A Review

The hair research field has seen great improvement in recent decades, with in vitro hair follicle (HF) models being extensively developed. However, due to the cellular complexity and number of various molecular interactions that must be coordinated, a fully functional in vitro model of HFs remains elusive. The most common bioengineering approach to grow HFs in vitro is to manipulate their features on cellular and molecular levels, with dermal papilla cells being the main focus. In this study, we focus on providing a better understanding of HFs in general and how they behave in vitro. The first part of the review presents skin morphology with an emphasis on HFs and hair loss. The remainder of the paper evaluates cells, materials, and methods of in vitro growth of HFs. Lastly, in vitro models and assays for evaluating the effects of active compounds on alopecia and hair growth are presented, with the final emphasis on applications of in vitro HFs in hair transplantation. Since the growth of in vitro HFs is a complicated procedure, there is still a great number of unanswered questions aimed at understanding the long-term cycling of HFs without losing inductivity. Incorporating other regions of HFs that lead to the successful formation of different hair classes remains a difficult challenge.

Textured Building Façades: Utilizing Morphological Adaptations Found in Nature for Evaporative Cooling

The overheating of buildings and their need for mechanical cooling is a growing issue as a result of climate change. The main aim of this paper is to examine the impact of surface texture on heat loss capabilities of concrete panels through evaporative cooling. Organisms maintain their body temperature in very narrow ranges in order to survive, where they employ morphological and behavioral means to complement physiological strategies for adaptation. This research follows a biomimetic approach to develop a design solution. The skin morphology of elephants was identified as a successful example that utilizes evaporative cooling and has, therefore, informed the realization of a textured façade panel. A systematic process has been undertaken to examine the impact of different variables on the cooling ability of the panels, bringing in new morphological considerations for surface texture. The results showed that the morphological variables of assembly and depth of texture have impact on heat loss, and the impact of surface area to volume (SA:V) ratios on heat loss capabilities varies for different surface roughness. This study demonstrates the potential exploitation of morphological adaptation to buildings, that could contribute to them cooling passively and reduce the need for expensive and energy consuming mechanical systems. Furthermore, it suggests areas for further investigation and opens new avenues for novel thermal solutions inspired by nature for the built environment.