A Priori Estimation of the Narrow-Band UVB Phototherapy Outcome for Moderate-to-Severe Psoriasis Based on the Patients' Questionnaire and Blood Tests Using Random Forest Classifier.

BACKGROUND: Nowadays, patients with moderate-to-severe psoriasis are treated with conventional immunosuppressants or with new biological agents. Phototherapy is the first-line treatment for patients in whom topical therapy is insufficient. Although numerous studies have been carried out, it is still difficult to predict the outcome of phototherapy in individual patients. METHODS: Prior to standard narrow band (NB) ultraviolet B (UVB) phototherapy, the patients filled out a questionnaire about personal life and health status. Several standard blood tests, including selected cytokine levels, were performed before and after a course of 20 NB-UVB treatments. The questionnaire answers, results of the blood tests, and treatment outcomes were analyzed using an artificial intelligence approach-the random forest (RF) classification tool. RESULTS: A total of 82 participants with moderate-to-severe psoriasis were enrolled. Prior to starting phototherapy, the patients with expected good outcome from the phototherapy, shorter remission, and quitting a possible second course of the NB-UVB treatment could be identified by the RF classifier with sensitivity over 84%, and accuracy of 75%, 85%, and 79%, respectively. The inclusion of cytokine data did not improve the performance of the RF classifier. CONCLUSION: This approach offers help in making clinical decisions by identifying psoriatic patients in whom phototherapy will significantly improve their skin, or those in whom other therapies should be recommended beforehand.

Optimal vitamin D3 daily intake of 2000IU inferred from modeled solar exposure of ancestral humans in Northern Tanzania.

Recently, high serum 25-hydroxyvitamin D concentration (~110nmol/L) was found in the Hadza tribe still keeping ancient hunter-gather life style. This level could serve as optimal vitamin D level that was built during millennia of human evolution. The personal vitamin D3 effective solar exposures of the Hadza adults are estimated using radiative model simulations with input from the satellite observations over lake Eyasi (3.7°S, 35.0°E). The calculations are carried out assuming the Hadza typical clothing habits and specific scenarios of the out-door activity comprising early morning and late afternoon working time in sun and prolonged midday siesta in the shade. The modeled doses received by the Hadza are converted to the vitamin D3 effective daily doses pertaining to the lighter skinned persons. We propose a novel formula to get adequate vitamin D level - exposure of 1/3 MED around local noon to 1/3 part of the whole body during warm sub-period of the year in the low- and mid-latitude regions. Such daily solar exposure is equivalent to ~2000IU of vitamin D3 taken orally. For many contemporary humans with limited out-door activity habit achieving such daily norm requires vitamin D3 supplementation of 2000IU throughout the whole year.

System for monitoring UV radiation level in phototherapy cabins in Poland.

INTRODUCTION: Ultraviolet phototherapy (UVP) is widely used in dermatological practice for the treatment of various skin diseases. Numerous studies support its beneficial curing effectiveness; however, overexposure to ultraviolet radiation can cause adverse health effects, such as sunburn reaction, erythema response, cataract, skin aging, etc. For these reasons, it is of special importance to monitor performance of UVP cabins using a calibration system to evaluate the UV doses incident upon the patient. MATERIAL AND METHODS: A mechanized cabin control system (CCS) is proposed. It consists of radiometers with a wide and narrow field of view to estimate the body irradiation and to identify malfunctioning cabin tubes. Quality control and quality assurance procedures are developed to keep high accuracy of the calibration procedure. The CCS has been used in the examination of two different types of UVP cabins routinely working in Poland. RESULTS: It allows precise calculation of UV doses and spatial variability of UV radiance inside the cabin, thus providing uncertainties of the doses assigned by medical staff. The CCS could potentially serve as a primary standard for monitoring various UVP cabins working in Poland. CONCLUSIONS: The methodology developed to quantify UV doses in UVP cabins may be easily extended to any UV radiation source.