Evaluation of the Biological Activity of Manna Exudate, from Fraxinus ornus L., and Its Potential Use as Hydrogel Formulation in Dermatology and Cosmetology.

Manna, a well-known herbal drug has multiple traditional and pharmaceutical uses and the entire composition, sugar derivatives and polyphenols, gives rise to a very interesting bioactive complex with versatile therapeutic and benefic properties such as antioxidant and anti-inflammatory activities. The aim of this research was to investigate a F. ornus manna extract loaded in a pectin hydrogel as a synergic vehicle to evaluate the potential use of the complex for cosmetic and dermatological applications. In particular, the study set out to disclose manna properties as a wound healing agent with antimicrobial and reparative activity on infected tissues. Moreover, considering the correlation between antioxidant activity and antiaging potential, the extract was investigated in regard to the anti-elastase activity and skin whitening potential. The total phenolic content of each extract was also determined and a safe profile by in vitro cytotoxicity studies was verified. The hydrogel complex, containing the manna extract and pectin as the gelling agent, exhibited suitable properties in terms of pH (from 5.50 to 6.80), rheological behavior and ability of preserving the antioxidant activity of the manna exudate (around 10%). All the peculiarities that make the pectin hydrogels ideal systems for skin disease, as wound dressings and for antiaging cosmetic formulations.

Nail cosmetology.

Nail cosmetics is enjoying growing success due to recent technological advances. Manicures can be responsible for mechanical, infectious or allergic adverse effects. Nail cosmetics (e.g., nail varnishes, acrylic false nails, light-curing gels, and adhesive false nails) incorporate substances that harden after solvent evaporation or after polymerization. Allergic reactions can occur, remotely with conventional varnishes and locally with polymerizing substances. Artificial nails incur a risk of carrying infectious agents which can cause serious infection, and should not be used by caregivers. Recently, there has been a worrisome increase in the frequency of acrylate allergy, due to the appearance of home kits and lack of information in the general public. The infectious, allergic and toxic risks incurred by consumers and professionals regarding manicure or pedicure treatments and the application of nail cosmetics are the subject of recommendations and monitoring measures.

Moringa oleifera (drumstick tree)-nutraceutical, cosmetological and medicinal importance: a review.

Moringa oleifera Lam. (Moringaceae) is a species of tree with an increasing utility, occurring naturally mainly in Pakistan and northern India. M. oleifera is currently cultivated in Africa, South America, Asia and the Middle East. The usage of its leaves, seed oil, bark, fruits, flowers and roots has positive opinions of FDA (American Food and Drug Administration), EFSA (European Food Safety Authority) and CosIng (Cosmetic Ingredients database). The chemical composition of M. oleifera is dominated by: proteins (consisting mainly of amino acids such as arginine or serine), fatty acids (omega-3 and omega-6), vitamins (vitamin A, B and C and tocopherols), mineral salts (including several bioelements, such as calcium, magnesium, sodium, and potassium), valuable polyphenolic compounds from the group of phenolic acids (e.g., gallic acid, ferulic acid) and flavonoids (e.g., myricetin, rutoside, and kaempferol). The raw materials show antioxidant, hepatoprotective, anti-inflammatory and antimicrobial properties. Dietary supplements and alimentary products containing M. oleifera are recommended as health-promoting and "novel food" preparations. The main purpose of this work was a review of the latest scientific literature on M. oleifera, with particular emphasis on the studies focusing on its chemical composition, biological activity and safety. Moreover, the review tends to discuss the results of biotechnological studies using this material and the agronomical significance.

Safety and efficacy evaluation of botulinum toxin an injection by FITTER® microneedle to treat medial lower eyelid wrinkles.

BACKGROUND: Treatment for medial lower eyelid wrinkles is in great demand now. However, conventional injection of botulinum toxin A (BTX-A) often leads to serious complications. AIMS: We aim to evaluate the safety and efficacy of BTX-A injection with microneedle to treat medial lower eyelid wrinkles. METHODS: We collected clinical data of 16 patients to treat dynamic wrinkles on the medial aspect of the lower eyelid. Adverse effects at each stage of the treatment were recorded. We used VISIA to compare the static and dynamic wrinkles of the medial lower eyelid before and after treatment. Furthermore, patients and physicians evaluated the wrinkles with Kappa scores. RESULTS: All 16 patients completed the study. The objective evaluation indicator (the Ra variable given by VISIA) progressively and significantly decreased at 1 month and 3 months after treatment. The kappa scores given by patients and by surgeons were both significantly reduced after treatment. No adverse reactions, such as pouch prolapse, diplopia, and canthal tendon laxity, occurred at 1 week, 1 month, or 3 months after the treatment. CONCLUSION: BTX-A treatment of medial lower eyelid wrinkles with microneedle injection allows better control of the injection depth and reduces both the amount of BTX-A needed and the incidence of complications while maintaining the natural dynamic expression.

Preparation of Cosmetic Emulsions Containing Hippophae Oil Isolated by Various Methods: Study of Their Antioxidant, Sun-Blocking and Physicochemical Properties.

An industry listed as one of the largest globally is the cosmetic industry. In recent years, this industry has shown growing interest in the application of natural ingredients providing advanced properties to cosmetic creams such as moisturizing, antioxidant, sun-protecting and antimicrobial effects. In this context, the present study concerns the production of cosmetic emulsions containing hippophae oil obtained via the methods of extraction, hydro-distillation and maceration using sunflower oil as the carrier oil. Firstly, an IR-ATR analysis was performed showing that the oils prepared were close to those commercially obtained. Then, the stability of the emulsions was tested over a time period of four months through measuring their pH and viscosity values with positive outcomes, and their antioxidant ability was also measured using the DPPH method. The latter one showed that hippophae oil greatly improves the antioxidant capacity. Moreover, based on the fact that sea buckthorn contains carotenoids, the SPF value of the emulsions was determined. The results showed that the addition of hippophae oil to the emulsions gave higher absorption in UV-Vis, thus higher SPF values. Py-GC/MS analysis was used to identify decomposition compounds in the produced oils. Among those, valuable compounds such as Ω-6, Ω-7 and Ω-9 fatty acids and many aldehydes were found by the decomposition of the oils.

Protective Effect of Amaranthus cruentus L. Seed Oil on UVA-Radiation-Induced Apoptosis in Human Skin Fibroblasts.

Since the exposure of fibroblasts to prolonged UVA radiation induces oxidative stress and apoptosis, there is a need for effective skin protection compounds with cytoprotective and antioxidant properties. One of their sources is Amaranthus cruentus L. seed oil (AmO), which is rich in unsaturated fatty acids, squalene, vitamin E derivatives and phytosterols. The aim of this study was to evaluate whether AmO evokes a protective effect on the apoptosis induced by UVA radiation in human skin fibroblasts. UVA radiation at an applied dose of 10 J/cm2 caused a significant reduction in the survival of human skin fibroblasts and directed them into the apoptosis pathway. Increased expression of p53, caspase-3, caspase-9 and PARP proteins in UVA-treated fibroblasts suggests the intrinsic mechanism of apoptosis. Application of the oil at 0.1% and 0.15% concentrations to UVA-treated cells decreased the expression of these proteins, which was accompanied by increased cell survival. Similarly, the UVA-dependent decrease in the expression of p-Akt and mTOR proteins was restored under the effect of the studied oil. The molecular mechanism of this phenomenon was related to the stimulation of antioxidant processes through the activation of Nrf2. This suggests that AmO stimulated the antioxidant system in fibroblasts, preventing the effects of UVA-induced oxidative stress, which may lead to pharmaceutical and cosmetological applications as a sun-protective substance.

An Evaluation of the Effect of Social Media Platforms on the General Population's Decision-Making About Cosmetic Procedures in Makkah City, Saudi Arabia.

Background and objective Aesthetic procedures are one of the most commonly performed medical procedures. Surgical and non-surgical cosmetic treatments that are routinely performed include breast augmentations, rhinoplasty, botulinum toxin, and fillers. Several factors contribute to the increase in the popularity of these procedures, including body image dissatisfaction, the opinion of peers, and surgeon-related factors such as the surgeon's reputation, board certification, or years of experience. In addition, recent evidence suggests that active and passive usage of highly visual social media that focus on appearance-centric content have been positively associated with the acceptance of, and desire for, cosmetic procedures. In this study, we aimed to investigate the influence of social media on individuals' decision-making in terms of cosmetic procedures. Method The setting for this population-based cross-sectional study was public places in Makkah City, Saudi Arabia, and it was conducted from September to November 2021. Our study included adults above the age of 18 years. The exclusion criteria were as follows: non-Arabic speakers and individuals with congenital anomalies or dysmorphic dermatological diseases. The final sample consisted of 364 participants. All analyses were carried out using IBM SPSS Statistics version 28 (IBM Corp., Armonk, NY). Continuous and categorical variables were compared using ANOVA and Pearson's Chi-squared test. Result A total of 364 participants were included in the study, and 80% of them used their phones on a daily basis for >4 hours per week. The mean age of the participants was 27.4 ± 8.3 years, and they had a mean BMI of 25.0 ± 6.4 kg/m2; 60% of the participants were female. Participants with a history of cosmetic procedures or a desire to undergo cosmetic procedures reported a similar pattern of daily phone use. There was no significant association between the reported history of cosmetic procedures and the daily duration of selected social media platform use. Conclusion We found no significant correlation between the hours spent on social media and the participants' history or desire for cosmetic procedures. Only 54 subjects compared themselves to social media celebrities. These findings could be attributed to the fact that the Makkah population is conservative in their religious attitudes and traditions, which makes them less susceptible to social media influences.

Construction of a system for head and neck tumor traceless resection with non-inflatable transaxillary total endoscopic surgery.

Radical cure and functional preservation of tumors are the fundamental goals of surgical treatment of head and neck tumors, and the preservation of good aesthetics is a higher pursuit on this basis. Fully hiding the surgical incision and reducing the visibility of scars are important goals of cosmetic surgery. Using complete endoscopy for the head and neck is an effective method. CO2-free transaxillary total endoscopic surgery is a method with many advantages, which has been widely used in the resection of thyroid tumors, but for other parts and types of tumors in the head and neck, this surgical method is rarely used. The research team expanded its application scope and applied it to submandibular gland tumor resection and other head and neck surgeries for the first time. Through this exploration, it improved traction devices such as retractors, strictly limited the surgical indications, analyzed and summarized the key points, steps and methods of surgery, and built a treatment system for head and neck tumor surgery under complete endoscopy using the non-inflatable transaxillary approach. In this article, we introduce the system and select typical cases to share.

The Effectiveness of Pyruvic Acid Peeling in Improving the Quality of Life of Patients with Acne Vulgaris.

Improving the quality of life (QoL) of patients with various chronic diseases has become a challenge and priority of contemporary medicine. The aim of this study was to assess the impact of pyruvic acid peeling on the QoL of patients with acne vulgaris. The study group consisted of 200 young patients (mean age 23.04 ± 4.71) with acne vulgaris of mainly mild or moderate severity. Basic data about the patient were collected using a self-reported questionnaire. The assessment of QoL was carried out using standardized questionnaires: CADI (Cardiff Acne Disability Index), DLQI (Dermatology Life Quality Index), SWLS (Satisfaction With Life Scale), and BDI (Beck Depression Inventory). The cosmetic intervention consisted of chemical peeling with 35% pyruvic acid for acne lesions on the body and included four series repeated at 7-day intervals. This study demonstrated that acne vulgaris impairs the quality of life of young people. There were no significant differences between the severity of acne and the lifestyles of the subjects. The applied cosmetic procedure significantly decreased the severity of the acne and improved the quality of life of the patients.

THE IMPORTANCE OF REMOTE COUNSELING IN COSMETOLOGY AND COSMETIC DERMATOLOGY.

Remote consultations are used for diagnosis, treatment recommendations, patient monitoring and health education. The aim of the study was to collect, assess and summarise data regarding remote consultations in cosmetology and cosmetic dermatology. The study is an introduction to the authors' research into the importance of remote counseling in cosmetology. A review of the literature available on PubMed; a diagnostic survey was carried out among those declared and qualified for the study; the author's preliminary unpublished results are reported (JMB). A total of 490 publications were identified in a search of 20 October 2021. A summary of ten research papers was produced in the narrative form. In addition, an analysis of an unpublished diagnostic survey was carried out (JMB research, 2021, respondents n=95, full survey completed n=46). The analysed research papers discussed: telephone counseling (n=2), e-counseling (n=3), e-learning (n=2), automatic counseling (n=2), and mobile health applications (n=1). The aim of each of the research papers analysed in this review was to educate patients in the field of skin care and to con¬solidate proper skin care and photo-protection behaviours. The diagnostic survey, as well as the literature review, confirmed the importance of and need for remote counseling in cosmetology and cosmetic dermatology as regards education, motivation and prophylaxis.

Determination of Chemical Composition and Investigation of Biological Activities of Ocimum basilicum L.

This study aimed to determine the chemical composition of the essential oils (EOs) of Ocimum basilicum L., as well as to evaluate the antibacterial, antidiabetic, dermatoprotective, and anti-inflammatory properties, and the EOs and aqueous extracts of O. basilicum. The antibacterial activity was evaluated against bacterial strains, Gram-positive and Gram-negative, using the well diffusion and microdilution methods, whereas the antidiabetic activity was assessed in vitro using two enzymes involved in carbohydrate digestion, α-amylase and α-glucosidase. On the other hand, the dermatoprotective and anti-inflammatory activities were studied by testing tyrosinase and lipoxygenase inhibition activity, respectively. The results showed that the chemical composition of O. basilicum EO (OBEO) is dominated by methyl chavicol (86%) and trans-anethol (8%). OBEO exhibited significant antibacterial effects against Gram-negative and Gram-positive strains, demonstrated by considerable diameters of the inhibition zones and lower MIC and MBC values. In addition, OBEO exhibited significant inhibition of α-amylase (IC50 = 50.51 ± 0.32 µg/mL) and α-glucosidase (IC50 = 39.84 ± 1.2 µg/mL). Concerning the anti-inflammatory activity, OBEO significantly inhibited lipoxygenase activity (IC50 = 18.28 ± 0.03 µg/mL) compared to the aqueous extract (IC50 = 24.8 ± 0.01 µg/mL). Moreover, tyrosinase was considerably inhibited by OBEO (IC50 = 68.58 ± 0.03 µg/mL) compared to the aqueous extract (IC50 = 118.37 ± 0.05 µg/mL). The toxicological investigations revealed the safety of O. basilicum in acute and chronic toxicity. The finding of in silico analysis showed that methyl chavicol and trans-anethole (main compounds of OBEO) validate the pharmacokinetics of these compounds and decipher some antibacterial targets.

NRF2 in dermo-cosmetic: From scientific knowledge to skin care products.

The skin is the organ that is most susceptible to the impact of the exposome. Located at the interface with the external environment, it protects internal organs through the barrier function of the epidermis. It must adapt to the consequences of the harmful effects of solar radiation, the various chemical constituents of atmospheric pollution, and wounds associated with mechanical damage: oxidation, cytotoxicity, inflammation, and so forth. In this biological context, a capacity to adapt to the various stresses caused by the exposome is essential; otherwise, more or less serious conditions may develop accelerated aging, pigmentation disorders, atopy, psoriasis, and skin cancers. Nrf2-controlled pathways play a key role at this level. Nrf2 is a transcription factor that controls genes involved in oxidative stress protection and detoxification of chemicals. Its involvement in UV protection, reduction of inflammation in processes associated with healing, epidermal differentiation for barrier function, and hair regrowth, has been demonstrated. The modulation of Nrf2 in the skin may therefore constitute a skin protection or care strategy for certain dermatological stresses and disorders initiated or aggravated by the exposome. Nrf2 inducers can act through different modes of action. Keap1-dependent mechanisms include modification of the cysteine residues of Keap1 by (pro)electrophiles or prooxidants, and disruption of the Keap1-Nrf2 complex. Indirect mechanisms are suggested for numerous phytochemicals, acting on upstream pathways, or via hormesis. While developing novel and safe Nrf2 modulators for skin care may be challenging, new avenues can arise from natural compounds-based molecular modeling and emerging concepts such as epigenetic regulation.

Directions of hyaluronic acid application in cosmetology.

BACKGROUND: Hyaluronic acid is a naturally occurring substance in the human body. It is a component of the intercellular matrix of the dermis and is often used as a raw material in cosmetology. This substance was isolated for the first time in the first half of the twentieth century, while cosmetology treatments and aesthetic medicine have been developing rapidly and gaining popularity. The same applies to companies producing cosmetic care products which contain hyaluronic acid. This is related to the growing desire of the society to improve the quality of the skin and maintain its vitality and firmness. AIMS: The study investigates different directions and possibilities of using hyaluronic acid in cosmetology. Moreover, the paper describes possible side effects observed after hyaluronic acid injections. PATIENTS/METHODS: The study was based on an anonymous questionnaire conducted between October 10, 2021, and February 21, 2022. 513 responses were collected. RESULTS: The awareness and level of knowledge in this field of cosmetology among potential beauty salon clients are on the rise. Hyaluronic acid is used in injections, as well as in care cosmetics, oral and vaginal preparations. Various areas of the face are injected, most often the lips. Face creams are among the most frequently purchased skincare products. CONCLUSIONS: The use of hyaluronic acid in cosmetology is multidirectional. It is mainly focused on skincare and specific anti-aging activities. Treatments of this type help preserve the skin's vitality, which translates into an improved quality of life due to the satisfaction of the need for attractiveness.

Application of Noise Control Combined with Relaxation Training in Patients with Skin Laser Cosmetology: A Single-center Retrospective Study.

Objective: Noise pollution has been listed as one of the three major types of pollution, along with air and water pollution. Hospitals should pay attention to noise control, which is of great importance for the treatment and rehabilitation of patients. This study focuses on the application value of noise control and relaxation training. Methods: This study retrospectively collected and analyzed the clinical data of 184 patients who underwent skin laser cosmetology in Ningbo Yinzhou No. 2 Hospital from January 2021 to December 2022. Twelve patients who did not meet the criteria were excluded, and the remaining 172 patients were divided based on the type of intervention into the control group (CG, n = 82) and the study group (SG, n = 90). The CG received relaxation training and routine noise management, while the SG received noise control combined with relaxation training. The intervention effect was discussed from the aspects of noise, psychology, and satisfaction. Results: After the intervention, the SG had overtly lower noise levels and lower scores of anxiety and depression compared to the CG (all P < 0.001). Correlation analysis showed that noise levels were positively correlated with scores of anxiety and depression (r = 0.553, r = 0.592, P < 0.001). The two groups had no significant difference in total satisfaction (P > 0.05). Conclusion: Noise poses a significant threat to the human body. Strengthening noise control in hospitals is beneficial for patients' recovery. Combining noise control with relaxation training is an intervention method worthy of clinical application. It can improve the hospitalization environment and reduce the noise levels to a great extent, thereby improving the psychological state of patients and enhancing the medical satisfaction.

Nanoparticles for Topical Application in the Treatment of Skin Dysfunctions-An Overview of Dermo-Cosmetic and Dermatological Products.

Nanomaterials (NM) arouse interest in various fields of science and industry due to their composition-tunable properties and the ease of modification. They appear currently as components of many consumer products such as sunscreen, dressings, sports clothes, surface-cleaning agents, computer devices, paints, as well as pharmaceutical and cosmetics formulations. The use of NPs in products for topical applications improves the permeation/penetration of the bioactive compounds into deeper layers of the skin, providing a depot effect with sustained drug release and specific cellular and subcellular targeting. Nanocarriers provide advances in dermatology and systemic treatments. Examples are a non-invasive method of vaccination, advanced diagnostic techniques, and transdermal drug delivery. The mechanism of action of NPs, efficiency of skin penetration, and potential threat to human health are still open and not fully explained. This review gives a brief outline of the latest nanotechnology achievements in products used in topical applications to prevent and treat skin diseases. We highlighted aspects such as the penetration of NPs through the skin (influence of physical-chemical properties of NPs, the experimental models for skin penetration, methods applied to improve the penetration of NPs through the skin, and methods applied to investigate the skin penetration by NPs). The review summarizes various therapies using NPs to diagnose and treat skin diseases (melanoma, acne, alopecia, vitiligo, psoriasis) and anti-aging and UV-protectant nano-cosmetics.

Efficacy of Hydrogen Purification and Cosmetic Acids in the Treatment of Acne Vulgaris: A Preliminary Report.

Acne and skin lesions that appear in its course deteriorate the quality of life of patients, cause depression and the emergence of suicidal thoughts. Cosmetic treatments can have a positive effect on improving skin condition by cleaning up skin eruptions, thus improving the well-being of affected people. Hydrogen purification is a treatment that uses alkaline water generated by a device, which reduces sebum from the surface of the epidermis. This is a novel treatment that has recently been introduced to beauty salons. On the other hand, cosmetic acids have been used for many years for treating people with acne vulgaris and give spectacular results in terms of improving the skin condition. In this study, skin condition was evaluated with a Derma Unit SSC 3 device. The Global Acne Grading System (GAGS) was used to check acne severity. Twenty-four women aged 19-21 years (M = 20.13, SD = 0.80) diagnosed with mild acne vulgaris and a high sebum level participated in the study. Group A underwent a hydrogen purification treatment using an H2jet manipulator, which ejected alkaline water from the manipulator under pressure. Group B underwent a hydrogen purification treatment with the use of a phytic, pyruvic, lactic and ferulic acids at 40% mixture (pH 1.4). A series of four treatments was performed at 14-day intervals in both groups. Skin parameters were measured before and 30 days after the series of treatment. Very good results were obtained in both groups. The skin eruptions in patients were reduced and we also observed lower amounts of sebum on the surface of the epidermis, and an improvement in skin hydration. However, in group B, the results were better than in group A. The study showed that the synergy of the treatments produced much better effects than those obtained by completing the hydrogen purification treatment alone.

Cosmetics: What Do Bruneian Female Adults Believe?

OBJECTIVES: The study aimed to measure the level of attitudes and the current practices of the female community in Brunei Darussalam regarding the usage of cosmetics. METHODS: An online survey was conducted using a non-probabilistic snowball sampling approach via the social media channels WhatsApp and Instagram. The inclusion criteria were female Bruneian citizens or permanent residents, aged between 18 and 65 years old, who can understand English or Malay, and use cosmetic products at least once a day. RESULTS: A total of 445 participants responded to the online survey. Most of the participants agreed that the use of cosmetic products improves one's physical appearance to the public (391, 87.8%) and also improves self-confidence (405, 91.1%). There were significant differences in monthly cosmetic product expenses and participants' attitudes about safe cosmetic use (p = 0.001). No significant changes in the individuals' attitudes based on their age or educational level were observed. Overall, the participants had a good level of cosmetic safety practice. Almost half of the participants use social media to obtain information regarding what cosmetics to use or purchase. CONCLUSION: There is a medium to high level of attitude and a high level of practice regarding the safe use of cosmetics among Bruneian female adults. Social media was the main source of information for the respondents, followed by friend circle and family members.

Effects of UV and UV-vis Irradiation on the Production of Microalgae and Macroalgae: New Alternatives to Produce Photobioprotectors and Biomedical Compounds.

In the last decade, algae applications have generated considerable interest among research organizations and industrial sectors. Bioactive compounds, such as carotenoids, and Mycosporine-like amino acids (MAAs) derived from microalgae may play a vital role in the bio and non-bio sectors. Currently, commercial sunscreens contain chemicals such as oxybenzone and octinoxate, which have harmful effects on the environment and human health; while microalgae-based sunscreens emerge as an eco-friendly alternative to provide photo protector agents against solar radiation. Algae-based exploration ranges from staple foods to pharmaceuticals, cosmetics, and biomedical applications. This review aims to identify the effects of UV and UV-vis irradiation on the production of microalgae bioactive compounds through the assistance of different techniques and extraction methods for biomass characterization. The efficiency and results focus on the production of a blocking agent that does not damage the aquifer, being beneficial for health and possible biomedical applications.

Emerging High-Frequency Ultrasound Imaging in Medical Cosmetology.

Cosmetic skin diseases are a part of many dermatological concerns brought up by patients, which negatively affect mental health and quality of life. Imaging technology has an established role in the diagnosis of cosmetic skin diseases by recognizing information on deep skin lesions. Due to the complex physiological and pathological nature of cosmetic skin diseases, the diagnostic imaging performance varies greatly. Developing noninvasive technology models with wide applicability, particularly high-frequency ultrasound (HFUS), which is able to achieve high-resolution imaging of the skin from the stratum corneum down to the deep fascia, is of great significance to medical cosmetology. To explore the great potential of HFUS in cosmetic skin diseases, a narrative review of literature from PubMed and Web of Science published between 1985 and 2022 was conducted. This narrative review focuses on the progression of HFUS imaging in medical cosmetology, especially on its promising application in the quantitative evaluation and differential diagnosis of cutaneous pathological scar, port wine stain (PWS), acne, skin aging, and other cosmetic applications.