CONCLUSIONS This work outlines the impact of the secreted dermal components on epidermal UVR-induced DNA damage repair and shed light on a novel role of CXCL5 in CPD repair. This article is protected by copyright. All rights reserved.BACKGROUND The treatment of distal (below the knee) deep vein thrombosis (DVT) is not clearly established. Distal DVT can either be treated with anticoagulation, or monitored with close follow-up to detect progression to the proximal veins (above the knee), which requires anticoagulation. Proponents of this monitoring strategy base their decision to withhold anticoagulation on the fact that progression is rare and most people can be spared from potential bleeding and other adverse effects of anticoagulation. OBJECTIVES To assess the effects of different treatment interventions for people with distal (below the knee) deep vein thrombosis (DVT). SEARCH METHODS The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase and CINAHL databases and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 12 February 2019. We also undertook reference checking to identify additional studies. SELECd major bleeding-related deaths. AUTHORS’ CONCLUSIONS Our review found a benefit for people with distal DVT treated with anticoagulation therapy using VKA with little or no difference in major bleeding events although there was an increase in clinically relevant non-major bleeding when compared to no intervention or placebo. The small number of participants in this meta-analysis and strength of evidence prompts a call for more research regarding the treatment of distal DVT. RCTs comparing different treatments and different treatment periods with placebo or compression therapy, are required. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.Human hair is highly responsive to stress, and human scalp hair follicles (HFs) contain a peripheral neuro-endocrine equivalent of the systemic hypothalamic-pituitary-adrenal (HPA) stress axis. Androgenetic alopecia (AGA) is supposed to be aggravated by stress. We used the HPA axis triggering corticotropin-releasing hormone (CRH) to induce a stress response in human ex vivo male AGA HFs. Furthermore, since caffeine is known to reverse testosterone-mediated hair growth inhibition in the same hair organ culture model, we investigated whether caffeine would antagonize CRH-mediated stress in these HFs. HFs from balding vertex area scalp biopsies of AGA-affected men were incubated with CRH (10-7 M) and with/without caffeine (0.001%, 0.005%). Compared to controls, CRH significantly enhanced the expression of catagen-inducing TGF-β2 (p less then 0.001), CRH receptors 1/2 (p less then 0.01), ACTH (p less then 0.001) and melanocortin-receptor-2 (MC-R2) (p less then 0.001), and additional stress-associated parameters, substance P and p75 neurotrophin receptor. CRH inhibited matrix keratinocyte proliferation and expression of anagen-promoting IGF-1 and pro-proliferative nerve growth factor receptor TrkA. Caffeine significantly counteracted all described stress effects and additionally enhanced IP3 -R, first time detected in human HFs. These findings provide the first evidence in ex vivo human AGA HFs, that the stress mediator CRH induces not only a complex intrafollicular HPA, but also a non-HPA related stress response. Moreover, we show that these effects can be effectively antagonized by caffeine. Thus, these data strongly support the hypothesis that stress can impair human hair physiology and induce hair loss, and that caffeine may effectively counteract stress-induced hair damage and possibly prevent stress-induced hair loss. This article is protected by copyright. All rights reserved.Giant congenital melanocytic naevi (CMN) arise primarily due to postzygotic mutations in NRAS, and are of clinical importance due to their increased risk of malignant transformation.1 A subtype of large CMN, termed naevus spilus (NS)-type CMN, is identified by the presence of a patch which may have café-au-lait pigmentation and superimposed macular or papular lesions, which are demonstrably melanocytic naevi on histology. This article is protected by copyright. All rights reserved.One persistent anti-vaccine argument goes like this Getting a disease gives a person stronger or longer-lasting “natural” immunity to that illness than taking the vaccine. It is true that many illnesses confer future immunity to those who get them. But to get that immunity, patients first have to survive pathogens that can permanently destroy their health or end their lives. The quest to obtain natural immunity can cause parents to endanger their children unnecessarily.Surgical learning curves are a representation of the number of cases required for a surgeon to reach a stable rate of outcomes and complications. In this study, the authors present the learning curve for the direct superior (DS) approach to total hip arthroplasty, which is a muscle-sparing modification to the mini-posterior technique. MEDICA16 This was a retrospective analysis of the first 40 primary DS cases done by a single surgeon. These cases were divided into 2 groups of 20 and compared for intra- and postoperative complications, acetabular component positioning, and Harris Hip Score at 90 days after surgery. As a control, the first 20 primary mini-posterior cases were analyzed as the baseline performance of the surgeon and the DS approach. There was no statistically significant difference between the first and second sets of DS patients regarding Harris Hip Score, intraoperative complications, dislocations, estimated blood loss, length of hospital stay, and components positioned within the Lewinnek safe zone. The only statistically significant difference between the first and second sets of DS cases was a decrease in operating time (P less then .001). This suggests that the learning curve is less than 20 patients. The results also indicate that the first 20 DS cases ambulated farther (P=.007) and had a shorter length of stay (P=.007), outperforming the mini-posterior approach. This study suggests that the DS learning curve is short for surgeons trained in the posterior approach. The data could be especially pertinent as 90-day results and safety are becoming increasingly important in evaluating performance for bundled-payment models. [Orthopedics. 2020;43(x)xx-xx.]. Copyright 2020, SLACK Incorporated.