Publications by authors named "Joel Cohen"

Objectives: This work highlights the methods used to develop a multi-pulse 1726 nm laser system combined with bulk air-cooling for selective sebaceous gland (SG) photothermolysis using thermal imaging and software algorithms. This approach enables treating to a desired tissue temperature and depth to provide a safe, effective, reproducible, and durable treatment of acne.

Methods: We designed and built a 1726 nm laser system with a 40 W maximum power output, a highly controlled air-cooling device, and a thermal camera in the handpiece, which permits real-time temperature monitoring of the epidermis.

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Background: Delayed reactions to hyaluronic acid (HA) fillers have been reported following various immunologic and infectious triggers.

Aim: Herein, we describe cases of delayed immunologic reactions (DIRs) following HA-soft tissue augmentation fillers precipitated by triggers not previously described in the literature.  Patients: Case 1 describes a 57-year-old female with DIR to HA-filler following a motor vehicle accident in the marionette lines and nasolabial folds.

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Identifying the scaling rules describing ecological patterns across time and space is a central challenge in ecology. Taylor's law of fluctuation scaling, which states that the variance of a population's size or density is proportional to a positive power of the mean size or density, has been widely observed in population dynamics and characterizes variability in multiple scientific domains. However, it is unclear if this phenomenon accurately describes ecological patterns across many orders of magnitude in time, and therefore links otherwise disparate observations.

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Objectives: To date there has been little observational evidence on the relationship between air lead and blood lead at relatively low workplace air lead concentrations. This study sought to improve upon prior studies methodologically and aimed to examine this relationship in a modern workplace environment.

Methods: Personal measurements of air lead and blood lead concentrations were collected in a modern lead-acid battery manufacturing facility in the United States.

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Article Synopsis
  • A study was conducted to analyze how often dermatologic surgeons face challenges in identifying the locations of skin cancer tumors before surgery.
  • Out of over 17,000 cases, only 0.60% involved uncertain sites, with these cases more common in older, male patients who had biopsies done over a month prior.
  • Surgeons commonly used various methods to confirm tumor locations, achieving success in identifying 82% of these uncertain sites, while some surgeries were delayed, especially for non-facial tumors.
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Mechanical force controls the opening and closing of mechanosensitive ion channels atop the hair bundles of the inner ear. The filamentous tip link connecting transduction channels to the tallest neighboring stereocilium modulates the force transmitted to the channels and thus changes their probability of opening. Each tip link comprises four molecules: a dimer of protocadherin 15 (PCDH15) and a dimer of cadherin 23, all of which are stabilized by Ca binding.

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  • Real-world experience with an allograft adipose matrix (AAM), specifically Renuva, is highlighted through seven cases handled by nine expert cosmetic physicians in the U.S. who successfully used it.
  • AAM is processed donated tissue that serves as a natural filler, replacing itself with the patient’s own fat cells to restore volume.
  • Experts found AAM to be an effective, safe, and easy-to-use alternative to traditional fillers and fat grafting, recommending it for use on various body parts like the face and hands.
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Background: Medical aesthetic procedures for facial rejuvenation with laser and energy-based devices (EBDs) are rapidly increasing. The following cases highlight real-life experience using a multi-modality system with various handpieces that combine intense pulsed light (IPL), laser hair removal (808 diode), high-intensity focused ultrasound (HIFU), radiofrequency microneedling (RFM), and thermal radiofrequency (RF) for antiaging and rejuvenation treatment. Laser and RFM treatments may improve skin conditions by inducing cutaneous changes that remodel the skin matrix.

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Platelet-rich concentrates (PRCs), derived from a patient's blood, are being used in various fields of medicine, including dermatology, for an increasing number of indications. Although considered a generally safe procedure for dermatologic indications, there have been reports in the last several years linking this treatment to cases of blood-borne infections including HIV and hepatitis.1 Patient safety should always be the primary focus for physicians and other health care professionals, and systems-based protocols should exist within care settings to minimize errors.

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Background: AbobotulinumtoxinA has become well established as a treatment option for moderate to severe glabellar lines since its first aesthetic approval in 2009.

Objective: Pivotal trials leading to regulatory approval showed that abobotulinumtoxinA treatment was associated with high responder rates when defined as achievement of none or mild glabellar lines (0 or 1 on the glabellar line severity scale) and a duration of action of up to 5 months. More recently, the goals for treatment of glabellar lines have shifted toward not only achieving a decrease in glabellar line severity but also ensuring that patients are satisfied with their experience.

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Background: The growing popularity of aesthetic procedures involving fillers, biostimulators, and neurotoxins has prompted concerns about patient safety. To address these concerns, a global Safety Task Force (STF) was formed.

Aims: The inaugural STF meeting prioritized vascular compromise prevention and management, guiding clinical trial design and materials for future meetings, and collecting data from experts on current safety methods.

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  • The study analyzes the use of large language models (LLMs) as educational tools for patients considering Mohs micrographic surgery (MMS), focusing on their effectiveness and accuracy.* -
  • A panel of 15 MMS surgeons assessed LLM-generated responses to common patient questions, finding that most responses were appropriate and 75% rated as mostly accurate, with ChatGPT scoring the highest in accuracy.* -
  • While LLM responses were deemed appropriate, only 33% were considered sufficient for clinical use, and their complexity may hinder patient understanding, highlighting the need for dermatologists to recognize these limitations.*
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All skin tones need to be protected from the damaging effects of solar radiation. Although mineral sunscreens offer protection, they can have a thick, greasy feel and leave a white cast, particularly on darker skin tones. Tints offset white cast and provide visible light protection; however, patients may prefer a sheer option.

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Importance: Unprecedented increases in hospital occupancy rates during COVID-19 surges in 2020 caused concern over hospital care quality for patients without COVID-19.

Objective: To examine changes in hospital nonsurgical care quality for patients without COVID-19 during periods of high and low COVID-19 admissions.

Design, Setting, And Participants: This cross-sectional study used data from the 2019 and 2020 Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project State Inpatient Databases.

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Objective:   This study aimed to investigate the ultraviolet (UV) protection/repair benefits of a patented Amino Acid Complex (AAComplex).

Methods: I) AAComplex was incubated with dermal fibroblasts, with/without UVA, and collagen I was measured with a GlasBoxPlus device. II) A lotion, with/without AAComplex (1%) was applied topically to skin explants, following UVA irradiation, and quantified for health-related biomarkers (TNFalpha, histamine, and MMP-1).

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Background: Keratoacanthomas (KAs) following laser treatment are a rare, but well-described entity.

Aim: Herein, we describe a case of eruptive keratoacanthoma (KA) following laser resurfacing treatment and aim to better characterize laser-associated KAs.

Methods: A literature search was performed on PubMed reviewing laser-associated KAs including various characteristics: epidemiology, history of skin cancer, location, and number, type of laser, as well as the management and outcome.

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Background: Hyperfunctional glabellar frown lines can transmit facial miscues that adversely affect emotional communication, increase perceptions of age, and diminish self-esteem.

Objective: To evaluate the efficacy of letibotulinumtoxinA in mitigating the negative psychological impact associated with moderate to severe glabellar lines and to assess subject satisfaction with treatment outcome in the BLESS phase 3 clinical trials.

Materials And Methods: Baseline and posttreatment assessments were made using validated subject-administered instruments: Modified Skindex-16 Glabellar Line Quality of Life (GL-QoL) Scale, Facial Assessment and Cosmetic Evaluation Questionnaire (FACE-Q) Appraisal of Lines Between Eyebrows Scale, FACE-Q Age Appraisal Visual Analog Scale, and FACE-Q Satisfaction with Outcome Scale.

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Background: An accumulation of adipose tissue on the lateral abdomen (flanks) coupled with muscle deconditioning negatively affects core stability, muscular balance, and the intrinsic strength essential for maintaining optimal body mechanics and posture. This lateral fat accumulation and diminution of muscle result in an unfavorable abdominal profile and present challenges in finding appropriately fitting attire.

Objectives: The aim of this study was to explore the effectiveness and safety of the simultaneous application of high-intensity focused electromagnetic (HIFEM) therapy and synchronized radiofrequency for sculpting the lateral abdomen.

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Clinical grade magnetic bead implants have important applications in interfacing with the human body, providing contactless mechanical attachment or wireless communication through human tissue. We recently developed a new strategy, magnetomicrometry, that uses magnetic bead implants as passive communication devices to wirelessly sense muscle tissue lengths. We manufactured clinical-grade magnetic bead implants and verified their biocompatibility via intramuscular implantation, cytotoxicity, sensitization, and intracutaneous irritation testing.

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Recognizing the "essential" factors that contribute to a clinical outcome is critical for designing appropriate therapies and prioritizing limited medical resources. Demonstrating a high correlation between a factor and an outcome does not necessarily imply an essential role of the factor to the outcome. Human protective adaptive immune responses to pathogens vary among (and perhaps within) pathogenic strains, human individual hosts, and in response to other factors.

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