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SummaryBackground Rosacea is currently diagnosed by consensus-defined primary and secondary features and managed by subtype. However, individual features (phenotypes) can span multiple subtypes, which has implications for clinical practice and research. Adopting a phenotype-led approach may facilitate patient-centred management. Objectives To advance clinical practice by obtaining international consensus to establish a phenotype-led rosacea diagnosis and classification scheme with global representation. Methods Seventeen dermatologists and three ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and severity evaluation. All voting was electronic and blinded. Results Consensus was achieved for transitioning to a phenotype-based approach to rosacea diagnosis and classification. The following two features were independently considered diagnostic for rosacea: (i) persistent, centrofacial erythema associated with periodic intensification; and (ii) phymatous changes. Flushing, telangiectasia, inflammatory lesions and ocular manifestations were not considered to be individually diagnostic. The panel reached agreement on dimensions for phenotype severity measures and established the importance of assessing the patient burden of rosacea. Conclusions The panel recommended an approach for diagnosis and classification of rosacea based on disease phenotype.

Summary Background Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address this issue. Objectives To incorporate current best treatment evidence with clinical experience from an international expert panel and establish consensus to improve outcomes for patients with rosacea. Methods Seventeen dermatologists and three ophthalmologists reached consensus on critical aspects of rosacea treatment and management using a modified Delphi approach. The panel voted on statements using the responses ‘strongly disagree’, ‘disagree’, ‘agree’ or ‘strongly agree’. Consensus was defined as ≥ 75% ‘agree’ or ‘strongly agree’. All voting was electronic and blinded. Results The panel agreed on phenotype‐based treatments for signs and symptoms presenting in individuals with rosacea. First‐line treatments were identified for individual major features of transient and persistent erythema, inflammatory papules/pustules, telangiectasia and phyma, underpinned by general skincare measures. Multiple features in an individual patient can be simultaneously treated with multiple agents. If treatment is inadequate given appropriate duration, another first‐line option or the addition of another first‐line agent should be considered. Maintenance treatment depends on treatment modality and patient preferences. Ophthalmological referral for all but the mildest ocular features should be considered. Lid hygiene and artificial tears in addition to medications are used to treat ocular rosacea. Conclusions Rosacea diagnosis and treatment should be based on clinical presentation. Consensus was achieved to support this approach for rosacea treatment strategies.

Opportunistic screening for osteoporosis can be performed using low‐dose computed tomography (LDCT) imaging obtained for other clinical indications. In this study we explored the CT‐derived bone mineral density (BMD) and prevalence of osteoporosis from thoracic LDCT in a large population cohort of Chinese men and women. A total of 69,095 adults (40,733 men and 28,362 women) received a thoracic LDCT scan for the purpose of lung cancer screening between 2018 and 2019, and data were obtained for analysis from the China Biobank Project, a prospective nationwide multicenter population study. Lumbar spine (L1–L2) trabecular volumetric bone mineral density (vBMD) was derived from these scans using quantitative computed tomography (QCT) software and the American College of Radiology QCT diagnostic criteria for osteoporosis were applied. Geographic regional differences in the prevalence of osteoporosis were assessed and the age‐standardized, population prevalence of osteoporosis in Chinese men and women was estimated from the 2010 China census. The prevalence of osteoporosis by QCT for the Chinese population aged >50 years was 29.0% for women and 13.5% for men, equating to 49.0 million and 22.8 million, respectively. In women, this rate is comparable to estimates from dual‐energy X‐ray absorptiometry (DXA), but in men, the prevalence is double. Prevalence varied geographically across China, with higher rates in the southwest and lower rates in the northeast. Trabecular vBMD decreased with age in both men and women. Women had higher peak trabecular vBMD (185.4 mg/cm3) than men (176.6 mg/cm3) at age 30 to 34 years, but older women had lower trabecular vBMD (62.4 mg/cm3) than men (92.1 mg/cm3) at age 80 years. We show that LDCT‐based opportunistic screening could identify large numbers of patients with low lumbar vBMD, and that future cohort studies are now required to evaluate the clinical utility of such screening in terms of fracture prevention and supporting national health economic analyses. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR)..

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Substantial evidence indicates that declines in cognitive and motor functioning are often observed when we age. The interdependence of cognition and behavior has been reported in a wide range of studies. However, research on the cognitive-motor associations in aging has been lacking. We review behavioral and neural characteristics of cognitive aging in relation to motor aging and aim to elucidate their interrelationships in an aging context. From a developmental view, we propose an integrative concept focusing on the dynamics of cognitive functioning, motor performance and skill acquisition. In the framework, representations and motor learning potential are closely related. and supported by distributed neural systems, which are less susceptible to functional declines in the aging process. Mostly supported by high-level areas, control processes, motor learning efficiency and motor performance are closely related. As high-level areas are more vulnerable during aging, control processes, motor learning efficiency and motor performance are substantially affected when one approaches late adulthood. Practical implications and future research directions are discussed.

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A single treatment of 20 U of BoNTA was effective and safe in reducing glabellar lines in Chinese subjects.