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ImportanceLaser-assisted drug delivery (LADD) is used for various medical and cosmetic applications. However, there is insufficient evidence-based guidance to assist clinicians performing LADD.ObjectiveTo develop recommendations for the safe and effective use of LADD.Evidence reviewA systematic literature review of Cochrane Central Register of Controlled Trials, Embase, and MEDLINE was conducted in December 2019 to identify publications reporting research on LADD. A multidisciplinary panel was convened to draft recommendations informed by the systematic review; they were refined through 2 rounds of Delphi survey, 2 consensus meetings, and iterative review by all panelists until unanimous consensus was achieved.FindingsOf the 48 published studies of ablative fractional LADD that met inclusion criteria, 4 were cosmetic studies; 21, oncologic; and 23, medical (not cosmetic/oncologic), and 6 publications of nonablative fractional LADD were included at the request of the expert panel, producing a total of 54 studies. Thirty-four studies (63.0%) were deemed to have low risk of bias, 17 studies (31.5%) had moderate risk, and 3 (5.5%) had serious risk. The key findings that informed the guidelines developed by the expert panel were as follows: LADD is safe in adults and adolescents (≥12 years) with all Fitzpatrick skin types and in patients with immunosuppression; it is an effective treatment for actinic keratosis, cutaneous squamous cell carcinoma in situ, actinic cheilitis, hypertrophic scars, and keloids; it is useful for epidermal and dermal analgesia; drug delivery may be increased through the application of heat, pressure, or occlusion, or by using an aqueous drug solution; laser settings should be selected to ensure that channel diameter is greater than the delivered molecule; antibiotic prophylaxis is not recommended, except with impaired wound healing; antiviral prophylaxis is recommended when treating the face and genitalia; and antifungal prophylaxis is not recommended. The guideline's 15 recommendations address 5 areas of LADD use: (I) indications and contraindications; (II) parameters to report; (III) optimization of drug delivery; (IV) safety considerations; and (V) prophylaxis for bacterial, viral, and fungal infections.Conclusions and relevanceThis systematic review and Delphi consensus approach culminated in an evidence-based clinical practice guideline for safe and effective use of LADD in a variety of applications. Future research will further improve our understanding of this novel treatment technique.

In this article, we advance on ongoing debates about how global supply chain monitoring can work to improve conditions for workers in those supply chains. We propose an approach to worker-driven monitoring and introduce a set of core elements that should form the basis of this new approach to monitoring labour conditions in global supply chains. We argue that supply chain workers' participation in labour monitoring systems cannot be confined to the moment of factory inspection. Instead it must be understood as part of a larger process which incorporates workers from the point of designing the systems that will be monitored through to the point of remediation. We conclude that such a systematic and comprehensive approach is necessary to ensure that monitoring processes are meaningful and place the rights of workers at their core. [ABSTRACT FROM AUTHOR]

This article analyses contractual governance practices within the value chains of large companies based in the USA and Europe between 2012 and 2017 with focus on human and labour rights. In line with the existing scholarship, we find that the use of contractual governance for safeguarding human and labour rights is best practice among large American and European businesses. The results show that value chain contractual governance should be studied in an interdisciplinary environment taking both legal and non-legal aspects into consideration. Moreover, we detect a general positive impact of the business and human rights regulatory wave of 2010–2011 on sustainable contractual governance practices. [ABSTRACT FROM AUTHOR]

Ideas about the social responsibility of business are in flux. The foundations of 'Corporate Social Responsibility' have been transformed in recent years by normative developments in the field of business and human rights. The latter norms are a direct response to the evolution of transnational modes of production, such as global value chains coordinated by multinational corporations. This special issue explores these attempts to advance respect for human rights in the context of business activity in global value chains. The special issue consists of an introduction and four articles which describe and interrogate some of the principle changes currently taking place in global value chain governance as these relate to human rights: the impact on worker power of the rise of larger emerging-market multinationals in value chains traditionally dominated by global brands; the limits of monitoring and transparency mechanisms as effective regulators of human rights in supply chains; the role of contracts in ensuring respect for human rights; and the possibility to use the courts to enforce respect for rights across fragmented production networks. [ABSTRACT FROM AUTHOR]

BACKGROUND: Successful treatment of acne scars is challenging. Many modalities have been used with marginal success. OBJECTIVE: The authors describe a combination of a superficial chemical peel, subcision, and fractional carbon dioxide (CO2) laser resurfacing in a single-treatment session as a novel treatment approach for rolling acne scars. METHODS: A total of 114 patients (75 women and 39 men) with predominantly rolling acne scars were treated with a 20% trichloracetic acid chemical peel, subcision with a novel dissecting instrument, and the CO2 laser under tumescent anesthesia. This was a retrospective, uncontrolled, unblinded study. RESULTS: The mean improvement after a single treatment was 2.9 on a scale of 1 to 4 with few complications. Ninety percent of the patients were satisfied with their final result and desired no additional treatment. CONCLUSION: The combination of a trichloracetic acid 20% chemical peel, subcision, and fractional CO2 laser resurfacing combined with tumescent anesthesia is both safe and effective in the treatment of rolling acne scars. [ABSTRACT FROM AUTHOR]