Search Results (26)

Background: Artificial intelligence (AI) has emerged as a transformative tool in modern medicine, particularly in dermatology, where it supports the diagnosis and management of various skin diseases, including skin cancer. Through machine learning and deep learning techniques, AI enables accurate analysis of clinical and dermoscopic images, improving early detection and clinical outcomes. Objective: This systematic review aimed to evaluate the clinical applications of AI in dermatology, focusing on its impact on diagnostic accuracy, workflow efficiency, and access to specialized care. Methods: The review was conducted according to PRISMA guidelines. Peer-reviewed studies published between January 2020 and March 2025 in English or Spanish were included if they evaluated AI-based tools for dermatological diagnosis, classification, or treatment. Animal studies, editorials, non-peer-reviewed articles, and studies with an unclear methodology were excluded. A comprehensive search was performed in PubMed, Scopus, IEEE Xplore, and Google Scholar between December 2024 and March 2025. The risk of bias was assessed qualitatively, using a tailored framework based on study design, dataset transparency, and clinical applicability. Results: A total of 29 studies met the inclusion criteria. AI tools demonstrated high performance in melanoma detection, achieving up to 90% accuracy and 85% sensitivity. In clinical settings, AI support reduced mismanagement of malignant lesions from 58.8% to 4.1% and avoided 27% of unnecessary procedures in benign cases. Additional tools such as convolutional neural networks and imaging systems like FotoFinder also showed promising results. Limitations: Limitations of the evidence include the heterogeneity of AI models, lack of external validation, and a moderate-to-high risk of bias. Conclusions: AI has demonstrated robust clinical potential in dermatology, particularly in cancer detection and workflow optimization. However, further studies are required to address challenges such as algorithmic bias, data privacy, and regulatory oversight. Funding and registration: This review received no external funding and was not registered in a systematic review registry. Full article

The European rabbit (Oryctolagus cuniculus) presents a significant conservation and management challenge in Greece. While it has been listed in national biodiversity assessments, its population dynamics on the island of Lemnos demonstrate the characteristics of a highly adaptable and rapidly expanding species, exerting substantial ecological and economic impacts. Addressing this issue requires a spatially explicit understanding of its distribution patterns and habitat preferences, particularly given its extensive population growth over the past three decades. To this end, we conducted 40 field surveys across the island, documenting 1534 presence records of the species. We applied Kernel Density Estimation, Getis-Ord Gi *, and Anselin Local Moran’s I to identify the spatial distribution patterns and significant hotspots. A spatial lag model was used to quantify hotspot intensity and clustering dynamics, while abiotic, biotic, and anthropogenic factors were analyzed to assess habitat associations. Our results revealed that rabbit hotspots are predominantly concentrated in fertile lowland agroecosystems, with nearly 60% of high-density areas overlapping conservation zones. Soil and field conditions, grazing-supporting landscapes, and arable and subsidized agricultural areas emerged as significant predictors of O. cuniculus presence. The observed spatial dependencies indicated that while hotspot intensities and clustering dynamics are influenced by the conditions in neighboring areas, habitat characteristics remain fundamental in shaping their distribution, highlighting the broader landscape-scale spatial patterns affecting rabbit populations. These findings underscore the necessity of adopting spatially informed management strategies that mitigate agricultural impacts while accounting for interconnected spatial dynamics, providing a foundation for informed decision-making to manage rabbit populations while balancing conservation and agricultural priorities. Full article

This study aimed to assess the impact of a combination of probiotic strains of Lactiplantibacillus on the treatment of androgenic alopecia (AGA). To this end, 136 individuals with AGA (62 men and 74 women) aged 18–65 years were enrolled in a double-blind, parallel-group clinical trial. A total of 115 individuals (57 in the probiotic group and 58 in the placebo group) completed this study within a 16-week intervention period. Capillary density, thickness, and length of hair were analyzed before and after the intervention using FotoFinder Trichoscale Pro. In addition, the gut microbiota was assessed by paired-end sequencing on the Illumina MiSeq platform (2 × 300 bp). At the conclusion of the treatment period, a notable decline (p < 0.05) in the number of telogen hairs was evident in the probiotic group while hair thickness decreased in the placebo group (p < 0.05). However, the remaining variables did not exhibit any statistically significant changes. In the probiotic-treated group, individuals aged less than 37.5 years exhibited a reduction in the number and density of telogen hair (p = 0.0693 and p = 0.0669, respectively) and an increase in hair length (p = 0.0871). Furthermore, a notable decline in the number and density of vellus hair (p < 0.05) was observed, and this was accompanied by no change in the hair thickness. The probiotic-treated group exhibited a significantly higher abundance of Lactobacillus (p-adjusted < 0.05, DEseq2 test) and demonstrated a notable reduction in the number and density of telogen hair, and this was accompanied by an increase in the percentage of anagen hair. The probiotic mixture was well tolerated by the participants, with a treatment adherence rate of 90%. In light of this study’s limitations, it can be concluded that a mixture of three strains of Lactiplantibacillus promotes the presence of terminal follicles, preventing their gradual miniaturization, which is a characteristic of AGA. Full article

Trade is considered one of the main drivers of a country’s economic growth and development. Therefore, a successful analysis that identifies the bilateral trade flows, their determinants, and the regional integration costs and benefits opens new horizons for international trade perspectives. This study examines the effects of new and existing regional agreements on the international trade patterns of Western Balkan countries based on the Albanian case. In this regard, an extended trade gravity model is applied with a panel data set of trade flows between Albania and 43 of its regional strategic partners during the period of 2008 to 2022. This work considers two different similarity indexes to explain the effect of the economic structures of partner countries on their trade volumes: the relative factor endowment and the absolute factor endowment. The first is used to test the Linder Hypothesis, and the latter is used to test the effect of similarity in economic size between trading partners. Empirical results indicate that the effect of the selected explanatory variables, such as transportation costs, economic size, economic strength, exchange rate, and their relative as well as absolute endowment, is within expectations. Unexpectedly, the domestic economic size and strength are found to be insignificant in explaining the import flows and inversely proportional to the exports of Albania. Finally, it is indicated that trade flows are clearly dependent on traditional ties rather than on new incentives like the Open Balkan, which cannot offer a new regional center of gravity. To the best of our knowledge, this is the first time that the gravity of the Open Balkan initiative has been tested for one of the participating countries. The study concludes that while the Open Balkan initiative shows potential, the Berlin Process remains a more reliable path toward EU integration for Albania. Full article

Urban sprawl leads to the degradation of aquatic environments and, consequently, to the destruction of biodiversity. With the aim of highlighting the distribution profile of benthic macroinvertebrates in the city of Yaoundé and its surroundings according to the level of degradation, this study was carried out in seven rivers. A total of 144 taxa of benthic macroinvertebrates, belonging to 74 families, 15 orders, five classes, and three phyla, were collected from seven rivers in urban, peri-urban, and forest environments on Yaoundé and its surroundings. The self-organizing map (SOM) analysis tool was used to group the collected taxa from all stations into three clusters or affinity cores. The indicator value analysis (IndVal) method was employed to determine, based on their ecological preferences, which organisms were most likely to belong to each group. Out of the 144 collected taxa, only 44 were indicated to represent the three different groups. Thus, three communities were defined: the Hydropsyche community, with Hydropsyche sp. as the predominant taxon in Group III, characterizing well-oxygenated and low-mineralized stations; the Hydrocyrius community, where the species Hydrocyrius sp. predominates in Group I, describing stations with low oxygenation and moderate mineralization; and the Lumbriculidae community, where Lumbriculidae is the taxon associated with environments with high mineralization and critical oxygenation. These two methods contribute to the biomonitoring of tropical aquatic environments, firstly by grouping organisms by affinity and then identifying those that reflect the environment conditions. This facilitates the detection of changes in the quality of hydrosystems and guides management and conservation efforts. Full article

Colostrum, the first milk produced by mammals, is rich in various bioactive components that provide numerous health benefits to newborns, such as growth factors, hormones, immunoglobulins, cytokines, and enzymes. Topical application of bovine or equine colostrum has been found to improve regeneration, accelerate cutaneous wound healing, and have moisturizing, protective, and anti-aging properties. The aim of this study was to examine the effect of a cosmetic preparation containing sheep colostrum on skin with signs of aging in mature women. Fifty-two women, aged 40–70, were randomized into two groups to receive either colostrum or placebo cream. The participants applied the cream for eight weeks. Skin hydration, TEWL, sebum, erythema, and tone were measured using a standardized Courage + Khazaka electronic GmbH Multi Probe Adapter; skin elasticity was measured with a cutometer, and images were taken by FotoMedicus. The treatment increased skin moisture, reduced TEWL, and improved skin firmness. These findings were confirmed by the subjective survey. The participants reported, inter alia, improved skin softness and less redness and hypersensitivity. Sheep colostrum cream was more effective at improving skin conditions than placebo cream. Colostrum creams can improve certain aspects of skin quality, especially the hydrolipid barrier, and overall rejuvenation. Full article

In Cameroon, the environmental profile is increasingly marked by anarchic urbanisation, which is strongly illustrated by the discharge of waste into the aquatic environment, leading to pollution. Indeed, the tributaries of the Mfoundi and Mefou river basins have nowadays become dumping grounds and receptacles for all kinds of waste, leading to the degradation of water quality and a reduction in biodiversity. This study aims to evaluate the effect of anthropogenic pressure on the biodiversity of benthic macroinvertebrates in three rivers of the Mfoundi basin (Ebogo, Abiergue, and Ako’o). For this purpose, some physicochemical parameters were measured according to standard methods, and benthic macroinvertebrates were collected according to the multihabitat approach. To this end, the physicochemical analyses revealed that the waters of these different streams are slightly basic and poorly oxygenated, with a saturation rate of 9.725 ± 11.74% and significant organic pollution. Biologically, a total of 5793 benthic macroinvertebrates divided into three phyla, eight orders, and more than thirty families were collected, with a population dominated by the order of insects and a low level of diversity dominated by pollutant organisms such as the Chironomidae, Lumbriculidae, and Physidae, which are saprobionts and saprophilous organisms. A redundancy analysis indicated that the main groups of benthic macroinvertebrates obtained were related to the gradients of the physicochemical parameters measured. The Shannon–Weaver diversity and Piélou equitability indexes showed the low diversity of the organisms within the different courses and their low equipartition, mainly due to the saprobiont and saprophilous groups that dominate the population. The exogenous inputs due to the increase in the population of the city of Yaoundé, which dumps its waste into the waterways, have major repercussions on the quality of the water and the population that abounds in this environment, particularly the benthic macroinvertebrates, which are an important link in the monitoring of water quality. Full article

The exponential increase in algorithm-based mobile health (mHealth) applications (apps) for melanoma screening is a reaction to a growing market. However, the performance of available apps remains to be investigated. In this prospective study, we investigated the diagnostic accuracy of a class 1 CE-certified smartphone app in melanoma risk stratification and its patient and dermatologist satisfaction. Pigmented skin lesions ≥ 3 mm and any suspicious smaller lesions were assessed by the smartphone app SkinVision^® (SkinVision^® B.V., Amsterdam, the Netherlands, App-Version 6.8.1), 2D FotoFinder ATBM^® master (FotoFinder ATBM^® Systems GmbH, Bad Birnbach, Germany, Version 3.3.1.0), 3D Vectra^® WB360 (Canfield Scientific, Parsippany, NJ, USA, Version 4.7.1) total body photography (TBP) devices, and dermatologists. The high-risk score of the smartphone app was compared with the two gold standards: histological diagnosis, or if not available, the combination of dermatologists’, 2D and 3D risk assessments. A total of 1204 lesions among 114 patients (mean age 59 years; 51% females (55 patients at high-risk for developing a melanoma, 59 melanoma patients)) were included. The smartphone app’s sensitivity, specificity, and area under the receiver operating characteristics (AUROC) varied between 41.3–83.3%, 60.0–82.9%, and 0.62–0.72% according to two study-defined reference standards. Additionally, all patients and dermatologists completed a newly created questionnaire for preference and trust of screening type. The smartphone app was rated as trustworthy by 36% (20/55) of patients at high-risk for melanoma, 49% (29/59) of melanoma patients, and 8.8% (10/114) of dermatologists. Most of the patients rated the 2D TBP imaging (93% (51/55) resp. 88% (52/59)) and the 3D TBP imaging (91% (50/55) resp. 90% (53/59)) as trustworthy. A skin cancer screening by combination of dermatologist and smartphone app was favored by only 1.8% (1/55) resp. 3.4% (2/59) of the patients; no patient preferred an assessment by a smartphone app alone. The diagnostic accuracy in clinical practice was not as reliable as previously advertised and the satisfaction with smartphone apps for melanoma risk stratification was scarce. MHealth apps might be a potential medium to increase awareness for melanoma screening in the lay population, but healthcare professionals and users should be alerted to the potential harm of over-detection and poor performance. In conclusion, we suggest further robust evidence-based evaluation before including market-approved apps in self-examination for public health benefits. Full article

Tropical rivers are strongly influenced by stormwaters, pollutants and agro-pastoral activities. These systems are no longer able to maintain their native biota. Therefore, it seems important to understand how biological assemblages are driven by environmental gradients at different spatial scales. However, information on the relationships between the distribution of aquatic macroinvertebrates and environmental variables remains scarce in Cameroon. To improve our knowledge on the drivers of such distributions, a study was carried out at 11 contrasted sites from three catchments located in West Cameroon. This study aimed at understanding the spatio-temporal variations of 19 taxonomic metrics calculated for the benthic macroinvertebrate assemblages of these sites sampled during 13 months, concurrently with physico-chemical analyses of water quality. Two hundred and twelve taxa were caught. Diptera(rf-S), Shannon-Wiener diversity, 1–GOLD, total richness, Pielou evenness and Heteroptera(rf-S) revealed their high ability to respond to anthropogenic pressures or disturbances. Conductivity, water temperature, dissolved oxygen, nitrates, total hardness and alkalinity were identified as the main physico-chemical drivers of the taxonomic structure of benthic assemblages. These results will allow further exploration of the implementation of a tool for monitoring the ecological quality of West Cameroon rivers. Full article

The exacerbation of antimicrobial resistance (AMR) is a major public health threat worldwide. In sub-Saharan Africa, there is a scarcity of data regarding multidrug-resistant (resistance to at least one antibiotic of three or more families of antibiotics) as well as extended spectrum β-lactamase-producing Enterobacterales (ESBL-PE), isolated among clinical and asymptomatically healthy patients, especially in women living with HIV (WLHIV) despite their immunocompromised status. The overarching aim of this study was set to determine the prevalence and characterize genotypically multi-drug resistant Enterobacterales (MDR-E) and ESBL- PE isolated from vaginal swabs of WLHIV attending the Yaoundé Central Hospital, Yaoundé, Cameroon. A cross-sectional study was conducted among WLHIV during a four-month periods from 1 February to 31 May 2021. A total of 175 WLHIV, of childbearing age and under antiretroviral treatment were contacted. One hundred and twenty participants (120) were recruited and vaginal swabs were collected from them. After culture on Eosine-Methylen Blue (EMB) agar, the identification of Enterobacterales was performed using API 20E kit. A double-screening of ESBL-PE was performed using a combined disc diffusion method and ROSCO Diagnostica kits. An antibiotic susceptibility test was carried out by disc diffusion as per the Kirby-Bauer method and the β-lactamase resistance genes, bla_CTX-M, bla_{CTX-M-group1-2-9}, bla_TEM were molecularly characterized using a conventional Polymerase Chain Reaction (PCR). Overall, 30.83% (37/120) of the included WLHIV were colonized with Enterobacterales and the prevalence of vaginal carriage of MDR Enterobacterales among them was 62.16% (23/37). Among MDR-E isolates, the most prevalent species were E. coli (56.0%; 14/25) and K. pneumoniae (20.0%; 5/25). High rates of resistance to trimethoprim-sulfamethoxazole (96.0%; 24/25), amoxicillin-clavulanic acid (88.0%; 22/25) and gentamicin (72%; 18/25) were observed. The resistance mechanisms detected among these isolates were ESBL (48.0%; 12/25), ESBL+ porin loss (8.0%; 2/25), ESBL+AmpC (24%; 6/25), with bla_CTX-M, bla_{CTX-M-group-1,2,9} being identified at 48.0% (12/25) for each of them and bla_TEM at 72.0% (18/25). Our findings confirm the high-prevalence of MDR as well as ESBL-PE isolated in WLHIV, and suggest that a real time monitoring system of antimicrobial resistant bacteria coupled with the reinforcement of infection prevention control (IPC) strategies are needed to sustainably contain these life-threatening pathogens especially in the most vulnerable populations. Full article

(1) Background: Periosteal dry needling (PDN) involves clinicians using a solid filiform needle to stimulate bone for analgesic purposes. This case report presents the use of PDN to the cervical articular pillars (CAPs) in an 85-year-old female with chronic neck pain and headache. (2) Case description: PDN was applied to the right C2–C3 articular pillars, following trigger point dry needling (TrPDN) and manual therapy, in order to provide a direct sensory stimulus to the corresponding sclerotomes. PDN added over two treatments led to improved cervical range of motion and eliminated the patient’s neck pain and headache at 1 week follow-up. (3) Outcomes: At discharge, clinically relevant improvements were demonstrated on the numeric pain rating scale (NPRS), which improved from an 8/10 on intake to a 0/10 at rest and with all movements. In addition, the patient exceeded the risk adjusted predicted four-point score improvement and the minimal clinically important improvement (MCII) value of four points on the Focus on Therapeutic Outcomes (FOTO) Neck Functional Status (Neck FS). At one month post-discharge, the patient remained symptom-free. (4) Discussion: In the context of an evidence-informed approach for neck pain and headache, PDN led to marked improvements in pain and function. Patient outcomes exceeded predictive analytic expectations for functional gains and efficient utilization of visits and time in days. Combined with other interventions, PDN to the CAPs could be a viable technique to treat chronic neck pain with headache. Full article

Photodynamic therapy (PDT) is safe and effective in the treatment of patients with actinic keratosis (AK). The aim of the study was to assess the efficacy, tolerability and cosmetic outcome of topical PDT in the treatment of AKs with three forms of photosensitizers: 5-Aminolevulinic acid hydrochloride (ALA-HCl), 5-Aminolevulinate methyl ester hydrochloride (MAL-HCl) and 5-Aminolevulinate phosphate (ALA-P). The formulations were applied onto selected scalp/face areas. Fluorescence was assessed with a FotoFinder Dermoscope 800 attachment. Skin areas were irradiated with Red Beam Pro+, Model APRO (MedLight GmbH, Herford, Germany). Applied treatments were assessed during the PDT as well as 7 days and 12 weeks after its completion. Ninety-four percent of patients rated obtained cosmetic effect excellent. The efficacy of applied PSs did not differ significantly. However, pain intensity during the PDT procedure was significantly lower in the area treated with ALA-P (5.8 on average) in comparison to the areas treated with ALA-HCl or MAL-HCl (7.0 on average on 0–10 scale). Obtained results show that ALA-P may undergo more selective accumulation than ALA-HCl and MAL-HCl. Our promising results suggest that PDT with the use of ALA-P in AK treatment may be an advantageous alternative to the already used ALA-HCl and MAL-HCl. Full article

Background: Clinically, three-dimensional (3D) printing technology is becoming a popular and efficient dental processing technology. Recently, there has been an increasing demand for dental materials that exhibit bioactive properties. The present study aimed to evaluate the mechanical properties, cytotoxicity, and fluoride ion release capacity of 3D-printed dental resins modified with bioactive glass. Materials and methods: The resin FotoDent splint used in the production of removable orthodontic splints, was modified by the addition of two types of bioactive glasses that are capable of releasing fluoride ions. The novel materials used for the production of dental splints were examined for their mechanical, physical, and biological properties (fracture resistance, sorption, solubility, elution of nonpolymeric substances, and release of fluoride ions over time) and cytotoxic effects on cell cultures. Results: Initially, the fracture toughness of the 3D-printed resin was found to be 55 MPa, but after modification with glass, the resistance was reduced to about 50 MPa. Sorption and solubility values of the materials (19.01 ÷ 21.23 µg/mm³ and 0.42 ÷ 1.12 µg/mm³, respectively) complied with the safety limits imposed by ISO standard. Modified resins were capable of releasing fluoride ions, and the maximum releasing effect was observed after 14 days of incubation. Both the modified resins, after four days of contact with human gingival fibroblasts, exhibited moderate cytotoxic properties. Conclusions: The experimental results showed that modification of methacrylate resin, used in 3D printing technology, with bioactive glasses produces novel dental materials that possess desirable bioactive properties. The findings of this study indicate the potential ability of modified polymethacrylate resins to release fluoride ions in the oral cavity environment. The modified materials are characterized with a moderate decrease in physical properties and mild cytotoxicity on direct contact with human fibroblasts. Full article

Antimicrobial photodynamic therapy (a-PDT) is attracting attention as a new form of dental treatment. While it is primarily applied to produce an antibacterial effect, it decreases lipopolysaccharide (LPS) and protease activity. Here, we evaluated differences in the antibacterial activity of a-PDT on three types of bacteria and the effects on the organic substances (i.e., albumin and LPS). Furthermore, we investigated the effects of a-PDT on root surfaces. A FotoSan630^® and toluidine blue were used to perform a-PDT in this study. We measured its antimicrobial activity against Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis. Antimicrobial testing revealed strong antimicrobial action and P. gingivalis, E. faecalis, and S. mutans were almost undetectable after 50, 120, and 100 s, respectively. In organic resolution tests, albumin was significantly decreased from 1 min after a-PDT application onward, while LPS significantly decreased at 5 min after the application. The root surfaces after a-PDT were confirmed to be cleaner than the controls without suffering any damage. Depending on the bacterial species, a-PDT exhibited antimicrobial activity against various types of bacteria and sensitivity differed. Moreover, we reported that a-PDT resolves protein and LPS, enabling the formation of a healthy root surface without any damage. Full article

There are many new land use and land cover (LULC) products emerging yet there is still a lack of in situ data for training, validation, and change detection purposes. The LUCAS (Land Use Cover Area frame Sample) survey is one of the few authoritative in situ field campaigns, which takes place every three years in European Union member countries. More recently, a study has considered whether citizen science and crowdsourcing could complement LUCAS survey data, e.g., through the FotoQuest Austria mobile app and crowdsourcing campaign. Although the data obtained from the campaign were promising when compared with authoritative LUCAS survey data, there were classes that were not well classified by the citizens. Moreover, the photographs submitted through the app were not always of sufficient quality. For these reasons, in the latest FotoQuest Go Europe 2018 campaign, several improvements were made to the app to facilitate interaction with the citizens contributing and to improve their accuracy in LULC identification. In addition to extending the locations from Austria to Europe, a change detection component (comparing land cover in 2018 to the 2015 LUCAS photographs) was added, as well as an improved LC decision tree. Furthermore, a near real-time quality assurance system was implemented to provide feedback on the distance to the target location, the LULC classes chosen and the quality of the photographs. Another modification was a monetary incentive scheme in which users received between 1 to 3 Euros for each successfully completed quest of sufficient quality. The purpose of this paper is to determine whether citizens can provide high quality in situ data on LULC through crowdsourcing that can complement LUCAS. We compared the results between the FotoQuest campaigns in 2015 and 2018 and found a significant improvement in 2018, i.e., a much higher match of LC between FotoQuest Go Europe and LUCAS. As shown by the cost comparisons with LUCAS, FotoQuest can complement LUCAS surveys by enabling continuous collection of large amounts of high quality, spatially explicit field data at a low cost. Full article