Search Results (613)

Teledermatology relies on digital transfer of dermatological images, but compression and resolution differences compromise diagnostic quality. Image enhancement techniques are crucial to compensate for these differences and improve quality for both clinical assessment and AI-based analysis. We developed a customized image degradation pipeline simulating common artifacts in dermatological images, including blur, noise, downsampling, and compression. This synthetic degradation approach enabled effective training of DermaSR-GAN, a super-resolution generative adversarial network tailored for dermoscopic images. The model was trained on 30,000 high-quality ISIC images and evaluated on three independent datasets (ISIC Test, Novara Dermoscopic, PH²) using structural similarity and no-reference quality metrics. DermaSR-GAN achieved statistically significant improvements in quality scores across all datasets, with up to 23% enhancement in perceptual quality metrics (MANIQA). The model preserved diagnostic details while doubling resolution and surpassed existing approaches, including traditional interpolation methods and state-of-the-art deep learning techniques. Integration with downstream classification systems demonstrated up to 14.6% improvement in class-specific accuracy for keratosis-like lesions compared to original images. Synthetic degradation represents a promising approach for training effective super-resolution models in medical imaging, with significant potential for enhancing teledermatology applications and computer-aided diagnosis systems. Full article

Papillomaviruses (PVs) are double-stranded DNA viruses known to induce a variety of epithelial lesions in dogs, ranging from benign hyperplasia to malignancies. In regions of rich biodiversity such as the Western Amazon, data on the circulation and genetic composition of canine papillomaviruses (CPVs) remain scarce. This study investigated CPV types present in oral and cutaneous papillomatous lesions in domiciled dogs from Acre and Rondônia States, Brazil. Sixty-one dogs with macroscopically consistent lesions were clinically evaluated, and tissue samples were collected for histopathological examination and PCR targeting the L1 gene. Among these, 37% were histologically diagnosed as squamous papillomas or fibropapillomas, and 49.2% (30/61) tested positive for papillomavirus DNA. Sequencing of the L1 gene revealed that most positive samples belonged to CPV1 (Lambdapapillomavirus 2), while one case was identified as CPV8 (Chipapillomavirus 3). Complete genomes of three CPV1 strains were obtained via high-throughput sequencing and showed high identity with CPV1 strains from other Brazilian regions. Phylogenetic analysis confirmed close genetic relationships among isolates across distinct geographic areas. These findings demonstrate the circulation of genetically conserved CPVs in the Amazon and reinforce the value of molecular and histopathological approaches for the accurate diagnosis and surveillance of viral diseases in domestic dogs, especially in ecologically complex regions. Full article

Background and Objectives: Acute metastatic cord compression (AMSCC) and femoral impending/pathological fracture negatively impact a patient’s quality of life, morbidity and survival, and are considered significant life events. This study aims to compare AMSCC and FMD as distinct yet overlapping metastatic orthopedic emergencies, addressing whether they represent sequential disease stages or distinct patient subpopulations—an analysis critical for prognosis and treatment planning. Materials and Methods: Records of all patients who underwent surgery for a femoral metastatic disease (FMD) over a decade (2004–2015) and patients who were treated for acute metastatic spinal compression (AMSCC) (2007–2017) were retrieved. There were no patients lost to follow-up. Results: The treatment cohorts were similar in terms of age, gender, tumour origin, and the number of spinal metastases. Fifty-four patients were diagnosed with AMSCC. Following treatment, the Frankel muscle grading improved by 0.5 ± 0.8 grades. Two hundred and eighteen patients underwent surgical intervention for FMD. Seventy percent of femoral metastases were located in the femoral neck and trochanteric area. Impending fractures accounted for 52% of the cohort. The FMD cohort, including impending and pathological fractures, was similar to the AMSCC cohort in terms of age and the time interval between cancer diagnosis and surgery (56.7 ± 74.2 vs. 51.6 ± 69.6, respectively, p = 0.646). The Karnofsky functional score was higher for the FMD cohort (63.3 ± 16.2) than for the AMSCC cohort (48.5 ± 19.5; p < 0.001). The mean survival time for the FMD cohort was double that of the AMSCC, at 18.4 ± 23.5 months versus 9.1 ± 13.6 months, respectively (p = 0.006). Conclusions: In conclusion, this study is novel in proposing that FMD and AMSCC are distinct clinical entities, differing in their impact on patient function and, most importantly, on patient survival. Full article

The unique molecular fingerprint spectral characteristics in the terahertz (THz) band provide distinct advantages for non-destructive and rapid biomolecular detection. However, conventional THz metasurface biosensors still face significant challenges in achieving highly sensitive and precise detection. This study proposes a sensing platform based on quasi-bound states in the continuum (Quasi-BIC), which enhances molecular fingerprint recognition through resonance amplification. We designed a symmetric graphene double-split square ring metasurface structure. By modulating the Fermi level of graphene, this system generated continuously tunable Quasi-BIC resonance peaks across a broad THz spectral range, achieving precise spectral overlap with the characteristic absorption lines of lactose (1.19 THz and 1.37 THz) and tyrosine (0.958 THz). The results demonstrated a remarkable 763-fold enhancement in absorption peak intensity through envelope analysis for analytes with 0.1 μm thickness, compared to conventional bare substrate detection. This terahertz BIC metasurface sensor demonstrates high detection sensitivity, holding significant application value in fields such as biomedical diagnosis, food safety, and pharmaceutical testing. Full article

Conventional ground reaction force (GRF) and load rate (LR) analyses may overlook temporal and waveform characteristics that reflect injury status and acuity. This study used an alternative GRF processing methodology to characterize GRF waveforms among runners with symptomatic medial tibial stress fractures (MTSS) and those recovering from tibial stress fractures (TSF; both unilateral [UL] and bilateral [BL]). This cross-sectional analysis of runners (n = 66) included four groups: symptomatic MTSS, recovering from UL or BL TSF, or uninjured case-matched controls. Participants ran at self-selected speed on an instrumented treadmill. Kinematics were collected with a 3D optical motion analysis system. Double-Gaussian models described the biphasic loading pattern of running gait (initial impact, active phases). Gaussian parameters described relative differences in the GRF waveform by injury condition. LR was calculated using the central difference numerical derivative of the raw normalized net force data. During the impact phase (0–20% of stance), controls and BL TSF produced higher GRF amplitudes than UL TSF and MTSS (p < 0.05). BL TSF and controls had greater maximal positive LR and minimum LR than UL TSF and MTSS. Peak medial GRF was 18–43% higher in the BL TSF group than in MTSS and UL TSF (p < 0.05). Correlations existed between tibial pain severity and early stance net GRF (r = 0.512; p = 0.016) and between pain severity and the duration since diagnosis for LR values during the impact phase (r values = 0.389–0.522; all p < 0.05). Collectively, these data suggest that this waveform modeling approach can differentiate injury status and pain acuity in runners. Early stance GRF and LR may offer novel insight into the management of running-related injuries. Full article

This study proposes a double inertial technique integrated with the Mann algorithm to address the fixed-point problem. Our method is further employed to tackle the split-equilibrium problem and perform classification using a urinary tract infection dataset in practical scenarios. The Extreme Learning Machine (ELM) model is utilized to categorize urinary tract infection cases based on both clinical and demographic features. It exhibits excellent precision and efficiency in differentiating infected from non-infected individuals. The results validate that the ELM provides a rapid and reliable method for handling classification tasks related to urinary tract infections. Full article

Background: Greater tuberosity fracture–dislocations (GTFDs) represent a distinct subset of proximal humerus fractures, occurring in up to 57% of anterior glenohumeral dislocations. Malreduction may result in impingement, instability, and functional limitation. Treatment is influenced by the displacement magnitude and direction, bone quality, and patient activity level. Methods: This narrative review was based on a comprehensive search of PubMed, Scopus, and Web of Science for English-language articles published between January 2000 and March 2025. Studies on pathomechanics, classification, diagnosis, treatment, and outcomes of GTFDs in adult and pediatric populations were included. Data were analyzed to summarize the current evidence and identify clinical trends. Results: A displacement ≥ 5 mm is the standard surgical threshold, though superior or posterosuperior displacement ≥ 3 mm—and ≥2 mm in overhead athletes—may justify surgery. Conservative treatment remains appropriate for minimally displaced fractures but is associated with up to 48% subacromial impingement and 11% delayed surgery. Surgical options include arthroscopic repair for small or comminuted fragments and open reduction and internal fixation (ORIF) with screws or plates for larger, split-type fractures. Locking plates and double-row suture constructs demonstrate superior biomechanical performance compared with transosseous sutures. Reverse shoulder arthroplasty (RSA) is reserved for elderly patients with poor bone stock, cuff insufficiency, or severe comminution. Pediatric cases require physeal-sparing strategies. Conclusions: GTFDs management demands an individualized approach based on fragment displacement and direction, patient age and activity level, and bone quality. While 5 mm remains the common threshold, lower cutoffs are increasingly adopted in active patients. A tiered treatment algorithm integrating displacement thresholds, fracture morphology, and patient factors is proposed to support surgical decision making. The incorporation of fracture morphologic classifications further refines fixation strategy. Further prospective and pediatric-specific studies are needed to refine treatment algorithms and validate outcomes. Full article

Background: Monkeypox virus, the etiological agent of Mpox, is a double-stranded DNA virus belonging to the Orthopoxvirus genus that has attracted increasing attention due to sporadic outbreaks in humans. In 2022, it was responsible for the largest Mpox outbreak outside the African continent, infecting over 117,000 individuals worldwide. In Brazil, since the first confirmed case in June 2022, more than 13,000 people have been diagnosed with the virus. Methods: In July 2022, we developed the first molecular test for the detection of monkeypox virus in the Midwest region of the country, allowing the diagnosis of the disease in various patients, mainly residents of the Federal District. Thus, in this work, we present the validation of a laboratory-developed qPCR test (LDT) for monkeypox virus detection, as well as a retrospective epidemiological analysis based on laboratory results. Results: The developed qPCR test demonstrated 100% accuracy, with a detection limit of 21.25 copies per reaction, and was validated for samples from swabbed pustule exudates and lesion crusts. To date, 295 tests have been conducted, with 88 (30%) returning positive. The positivity rate was 41.15% in male patients and 2.41% in female patients. A peak in positivity was observed in August 2022. From 2023 to 2024, there was a marked decline in test demand with occasional positive results. Conclusions: The rapid implementation of the test by our laboratory allowed for an immediate response to patients and provided important data for understanding the dynamics of monkeypox virus spread in Brazil, particularly in the Midwest region. Full article

Extracellular vesicles (EVs) are released by nearly all types of cells, and they communicate between cells by transporting bioactive molecules, including proteins, DNA, RNA, and lipids. In recent years, RNA carried by EVs, particularly the long-chain non-coding RNA (lncRNA) and circular RNA (circRNA) subtypes, has garnered interest with respect to their role in controlling tumor progression. Among them, there are increasing reports that mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) maintain a recently discovered function as transporters of lncRNAs and circRNAs. However, detailed molecular functions of lncRNAs and circRNAs contained in MSC-EVs are not presently summarized, and the efficacy of MSC-EVs as molecular carriers requires further elucidation. This review summarizes the biological characteristics of EVs and the common mechanisms of lncRNAs and circRNAs contained within them. The “double-edged sword” effect and related molecular mechanism of EV-derived lncRNAs (EV-lncRNAs) and circRNAs (EV-circRNAs) between differing tumor types and MSCs are highlighted. The potential of MSC-EVs in the field of tumor diagnosis and treatment is discussed to suggest new directions for the strategy of engineering MSC-EVs as anti-tumor drug carriers. Full article

Trichomonas vaginalis, a prevalent sexually transmitted protozoan parasite, is associated with adverse birth outcomes, increased risk of HIV and other sexually transmitted infections, infertility, and cervical cancer. Despite its widespread impact, trichomoniasis remains underdiagnosed and underreported globally. Trichomonas vaginalis virus (TVV), a double-stranded RNA (dsRNA) virus infecting T. vaginalis, could impact T. vaginalis pathogenicity. We provide an overview of TVV, including its genomic structure, transmission, impact on protein expression, role in 5-nitroimidazole drug susceptibility, and clinical significance. TVV is a ~5 kbp dsRNA virus enclosed within a viral capsid closely associated with the Golgi complex and plasma membrane of infected parasites. Hypothetical mechanisms of TVV transmission have been proposed. TVV affects protein expression in T. vaginalis, including cysteine proteases and surface antigens, thus impacting its virulence and ability to evade the immune system. Additionally, TVV may influence the sensitivity of T. vaginalis to treatment; clinical isolates of T. vaginalis not harboring TVV are more likely to be resistant to metronidazole. Clinically, TVV-positive T. vaginalis infections have been associated with a range in severity of genital signs and symptoms. Further research into interactions between T. vaginalis and TVV is essential in improving diagnosis, treatment, and the development of targeted interventions. Full article

The accurate and early detection of respiratory diseases is vital for effective diagnosis and treatment. This study presents a new approach for classifying lung sounds using a double denoising method combined with a 1D Convolutional Neural Network (CNN). The preprocessing uses Fast Fourier Transform to clean up sounds and High-Pass Filtering to improve the quality of breathing sounds by eliminating noise and low-frequency interruptions. The Short-Time Fourier Transform (STFT) extracts features that capture localised frequency variations, crucial for distinguishing normal and abnormal respiratory sounds. These features are input into the 1D CNN, which classifies diseases such as bronchiectasis, pneumonia, asthma, COPD, healthy, and URTI. The dual denoising method enhances signal clarity and classification performance. The model achieved 96% validation accuracy, highlighting its reliability in detecting respiratory conditions. The results emphasise the effectiveness of combining signal augmentation with deep learning for automated respiratory sound analysis, with future research focusing on dataset expansion and model refinement for clinical use. Full article

The efficacy of Hymenoptera venom immunotherapy is contingent upon the accurate identification of the insect responsible for the allergic reaction. The techniques used to detect specific IgE suffer from difficulties due to the cross-reactivity between Hymenoptera venoms (false positives), diagnostic ability, and the limited availability of allergenic components (false negatives). In this study, we analyzed the discrepancies in the results obtained with Euroline^® DPA-Dx and ImmunoCAP^® in the diagnosis of allergic reactions due to Hymenoptera stings in 151 patients. The results (positive/negative) of ImmunoCAP^® and Euroline^® agreed in 77/151 (50.99%) cases; with 15/151 (9.93%) cases positive for the same insect, and 61/151 (40.4%) cases positive for multiple insects. When the results were used to decide which venom to use for immunotherapy, there was a statistically significant discrepancy for Polistes dominula (21.8% of cases with ImmunoCAP^® compared to only 8.4% with Euroline^®). The presence of Polistes venom phospholipase (Pol d 1) in Euroline^® did not increase its ability to differentiate double sensitization to wasps. ImmunoCAP^® and Euroline^® exhibited comparable diagnostic performance in bee venom allergy. For vespid venom allergy—particularly involving Polistes species—ImmunoCAP^® appeared to show a slight diagnostic advantage, although this finding should be interpreted with caution. Full article

Circulating tumor DNA (ctDNA), a newly developed cancer biomarker, consists of single- or double-stranded DNA fragments that are shed from tumor cells in primary or metastatic sites. They are released into peripheral blood and exhibit distinct characteristics associated with cancer, even in the early stages. With advancements in technology, ctDNA detection has become more diverse and precise, including digital Polymerase Chain Reaction (dPCR) and next-generation sequencing (NGS), among others. As a chronic disease that develops over an extended period, early detection is crucial for the accurate diagnosis and treatment of cancer and can significantly improve patient prognosis. Therefore, analyzing ctDNA features is important. Additionally, ctDNA can be used to assess post-surgical minimal residual disease (MRD), aiding in treatment decisions. Overall, ctDNA plays a crucial role in the progression of cancer and its treatment. This review summarizes the sources and features of ctDNA, the analytical techniques used, and its application in both solid and non-solid tumors. Full article

Background/Objectives: Dental anomalies can manifest as a consequence of developmental defects and/or genetic influences, which disrupt the normal functioning of the oral cavity and present in various forms. Cases of fusion, gemination and concrescence are rare dental anomalies which are seen in the area of the mandibular molars. Case report: This case report concerns a 69-year-old Greek male patient who presented in the dental office asking for comprehensive oral treatment. During the clinical examination, a morphologically atypical molar was identified in the area of #37–38 presented with a large crown in the mesio-distal dimension (‘double’ crown). Panoramic and periapical radiographs offered valuable insights on the morphology of the irregular tooth, as they revealed the crown and root morphology, including the two pulp chambers and the three parallel roots of the tooth. Discussion: A plausible hypothesis identifies the atypical tooth as a third molar exhibiting morphological variation, a common characteristic of third molars. Additional diagnostic considerations—while supposing the existence of a supernumerary fourth molar—include the developmental anomalies of gemination, concrescence and fusion, as the clinical and radiographic features of the tooth display elements associated with all three. Conclusions: Considering the patient’s history, clinical and radiographic findings and the relevant literature, fusion is determined to be the most probable diagnosis. Early identification of the atypical tooth is essential to facilitate the implementation of appropriate preventive measures and to support informed treatment planning, should invasive procedures such as endodontic or surgical intervention be required in the future. Full article

The aim of the study was to determine the prevalence rates of respiratory pathogens using syndromic tests and also to show which respiratory viruses were detected in suspected cases, especially during and after the pandemic period. A total of 1984 different respiratory tract samples from various departments were included and studied with the QIAstat-Dx device in 2021–2023. The samples were studied with the QIAstat-Dx1 Respiratory SARS-CoV-2 Panel. The kit used was a fully automated, multiplex syndromic test that detected SARS-CoV-2 and 21 other respiratory tract pathogens. As a result of the study, the prevalence of Rhinovirus/Enterovirus (RV/EV) (18.59%), RV/EV-SARS-CoV-2 (42.74%), SARS-CoV-2 (5.04%), and Influenza A Virus (IAV) (5.59%) agents was found to be higher than other agents during the period investigated. Among the 1984 patients examined, 959 (48.33%) had a single viral agent, 156 (7.86%) had double coinfection, 11 (0.55%) had triple coinfection and 1 patient had quadruple coinfection. Nearly half of the patients had a straightforward infection, which helps clinicians in directing specific treatment methods. The study results demonstrate that during the pandemic period, the detection of respiratory pathogens such as SARS-CoV-2 and RV/EV was not only critical for accurate diagnosis but also served as an important indicator of the broader epidemiological trends in respiratory infections. The seasonal distribution showed that while RV/EV was frequently present, its coinfection with SARS-CoV-2 was notably observed only in the first trimester. In light of our findings showing high rates of SARS-CoV-2 and RV/EV detection, along with diverse patterns of coinfection in clinical samples, such comprehensive testing not only assists in rapid diagnosis but also informs public health strategies by reflecting the evolving landscape of respiratory infections in the pandemic and post-pandemic era. Full article