Search Results (2,988)

Infrared thermography is a non-contact tool for monitoring inflammatory processes in the diabetic foot, but quantitative bedside use remains challenging with low-cost thermal infrared cameras due to radiometric drift, non-uniformity (vignetting), geometric distortions, and visible–thermal parallax. This paper presents an end-to-end clinical and instrumental framework built around a cheap thermal camera to ensure reproducible acquisition and physically consistent temperature estimation. The approach combines a standardized mobile acquisition setup and measurement protocol, extraction of embedded radiometric data from raw images, radiometric inversion with atmospheric correction, vignette correction performed in the radiometric domain, and geometric calibration of both visible and infrared sensors using dedicated (thermal) calibration targets. Accurate visible–infrared registration is obtained from hybrid heated markers, enabling reliable overlay and downstream analysis. The full processing chain yields quantitative thermograms with radiometric errors below 0.15 °C and sub-pixel multimodal alignment, supporting the detection of clinically relevant plantar temperature asymmetries and paving the way for routine calibrated low-cost thermography in diabetic foot care. Full article

Botulinum neurotoxin (BoNT) treatment outcomes are commonly assessed through visual evaluation of facial wrinkle patterns, a process that remains inherently subjective despite structured grading systems. This study evaluated whether contemporary multimodal artificial intelligence (AI) systems can identify facial changes associated with BoNT treatment, using region-specific wrinkle patterns as surrogate markers of underlying muscle activity. A dataset of 46 facial images (23 pre-treatment, 23 post-treatment) was analyzed using four multimodal models, each assessed across five independent runs. Models were tasked with classifying treatment state from single images, detecting wrinkle presence in the forehead, glabella, and periorbital regions, and generating exploratory severity scores and age estimates. Two models achieved 100% accuracy in distinguishing pre- from post-treatment images in this dataset, while region-specific wrinkle detection was variable and frequently did not exceed majority-class baselines. Inter-run reliability varied substantially across models. Exploratory wrinkle severity scores showed directional differences between treatment states, whereas apparent age estimates demonstrated minimal systematic variation. These findings suggest that global facial changes associated with BoNT treatment appear to be detectable in model outputs, but region-specific assessment remains limited, underscoring the need for cautious interpretation and further validation. Full article

Neuroimplants represent an emerging medical technology, offering new therapeutic approaches for severe neurological and psychiatric disorders. One of the key limitations to long-term neuroimplant performance is the foreign body response elicited by intracortical implantation. Among the contributing cell types, astrocytes play a central role in glial scar formation around the implant, which can compromise device functionality. Immunofluorescence of glial fibrillary acidic protein (GFAP) provides a well-established marker of astrogliosis (neuroinflammation), yet quantitative and reproducible assessment of astrocyte morphology remains challenging due to the complexity and variability of image analysis approaches. Here, we aimed to quantitatively assess implantation-induced astrogliosis and to determine how classifier training strategy influences segmentation outcomes and morphometric measurements. We present a machine learning-assisted pipeline based on the LabKit plugin in Fiji for segmentation and morphometric analysis of GFAP-positive astrocytes in peri-implant scar versus distant cortical regions. Using this approach, we demonstrate an increase in GFAP expression, cell area, and astrocytic process length as well as the redistribution of GFAP signal along astrocytic processes within scar regions. We show that different classifier training strategies produce systematically distinct segmentation outcomes, with rule-compliant annotation improving agreement with manually defined ground truth. These findings highlight the critical role of annotation strategy in shallow learning-based segmentation and provide a practical framework for improving reproducibility of astrocyte morphometry in studies of neuroinflammation and neuroimplant biocompatibility. Full article

Background and Clinical Significance: Nodular fasciitis is a benign, self-limited myofibroblastic proliferation that frequently mimics malignant soft-tissue tumors both clinically and radiologically. Although it has been well described in the extremities, its uncommon occurrence in the submandibular region poses a diagnostic challenge. Case Presentation: We report the case of a 22-year-old male patient, presenting with a rapidly enlarging painless swelling in the left submandibular region. Ultrasound demonstrated a well-defined subcutaneous lesion, while magnetic resonance imaging revealed heterogeneous enhancement with diffusion restriction, suggesting inflammatory or neoplastic pathology. Fine-needle aspiration cytology showed spindle-cell proliferation with pseudosarcomatous features, warranting histological examination to exclude malignancy. Surgical resection was performed. Histopathological examination demonstrated a myofibroblastic proliferation with tissue culture-like morphology. Immunohistochemistry showed diffuse SMA positivity while many other immunohistological markers were negative, arguing against several histologic mimics. Fluorescence in situ hybridization confirmed USP6 gene rearrangement, establishing the diagnosis of nodular fasciitis. Conclusions: This case highlights the diagnostic challenges posed by nodular fasciitis in the head and neck region and emphasizes the importance of correlating imaging, cytology, histopathology, and molecular findings to avoid overtreatment. The literature review further supports the benign clinical course of this rare entity in the submandibular region and underscores the value of including it in the differential diagnosis of submandibular masses. Full article

Testicular tumors are the most common neoplasms of the canine male reproductive tract, corresponding to approximately 25% of all tumors in intact males. A large percentage of cases are characterized by one of three main tumor types: seminomas, interstitial Leydig cell tumors, or Sertoli cell tumors. Clinical importance is primarily associated with endocrine activity rather than malignant behavior; orchiectomy is the treatment of choice for most canine testicular cancers. Endocrine activity, particularly estrogen secretion, may result in feminization syndrome and, in severe cases, bone marrow suppression. The diagnostic approach combines physical examination, ultrasonography with hormonal assessment using endocrine testing (testosterone, estradiol, and T:E ratio), and/or tissue level evidence of the estrogen effect (preputial cytology). Management is centered on orchiectomy; unilateral surgery may be considered when the contralateral testis is clinically and ultrasonographically normal and when preservation of reproductive capacity or working ability is still a priority. Dogs with hormonally active tumors benefit from postoperative hematologic and endocrine monitoring. Recent advances in immunohistochemistry (IHC), such as Ki-67 and inhibin-α markers, and imaging techniques are improving tumor characterization and individualized clinical decision making. Full article

Activewear has become a common component of women’s everyday clothing, yet emerging evidence suggests that exposure to activewear imagery may adversely affect body image. This study aimed to describe women’s activewear engagement across contexts and to investigate how different markers of engagement correspond with positive outcomes such as fitness behavior, body appreciation, and self-esteem, as well as negative outcomes including media pressure, idealized appearance aspirations, and self-objectification. We collected survey data from student (N = 455) and community (N = 37) samples to assess activewear-related behaviors, including online browsing, social media following, purchasing, and wearing, as well as measures of fitness behaviors, body appreciation, self-esteem, idealized body aspirations, appearance comparisons, perceived media pressure, and self-objectification. Across samples, 40–87% of women engaged with activewear in some form, and 30% reported feeling self-conscious at least half the time they wore it; notably, activewear was worn for exercise less than 50% of the time. Activewear engagement showed positive correlations with fitness behaviors but also with idealized body aspirations, appearance comparisons, media pressure, and self-objectification, while showing no associations with body appreciation or self-esteem. These findings highlight the growing cultural prominence of activewear and suggest that engagement with this clothing trend is linked to both adaptive and risk-related psychological factors, underscoring the need for further research into its broader psychological implications. Full article

Background: Women face underdiagnosed cardiovascular disease (CVD)/stroke risks due to sex-specific pathophysiological mechanisms, including hormonal variations such as oestrogen decline, adverse pregnancy outcomes (APOs), endothelial dysfunction, autoimmune-mediated factors, and sexual dimorphism in cardiac remodelling. Conventional risk assessment tools, predominantly calibrated to male pathophysiology, lack sensitivity in detecting these female-specific determinants. We hypothesise that artificial intelligence (AI), machine learning (ML) and deep learning (DL) may offer a transformative approach by integrating multimodal data, including pathological biomarkers, clinical history, and vascular imaging, to enable precision CVD/stroke risk stratification, pending rigorous external validation in sex-stratified cohorts. Method: This narrative review adopts a PRISMA-informed study selection framework and oversees gender-specific biomarkers, including vasoactive peptides (adrenomedullin), adipocytokines (adiponectin), inflammatory mediators (hs-CRP, IL-6), and thrombogenic factors (homocysteine, D-dimer), alongside clinical variables (APOs, autoimmune disorders) and ultrasonographic markers, carotid intima-media thickness (cIMT), plaque burden and plaque area (PA). Advanced ML/DL algorithms were employed to synthesise these heterogeneous datasets, identifying nonlinear interactions for better outcomes. Findings: Key insights reveal that hormonal dynamics (e.g., hypoestrogenism post-menopause) modulate CVD risk, while APOs induce persistent endothelial dysfunction and subclinical atherosclerosis. Biomarker sexual dimorphism is evident; hs-CRP exhibits higher baseline levels in women, whereas adiponectin declines with metabolic dysfunction. Radiomic features (cIMT progression, plaque morphology) are a well-established biomarker for CVD risk stratification. Conclusions: The integration of AI-driven multimodal systems holds the potential to enable a paradigm shift from population-based to personalised risk assessment, addressing critical gaps in female CVD health. However, this potential is currently at the early validation stage, and widespread clinical implementation requires prospective, externally validated, and ethnically diverse studies. Future applications should incorporate longitudinal biomarker profiling and advanced imaging, namely shear wave elastography and plaque radiomics, to optimise predictive models. Full article

Background/Objectives: Impairment in pulsatile insulin release contributes to insulin resistance and is one of the earliest markers of developing type 2 diabetes. Insulin delivered to the liver in pulses has a stronger glucose-lowering effect than continuous insulin delivery. Whether pulsatility benefits the islet itself is an open question. We previously showed that reducing glucokinase activity with the glucokinase inhibitor D-mannoheptulose (MH) improves function in islets exposed to prolonged hyperglycemic conditions. In this study, we test whether pulsatile vs. continuous delivery impacts the effectiveness of MH in islets. Methods: Islets were exposed to high-glucose conditions (20 mM glucose) for 24 or 48 h to induce early adaptations to hyperglycemia. We then used a specially designed perifusion system to impose pulsatile activity by exposing mouse islets to 3 min of MH in 20 mM glucose and 3 min of only high levels of glucose. Islets given intermittent MH for 18 h were compared with continuous delivery of MH at a full (2.5 mM) or half (1.25 mM) dose. Results: MH delivered by the forced oscillatory system reversed the effects of hyperglycemia and restored glucose sensing more effectively than continuous delivery. Specifically, fura-2AM imaging of intracellular calcium showed that islets given pulsatile MH had greater reductions in the elevated basal calcium caused by hyperglycemic conditions, improved the glucose stimulation index, and improved phase 0 response (indicating glucose-stimulated calcium uptake by the endoplasmic reticulum). Conclusions: These findings suggest that the loss of oscillatory glucose metabolism in islets contributes directly to beta-cell dysfunction. Full article

Background: We aimed to investigate the prevalence and clinical significance of pontine microtubular signal intensity (MSI), presumed dilated perivascular or perineural spaces, in patients with hemifacial spasm (HFS) using high-resolution MRI using proton density-weighted imaging (HR-PDI). Methods: We retrospectively analyzed 438 patients with unilateral HFS who underwent microvascular decompression (MVD) and preoperative HR-PDI. MSI was defined as a linear or curvilinear hyperintense lesion along the presumed course of the intraparenchymal facial nerve fascicles within the pons on HR-PDI. The presence and laterality of MSI were evaluated by consensus between two reviewers and classified according to their relationship to the symptomatic side of HFS as ipsilateral (same side as the facial spasm), contralateral (opposite side), or bilateral. Clinical characteristics, surgical findings, and postoperative outcomes were compared according to the presence of ipsilateral MSI. A control group of 307 subjects who underwent HR-PDI for non-central neurologic symptoms was included to assess the prevalence of MSI. Multivariable logistic regression analysis was performed to identify factors associated with immediate postoperative improvement after MVD. Results: MSI was more frequently observed in patients with HFS than in controls after adjusting age and sex (OR, 3.78; 95% CI, 2.747–5.197; p < 0.001). Ipsilateral MSI was identified in 267 of 438 patients (61.0%). Patients with ipsilateral MSI showed a significantly higher frequency of contralateral MSI (p < 0.001) and vertebralartery-related compression (p = 0.002). Immediate postoperative improvement after MVD was less frequent in patients with ipsilateral MSI than in those without MSI (77.5% vs. 86.5%, p = 0.019). Multivariable logistic regression analysis demonstrated that ipsilateral MSI was independently associated with a lower likelihood of immediate postoperative improvement (OR, 0.411; 95% CI, 0.222–0.759; p = 0.005). However, long-term surgical outcomes were not significantly different according to the presence of MSI. Conclusions: Pontine MSI on HR-PDI is more frequently observed in patients with HFS and is associated with a lower likelihood of immediate postoperative improvement and a tendency toward delayed recovery after MVD but not with poorer long-term outcomes. These findings suggest that MSI may represent microstructural or neurofluidic alterations along the pontine facial nerve pathway and may serve as an imaging marker of delayed recovery dynamics. Full article

Background and Objectives: Fibromyalgia syndrome (FMS) is frequently accompanied by autonomic symptoms and autonomic dysregulation, which may influence ocular blood flow regulation. The choroid is a densely vascular, autonomically innervated tissue, and optical coherence tomography (OCT)-derived markers have been used to explore potential ocular microvascular changes in FMS, with inconsistent findings. The choroidal vascularity index (CVI), defined as the proportion of luminal area within the total choroidal area, has been proposed as a potentially more robust marker of choroidal vascular status than thickness alone. We aimed to compare CVI and choroidal thickness between patients with FMS and healthy controls and examine the association between autonomic symptom burden and CVI in FMS. Materials and Methods: This single-centre observational cross-sectional case–control study enrolled adults aged 18–65 years. Swept-source OCT was performed; low-quality scans were excluded, and only right eyes were analysed. CVI, subfoveal maximum and mean choroidal thickness were obtained using an artificial intelligence-assisted analysis platform. Autonomic symptom burden, fibromyalgia impact, and central sensitization-related symptoms were assessed using the Composite Autonomic Symptom Score-31 (COMPASS-31), the Revised Fibromyalgia Impact Questionnaire (FIQ-R), and the Central Sensitization Inventory (CSI), respectively. Group comparisons, Spearman correlations, and multivariable linear regression were performed. Results: COMPASS-31, FIQ-R, and CSI scores were higher in the FMS group (all p < 0.001). CVI and choroidal thickness did not differ significantly between groups (CVI p = 0.124; maximum thickness p = 0.136; mean thickness p = 0.097). CVI was not correlated with COMPASS-31, FIQ-R, or CSI within either group. In adjusted models, age was independently associated with CVI (p < 0.001), whereas FMS status and COMPASS-31 total score were not. Conclusions: CVI and choroidal thickness were similar in FMS and controls, and CVI was not associated with self-reported autonomic symptom burden in FMS. Studies incorporating objective autonomic testing and dynamic vascular imaging paradigms are warranted. Full article

Motion blur degrades single-frame imaging when relative motion occurs during sensor exposure; yet, quantitative validation is difficult because ground-truth motion parameters are rarely available in real images. This paper presents an interpretable, measure-first framework for detecting, localizing, and quantifying motion blur in single-frame grayscale images under a validated operating condition of one-dimensional horizontal uniform motion. The method analyzes each image row as a one-dimensional spatial signal, where Movement Artifact denotes the scanline-level imprint of motion blur retained in the legacy algorithm names MAPE and MAQ. The pipeline combines three stages: Movement Artifact Position Estimation (MAPE) using scanline self-similarity, Reference Origin Point Estimation (ROPE) using robust structural trends, and Movement Artifact Quantification (MAQ), which summarizes blur magnitude as an average horizontal spatial displacement after adaptive filtering. The pipeline is evaluated on a controlled empirical dataset of 110 images of a high-contrast marker acquired at known tangential velocities from 0.0 to 1.0 m/s in 0.1 m/s increments (10 images per level). MAPE achieves 70–90% detection rates across velocities, and ROPE localizes reference origins with 97–99% detection. An empirical polynomial mapping from MAQ to velocity attains $R^2=0.9900$ with RMSE 0.0229 m/s and MAE 0.0221 m/s over 0.0–0.7 m/s, enabling calibrated velocity estimates from blur measurements within the validated regime. An extended additive-noise robustness analysis further shows that severe perturbation can preserve candidate self-similarity responses while progressively destabilizing reference-origin localization and MAQ pairing, thereby clarifying the empirical boundary of the current controlled single-marker regime. The approach is not claimed to generalize to uncontrolled scenes, non-uniform blur, or multi-dimensional and non-rigid motion. Full article

Background/Objectives: To describe retinal imaging characteristics and the natural history of rhodopsin (RHO)-associated autosomal dominant retinitis pigmentosa (ADRP) by evaluating ellipsoid zone (EZ) width loss and measuring the degree of constriction of the area within and including the hyperautofluorescent ring. Methods: Eighteen patients with molecularly confirmed RHO variants were retrospectively evaluated. EZ width on spectral-domain optical coherence tomography (SD-OCT) and the area within and including the hyperfluorescent ring on fundus autofluorescence (FAF) were measured. The correlation between EZ width and hyperfluorescent ring area was assessed using a linear mixed-effects model. Results: Mean best corrected visual acuity (BCVA) (logMAR) was 0.21 at baseline and 0.29 at last visit over a mean follow-up of 5 years. Nine patients presented with sectoral RP, eight with typical RP, and one with unilateral RP. The mean EZ width constriction rate was −93.43 µm/year (SD = 130.58), and the area within and including the hyperautofluorescent ring decreased by −0.54 mm²/year (SD = 0.50). A strong positive association was observed between the EZ width and hyperfluorescent ring area at baseline (β = 151.7 ± 17.9, p < 0.001) and at the final visit (β = 185.7 ± 18.2, p < 0.001). Conclusions: In this study, patients with RHO-associated ADRP appeared to show a relatively slow rate of progression. Quantitative imaging markers, such as EZ width and the area within and including the hyperautofluorescent ring, may offer potentially reproducible measures of disease progression. These imaging biomarkers could be useful as outcome measures in future natural history studies and therapeutic trials, pending further validation. Full article

Parathyroid allotransplantation is a promising treatment for hypoparathyroidism, yet immune rejection and fibrosis remain significant barriers. This study evaluates a novel immunoprotective culture system utilizing a moderate-intensity static magnetic field (SMF) to modulate lymphocyte migration without compromising graft functionality. Human parathyroid cells were encapsulated and divided into 10 experimental groups, co-cultured with Jurkat T-lymphocytes, and either exposed to SMF or maintained as controls. Over 72 h, we analyzed parathormone (PTH) secretion, cell viability (via proliferation assays), and molecular expression patterns of key markers (VitDR, PTH, GCM2, and CaSR). Lymphocyte dynamics were monitored through comparative imaging and cytokine profiling (IL-1α, IL-1β, and IL-2). SMF exposure significantly altered Jurkat cell behavior; while lymphocytes in unexposed groups aggregated around microcapsules, they were effectively repelled and migrated away from the graft interface under SMF exposure. Crucially, this biophysical manipulation was safe: no significant differences in PTH secretion or viability were observed across groups. All groups maintained essential genetic markers. Our findings demonstrate that SMF exposure induces lymphocyte migration away from the capsule without compromising parathyroid cell characteristics or functionality. Integrating encapsulation with SMF represents a novel, non-pharmacological, non-invasive immunoprotective strategy for parathyroid allotransplantation, offering a technological alternative to systemic immunosuppression. Full article

Background: Left ventricular global longitudinal strain (GLS) measured by speckle-tracking echocardiography (STE) has become a key marker of myocardial systolic function, yet normal reference values remain heterogeneous, and the magnitude of physiological sex differences is not fully defined. We performed a systematic review and meta-analysis to establish pooled GLS reference estimates in healthy individuals, quantify sex-related differences, and contextualize deformation findings relative to conventional systolic function. Methods: A systematic search of PubMed, Scopus, and EMBASE identified observational studies reporting GLS in healthy adults assessed by two-dimensional or three-dimensional STE. Random-effects meta-analysis using standardized mean differences (SMD) compared GLS between women and men. Descriptive pooled reference values were derived using weighted median and interquartile range (IQR) reconstruction from study-level distributions. Meta-regression analyses explored demographic, clinical, and methodological sources of heterogeneity. A complementary analysis evaluated sex-related differences in left ventricular ejection fraction (LVEF) within the same populations. Results: Thirty-two studies, including 19,157 healthy individuals, were analyzed. The pooled population had a weighted median age of 47.5 years and 53% female participants. Overall, GLS demonstrated a weighted median of 20.3% (IQR 17.8–22.5). Women showed higher GLS values than men (20.8% [18.4–23.1] vs. 19.4% [17.0–21.6]). Meta-analysis of 28 studies confirmed significantly greater GLS in females (SMD 0.487, 95% CI 0.409–0.565; p < 0.001), with consistent findings across imaging modalities and no subgroup interaction. Between-study heterogeneity was substantial (I² = 82.7%), although effect direction was uniform. Meta-regression analyses identified no significant moderators, and sensitivity analyses confirmed stable estimates without publication bias. Segmental analysis demonstrated a physiological base-to-apex strain gradient. In contrast, LVEF was largely comparable between sexes, with no clinically meaningful difference (SMD 0.257, 95% CI 0.186–0.327; p < 0.001), indicating preserved global systolic performance despite differences in myocardial deformation. Conclusions: GLS demonstrates a consistent physiological range in healthy populations, with women exhibiting higher longitudinal deformation than men, independent of the imaging modality. These findings support the adoption of sex-specific GLS reference values and highlight the complementary roles of deformation and volumetric indices in improving the interpretation of myocardial function and reducing misclassification in clinical practice. Full article

Median overall survival remains a central endpoint in oncology, but it can obscure a clinically meaningful long tail of patients with advanced solid tumors who survive well beyond the median. One biological context in which this pattern may be relevant is tumor microenvironment (TME) acidosis. Driven by aerobic glycolysis, hypoxia, impaired perfusion, and proton-export programs, acidic TME is increasingly implicated in invasion, therapeutic resistance, and immune suppression. This narrative review examines TME acidosis as the primary biological framework and considers long-tail survival as a clinical lens through which its implications may be interpreted. We summarize the biological basis and heterogeneity of acidic TME, review current approaches to clinical and translational assessment of tumor acidity, including acidoCEST magnetic resonance imaging (MRI) and positron emission tomography (PET)-based approaches, and discuss the potential and limitations of alkalization-oriented interventions such as buffering and diet-based strategies. Particular attention is given to the distinction between direct measurements of tumor acidity and clinically feasible but indirect markers such as urinary pH, which should not be interpreted as a direct surrogate for local tumor extracellular pH. From a science-based medicine perspective, long-tail survival is treated here as a hypothesis-generating clinical signal rather than proof of causality. Overall, alkalization-oriented interventions appear biologically plausible and clinically testable, but current clinical evidence remains limited and context-dependent. Future progress will require mechanistically informed biomarkers, careful safety evaluation, and trial designs capable of detecting delayed separation of survival curves and tail-oriented patterns of benefit. Full article