Search Results (1,302)

Rare-earth fluoride nanocrystals have emerged as promising scintillator materials due to their excellent optical properties, environmental stability, and ease of fabrication into flexible screens. However, their practical application is often hindered by persistent afterglow, a phenomenon caused by deep trap states that capture and slowly release charge carriers after X-ray excitation, which leads to signal overlap and image artifacts in dynamic imaging scenarios. This study addresses this critical challenge by developing Ce³⁺/Tb³⁺ co-doped NaLuF₄ nanoscintillators with suppressed afterglow. By introducing Ce³⁺ions as dopants into the Tb³⁺-activated NaLuF₄ host, we successfully quenched the characteristic long afterglow without compromising the intrinsic radioluminescence efficiency of the Tb³⁺ centers. The optimized nanocrystals were subsequently incorporated into a poly (vinyl alcohol) matrix to fabricate transparent, high-loading composite scintillator films. The resulting films exhibit negligible afterglow, maintain high spatial resolution, and demonstrate excellent radiation stability. This work presents an effective strategy for suppressing afterglow in rare-earth fluoride scintillators through targeted ion doping, which paves the way for their application in real-time, high-quality X-ray imaging technologies such as medical diagnostics and industrial inspection. Full article

Background: Ultra-widefield (UWF) images are frequently used for fundus examinations during medical screening. Optos^® generates pseudo-color images using only red and green lasers, which may reduce the visibility of retinal interface lesions. In contrast, Clarus™ incorporates blue light, suggesting potential superiority in epiretinal membrane (ERM) detection. Methods: This retrospective study included 233 patients (408 eyes; 816 UWF images per device) who underwent simultaneous Optos^® and Clarus™ imaging plus optical coherence tomography (OCT) at our institution from March to April 2019. Ten blinded ophthalmologists assessed only the UWF images for ERM presence or absence. Diagnosis was confirmed by fundus examination and OCT. McNemar’s test compared detection accuracy. Results: Clarus™ consistently outperformed Optos^®, with superior sensitivity [median 49% (range 42–70) vs. 14% (4–47); p = 0.002], correct judgment rate [85% (82–90) vs. 78% (44–88); p = 0.010], and lower unassessed rate [6% (2–13) vs. 13% (3–52); p = 0.002]. This superiority held across ERM stages, lens status, and ophthalmologist experience levels. Conclusions: This study demonstrated that Clarus™ significantly outperformed Optos^® in ERM detection accuracy. These results suggest that true-color UWF systems like Clarus™ may be more useful for macular screening in routine practice and health examinations. Full article

Manual pill identification is often inefficient and error-prone due to the large variety of medications and frequent visual similarity among pills, leading to misuse or dispensing errors. These challenges are exacerbated when pill imprints are engraved, curved, or irregularly arranged, conditions under which conventional optical character recognition (OCR)-based methods degrade significantly. To address this problem, we propose GO-PILL, a geometry-aware OCR pipeline for robust pill imprint recognition. The framework extracts text centerlines and imprint regions using the TextSnake algorithm. During imprint refinement, background noise is suppressed and contrast is enhanced to improve the visibility of embossed and debossed imprints. The imprint localization and alignment stage then rectifies curved or obliquely oriented text into a linear representation, producing geometrically normalized inputs suitable for OCR decoding. The refined imprints are processed by a multimodal OCR module that integrates a non-autoregressive language–vision fusion architecture for accurate character-level recognition. Experiments on a pill image dataset from the U.S. National Library of Medicine show that GO-PILL achieves an F1-score of 81.83% under set-based evaluation and a Top-10 pill identification accuracy of 76.52% in a simulated clinical scenario. GO-PILL consistently outperforms existing methods under challenging imprint conditions, demonstrating strong robustness and practical feasibility. Full article

Background: Optical genome mapping (OGM) detects genome-wide structural variants (SVs), including balanced rearrangements and complex copy-number alterations beyond standard-of-care cytogenomic assays. In chronic lymphocytic leukemia (CLL), cytogenetic and genomic risk stratification is traditionally based on fluorescence in situ hybridization (FISH), karyotyping, targeted next-generation sequencing (NGS), and immunogenetic assessment of immunoglobulin heavy chain variable region (IGHV) somatic hypermutation status, each of which interrogates only a limited aspect of disease biology. Methods: We retrospectively evaluated fifty patients with CLL using OGM and integrated these findings with cytogenomics, targeted NGS, IGHV mutational status, and clinical time-to-first-treatment (TTFT) data. Structural variants were detected using OGM and pathogenic NGS variants were derived from a clinical heme malignancy panel. Clinical outcomes were extracted from the electronic medical record. Results: OGM identified reportable structural variants in 82% (41/50) of cases. The most frequent abnormality was del(13q), observed in 29/50 (58%) and comprising 73% (29/40) of all OGM-detected deletions with pathologic significance. Among these, 12/29 (42%) represented large RB1-spanning deletions, while 17/29 (58%) were focal deletions restricted to the miR15a/miR16-1 minimal region, mapping to the non-coding host gene DLEU2. Co-occurrence of adverse lesions, including deletion 11q/ATM, BIRC3 loss, trisomy 12, and deletion 17p/TP53, were recurrent and strongly associated with shorter TTFT. OGM also uncovered multiple cryptic rearrangements involving chromosomal loci that are not represented in the canonical CLL FISH probe panel, including IGL::CCND1, IGH::BCL2, IGH::BCL11A, IGH::BCL3, and multi-chromosomal copy-number complexity. IGHV data were available in 37/50 (74%) of patients; IGHV-unmutated status frequently co-segregated with OGM-defined high-risk profiles (del(11q), del(17p), trisomy 12 with secondary hits, and complex genomes whereas mutated IGHV predominated in OGM-negative or structurally simple del(13q) cases and aligned with indolent TTFT. Integration of OGM with NGS further improved genomic risk classification, particularly in cases with discordant or inconclusive routine testing. Conclusions: OGM provides a comprehensive, genome-wide view of structural variation in CLL, resolving deletion architecture, identifying cryptic translocations, and defining complex multi-hit genomic profiles that tracked closely with clinical behavior. Combining OGM and NGS analysis refined risk stratification beyond standard FISH panels and supports more precise, individualized management strategies in CLL. Prospective studies are warranted to evaluate the clinical utility of OGM-guided genomic profiling in contemporary treatment paradigms. Full article

Silymarin—a standardized extract from the seeds of milk thistle (Silybum marianum L. Gaertn.)—is mainly used for the treatment of hepatitis and other liver diseases. In recent years, the attention of researchers has been directed to its use in dermatology and wound treatment. Despite the promising results, there are still many unresolved issues in this area. The aim of the present study is to develop and characterize hydrogel chitosan–pectin films containing silymarin as an active ingredient with potential medical application. Six variants of hydrogel films (control and silymarin-loaded) were obtained from chitosan and pectin solutions by the casting method and analyzed in terms of their physicochemical, structural, mechanical and optical properties, as well as the in vitro dissolution profile of silymarin. The highest tensile strength was measured for the chitosan-based films—23.35 ± 1.74 MPa (control) and 22.01 ± 2.67 MPa (silymarin-loaded), while the barrier properties to UV and visible light were the strongest for chitosan–pectin films with silymarin. The antioxidant potential of the films was determined by DPPH assay and it was found that the variants with silymarin have over 20 times higher antioxidant activity (from 2.020 ± 0.048 to 2.106 ± 0.190 mg TE/g) than the corresponding controls. The results showed that chitosan–pectin films with incorporated silymarin could find application as potential hydrogel dressings in the therapy of wounds and superficial burns. Full article

Background/Objectives: Effective airway management during pediatric cardiopulmonary resuscitation (CPR) is crucial but technically challenging, especially during continuous chest compressions. While direct laryngoscopy with Macintosh (MAC) or Miller (MIL) blades remains the standard, optical devices such as the VieScope (VSL) may enhance performance under dynamic resuscitation conditions. This study compared first-pass success and intubation time, as well as procedural difficulty and glottic visualization, of MAC, MIL, and VSL during simulated pediatric cardiopulmonary resuscitation. Methods: This prospective, randomized crossover simulation study involved 53 medical students. Participants performed endotracheal intubation on a high-fidelity manikin simulating a 5-year-old pediatric patient using MAC, MIL, and the Bebé VieScope laryngoscope. Each technique was evaluated in two scenarios: with and without continuous chest compressions. Results: Without chest compressions, first-pass success (FPS) and intubation time varied significantly between techniques. VSL achieved the highest FPS (100%; p = 0.032) and the shortest intubation time (27.9 ± 9.2 s; p = 0.040), performing faster than MIL and achieving higher FPS than MAC. Visualization quality, ease of intubation, and optimization maneuvers were similar across techniques. During continuous chest compressions, all outcomes differed significantly. FPS increased from MAC to MIL and VSL (p = 0.001), with MAC showing the lowest success rate. VSL showed the shortest intubation time (35.9 ± 13.0 s; p < 0.001), better glottic visualization, easier intubation, and fewer optimization maneuvers, followed by MIL. Conclusions: In this simulated pediatric cardiac arrest model, the VieScope laryngoscope demonstrated superior overall performance, especially during uninterrupted chest compressions. Optical tubular laryngoscopy may therefore provide clinically relevant benefits in pediatric resuscitation where maintaining high-quality chest compressions is crucial. Given the manikin-based design of this study, confirmation of these findings in clinical pediatric cardiac arrest settings will require further prospective clinical investigation. Full article

Background: Glaucoma is an age-related optic neuropathy frequently accompanied by systemic comorbidities. Vitamin D deficiency (VDD) has been associated with cardiovascular and renal diseases in the general population, yet its relationship with long-term systemic outcomes in glaucoma remains unclear. This study evaluated the association between baseline vitamin D status and subsequent mortality and cardiorenal events in patients with primary glaucoma. Methods: We conducted a retrospective cohort study using deidentified electronic health records from the TriNetX U.S. Collaborative Network, a federated network of participating healthcare organizations. Adults (≥18 years) with incident primary glaucoma (2005–2020) and a serum 25-hydroxyvitamin D (25(OH)D) test within 12 months prior to diagnosis were categorized as VDD (<30 ng/mL) or vitamin D adequacy (VDA; ≥30 ng/mL). After 1:1 propensity score matching across 47 demographic, clinical, medication, and laboratory variables, 11,855 patients per group were followed for up to 5 years. Outcomes included all-cause mortality, major adverse cardiovascular events (MACE), acute kidney injury (AKI), and renal function decline (eGFR < 60 mL/min/1.73 m²). Analyses incorporated Kaplan–Meier curves, Cox models, landmark tests, sensitivity analyses, and competing risk methods. Results: Among the 35,100 eligible patients, the matched cohorts demonstrated higher 5-year risks associated with VDD for all-cause mortality (HR 1.104; 95% CI 1.001–1.217), MACE (HR 1.151; 95% CI 1.078–1.229), and AKI (HR 1.154; 95% CI 1.056–1.261), whereas the risks of renal function decline did not differ (HR 0.972; 95% CI 0.907–1.042). Risk divergence emerged within the first year of follow-up and persisted through the 5-year observation period. Conclusions: In patients with primary glaucoma, vitamin D deficiency was associated with higher long-term risks of mortality and cardiorenal complications, but not renal function decline. Taken together, the results are consistent with vitamin D status serving as a marker of broader systemic vulnerability in glaucoma and highlight the need for prospective studies to further clarify its prognostic significance. Full article

For retinal degenerative diseases, advanced therapies such as gene therapy and retinal stem cell therapy have emerged as promising treatments, which are often delivered through subretinal injection. However, clinical subretinal injection remains challenging due to the extremely high precision requirements, lack of depth information, and the physiological limitations of manual operation, often leading to complications such as hypotony and globe atrophy. To address these challenges, this study proposes a novel ophthalmic surgical robotic system designed for high-precision subretinal injections. The robotic system incorporate a remote center of motion mechanism for its mechanical structure and employs a master–slave control system to achieve motion scaling. A microscope-integrated optical coherence tomography device is applied to provide real-time microscopic imaging and depth information. The design and performance of the proposed system are validated through simulations and experiments. Precision tests demonstrate that the system achieves an overall positioning accuracy of less than 30 $\mathsf{\mu }$m, with injection positioning accuracy under 20 $\mathsf{\mu }$m. Subretinal injection experiments conducted on artificial eye models further validate the clinical feasibility of the robotic system. Full article

Nowadays, the population is subject to a lot of stress, being one of society’s most encountered problems affecting people all over the world. Being under a lot of stress for prolonged periods of time impacts the physical and mental health of individuals with effects on society as an economic burden. Cortisol is one of the main indicators of stress. Long-term exposure to this stress hormone can lead to severe medical conditions such as heart disease, lung issues, obesity, anxiety, or depression. In this context, the current review aims to provide a comprehensive overview of the most recent advances made in the development of versatile and efficient cortisol devices and biosensors capable of monitoring the cortisol levels in biofluids. Lately, both non-plasmonic (polymer-based sensors, optical sensors, electrochemical sensors) and plasmonic sensors (mono- and multiple-metallic nanoparticles-based sensors) have shown great results in cortisol detection. The work focuses on the advantages, remaining restrictions, and limitations in the field of cortisol biosensors from solution-based immunosensors to wearable and Lab-on-Skin monitoring devices, providing a better understanding of the fulfilled requirements and persisting challenges in the accurate detection and monitoring of the cortisol stress hormone. Full article

Artificial intelligence (AI) and machine learning (ML) are transforming medical diagnostics, but human nail, an easily accessible and rich biological substrate, is still not fully exploited in the digital health field. Nail pathologies are easily diagnosed, non-invasive disease biomarkers, including systemic diseases such as anemia, diabetes, psoriasis, melanoma, and fungal diseases. This review presents the first big synthesis of image analysis for nail lesions incorporating AI/ML for diagnostic purposes. Where dermatological reviews to date have been more wide-ranging in scope, our review will focus specifically on diagnosis and screening related to nails. The various technological modalities involved (smartphone imaging, dermoscopy, Optical Coherence Tomography) will be presented, together with the different processing techniques for images (color corrections, segmentation, cropping of regions of interest), and models that range from classical methods to deep learning, with annotated descriptions of each. There will also be additional descriptions of AI applications related to some diseases, together with analytical discussions regarding real-world impediments to clinical application, including scarcity of data, variations in skin type, annotation errors, and other laws of clinical adoption. Some emerging solutions will also be emphasized: explainable AI (XAI), federated learning, and platform diagnostics allied with smartphones. Bridging the gap between clinical dermatology, artificial intelligence and mobile health, this review consolidates our existing knowledge and charts a path through yet others to scalable, equitable, and trustworthy nail based medically diagnostic techniques. Our findings advocate for interdisciplinary innovation to bring AI-enabled nail analysis from lab prototypes to routine healthcare and global screening initiatives. Full article

Purpose: While migraine is linked to increased cerebrovascular risk, its association with non-arteritic anterior ischemic optic neuropathy (NAION) remains underexplored. Methods: We conducted a retrospective case–control study using population-based electronic medical records. NAION patients were compared to propensity score-matched controls regarding migraine prevalence and clinical characteristics. Results: From 2001 to 2022, among 6,566,619 patients, 1629 NAION cases (mean age 67 ± 13 years; 45% female) and 6433 propensity matched controls were identified. The prevalence of migraine was similar in both groups (3.8% vs. 3.3%, p = 0.3). Among migraine patients, those with NAION (n = 62, age 62 ± 11) and controls (n = 212, age 60 ± 11) had comparable baseline characteristics, except for congestive heart failure (9.7% vs. 2.4%, p = 0.027). Within the NAION cohort, migraineurs (n = 64) were younger (62 ± 12 vs. 67 ± 13 years, p < 0.001), and had lower rates of diabetes mellitus (35% vs. 57%, p < 0.001) and peripheral vascular disease (1.6% vs. 9.6%, p = 0.03). Female migraineurs developed NAION at a younger age than females without migraine (60 ± 12 vs. 69 ± 12 years, p < 0.001); no such difference was seen in males. Multinomial logistic regression revealed that migraine was independently associated with younger age at NAION onset, particularly in patients aged <59 (OR = 5.8, p = 0.001) compared with those >70. An independent 1:4 migraine to non-migraine matched cohort (n = 310) showed similar age-dependent trends. Conclusions: While migraine was not more prevalent among NAION patients, females with migraine developed NAION at a younger age and had fewer vascular comorbidities. Congestive heart failure was more prevalent among migraine patients who developed NAION, suggesting a potential contributory role of systemic hypoperfusion. Full article

Diffuse optical imaging (DOI) uses scattered light to non-invasively sense and image highly diffuse media, including biological tissues such as the breast and brain. Despite its clinical potential, widespread adoption remains limited because physical constraints, limited available datasets, and conventional reconstruction algorithms struggle with the strongly nonlinear, ill-posed inverse problem posed by multiple photon scattering. We introduce Diffuse optical Imaging using Genetic Programming (DI-GP), a physics-guided and fully interpretable genetic programming framework for DOI. Grounded in the diffusion equation, DI-GP evolves closed-form symbolic mappings that enable fast and accurate 2-D reconstructions in strongly scattering media. Unlike deep neural networks, Genetic Programming (GP) naturally produces symbolic expressions, explicit rules, and transparent computational pipelines—an increasingly important capability as regulatory and high-stakes domains (e.g., FDA/EMA, medical imaging regulation) demand explainable and auditable AI systems, and where training data are often scarce. DI-GP delivers substantially faster inference and improved qualitative and quantitative reconstruction performance compared to analytical baselines. We validate the approach in both simulations and tabletop experiments, recovering targets without prior knowledge of shape or location at depths exceeding ~25 transport mean-free paths. Additional experiments demonstrate centimeter-scale imaging in tissue-like media, highlighting the promise of DI-GP for non-invasive deep-tissue imaging and its potential as a foundation for practical DOI systems. Full article

Photocatalytic water sterilization has emerged as a promising sustainable technology for addressing microbial contamination across diverse sectors including healthcare, food production, and environmental management. This review examines the fundamental mechanisms and recent advances in photocatalytic water sterilization, with a particular emphasis on the differential bactericidal pathways against Gram-negative and Gram-positive bacteria. Gram-negative bacteria undergo a two-step inactivation process involving initial outer membrane lipopolysaccharide (LPS) degradation followed by inner membrane disruption, whereas Gram-positive bacteria exhibit simpler kinetics due to direct oxidative attacks on their thick peptidoglycan layer. Escherichia coli has long been used as the gold standard in photocatalytic sterilization studies owing to its aerobic nature and suitability for the colony-counting method. In contrast, Lactobacillus casei, a facultative anaerobe, can be cultured statically and evaluated rapidly using turbidity-based optical density measurements. Therefore, both organisms serve complementary roles depending on the experimental objectives—E. coli for precise quantification and L. casei for rapid, practical assessments of Gram-positive bacterial inactivation under laboratory conditions. We also describe sterilization using light alone while comparing it to photocatalytic sterilization and then discuss two innovative suspension-based photocatalyst systems: polystyrene bead-supported TiO₂/SiO₂ composites offering balanced reactivity and separability and magnetic TiO₂-SiO₂/Fe₃O₄ nanoparticles enabling rapid magnetic recovery. Future research directions should prioritize enhancing visible-light efficiency using metal-doped TiO₂ such as Cu-doped systems; improving catalyst durability; developing new applications of photocatalysts, such as protecting RO membranes; and validating scalability across diverse industrial and medical water treatment applications. Full article

Background/Objectives: Thyroid eye disease (TED) can lead to structural and microvascular changes in the orbit and retina. This study aimed to investigate the associations between Clinical Activity Score (CAS), orbital magnetic resonance imaging (MRI) measurements, and retinal microvascular changes in TED patients. Methods: This cross-sectional study included 38 patients (76 eyes) with TED. Each patient underwent a comprehensive ophthalmological evaluation, CAS assessment, and a detailed medical history. Optical coherence tomography angiography (OCTA) was performed to quantify vessel density (VD) in the superficial and deep capillary plexus (SCP and DCP). Exophthalmos, extraocular muscle thickness and orbital fat thickness were measured on MRI scans to evaluate structural changes. Laboratory analyses included thyroid hormone levels, thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase antibodies (anti-TPO), and lipid profile. Results: Active TED patients (CAS ≥ 3) had significantly higher TRAb levels (p < 0.001), while anti-TPO did not differ between groups. Active eyes showed significantly higher DCP VD in the whole image (p = 0.013), parafovea (p = 0.012), and perifovea (p = 0.009) across all quadrants, with no difference in SCP or the foveal avascular zone (FAZ). In linear mixed model regression analyses, after adjusting for previous glucocorticosteroid therapy, higher triglycerides, greater medial rectus thickness, and whole-image DCP VD independently predicted higher CAS values (R² = 42, p < 0.001). After adjusting for age and sex, CAS remained significantly positive predictor of DCP VD in the parafovea (R² = 0.22, p < 0.001). Conclusions: Changes in DCP VD reflect TED activity and structural orbital involvement. Full article

Objectives: Glaucoma is an age-related neurodegenerative disease, characterized by retinal ganglion cell loss and progressive visual field deterioration. Beyond intraocular pressure (IOP), vascular and metabolic dysregulation contributes to optic nerve head (ONH) ischemia and neuronal vulnerability. Nutritional factors with antioxidative and vasodilatory properties may help preserve ocular perfusion. This study investigated the acute and subacute effects of a single dose of a dietary supplement containing red ginger extract (Zingiber officinale var. rubra), lutein, and vitamin B6 on ONH blood flow in patients with open-angle glaucoma (OAG). Methods: A retrospective self-controlled study was conducted at Tohoku University Hospital between August 2023 and March 2025. ONH blood flow was quantified using a laser speckle flowgraphy (LSFG) baseline one hour after and one month after continuous oral supplementation in patients with OAG. Systemic parameters, ocular biometry, and concomitant glaucoma medications were recorded in medical charts. Relative mean blur rate (MBR) changes were analyzed using a linear mixed-effects model, accounting for repeated measures and inter-eye correlations. Results: Nineteen glaucoma patients (38 eyes) were included in the acute phase and 13 patients (26 eyes) completed the one-month follow-up. After adjusting for age and sex, a single oral dose of red ginger extract significantly increased the relative MBR at 1 h (106.9 ± 3.1%; p < 0.05), and this enhancement increased after 1 month of continuous intake (115.4 ± 6.7%; p < 0.05). Greater ONH perfusion was particularly prominent in eyes with shorter axial length. Conclusions: Oral supplementation was associated with acute and short-term increases in ONH blood flow in glaucomatous eyes. Although this study was a retrospective study without a placebo-controlled comparison group, our findings offer hypothesis-generating evidence that nutritional interventions may support ocular perfusion alongside conventional glaucoma management. Future prospective randomized controlled trials are required to confirm these associations. Full article