Search Results (691)

Objective: With a global prevalence ranging from 50% to 100%, gingivitis is considered the most common oral disease in adults worldwide. It is characterized by clinical signs of inflammation, such as redness, swelling and bleeding, on gentle probing. Although it is considered a milder form of periodontal disease, gingivitis plays an important role in overall oral health. Early detection and treatment are essential to prevent progression to more severe conditions. Typically, diagnosis is performed by dental professionals, as individuals are often unable to accurately assess whether they are affected. Therefore, the aim of the present study was to determine to what degree gingivitis is visually detectable by an easy-to-use camera-based application. Materials and methods: Standardized intraoral photographs were taken using a specialized intraoral camera and processed using a custom-developed filter based on a machine-learning algorithm. The latter was trained to highlight areas suggestive of gingivitis. A total of 110 participants were enrolled through ad hoc sampling, resulting in 320 assessable test sites. A dentist provided two reference standards: the clinical diagnosis based on bleeding on probing of the periodontal sulcus (BOP) and an independent visual assessment of the same images. Agreement between diagnostic methods was measured using Cohen’s kappa statistic. Results: The agreement between the application’s output and the BOP-based clinical diagnosis was low, with a kappa value of 0.055 [p = 0.010]. Similarly, the dentist’s visual assessment of clinical photos showed low agreement with BOP, with a kappa value of 0.087 [p < 0.001]. In contrast, the agreement between the application and the dentist’s photo-based evaluations was higher, with a kappa value of 0.280 [p < 0.001]. Conclusions: In its current form, the camera-based application is not able to reliably detect gingivitis. The low level of agreement between dentists’ visual assessments and the clinical gold standard highlights that gingivitis is difficult to identify merely visually. These results underscore the need to refine visual diagnostic approaches further, which could support future self-assessment or remote screening applications. Full article

As part of contemporary urban culture, murals support place making and city identity. While much attention has been paid to their role in activating public space during daylight hours, their presence after dark remains largely unexamined. This paper analyzes how mural content interacts with night-time illumination. The research draws on case studies, photographs, luminance measurements, and lighting simulations. It evaluates how existing lighting systems support or undermine the legibility and impact of commercial murals in urban environments. It explores whether standardized architectural lighting guidelines suit murals, how color and surface affect visibility, and which practices improve night-time legibility. The study identifies a gap in existing lighting strategies, noting that uneven lighting distorts intent and reduces public engagement. In response, a new design tool—the Floodlighting Content Readability Map—is proposed to support artists and planners in creating night-visible murals. This paper situates mural illumination within broader debates on creative urbanism and argues that lighting is not just infrastructure, but a cultural and aesthetic tool that extends the reach and resonance of public art in the 24 h city. It further emphasizes the need for interdisciplinary collaboration and a multi-contextual perspective—encompassing visual, social, environmental, and regulatory dimensions—when designing murals in cities. Full article

Background: Diaper dermatitis (DD) frequently occurs following pediatric gastrointestinal surgery and may lead to severe morbidity despite preventive measures. This study aims to evaluate the effectiveness of potato-derived protease enzyme inhibitor cream (PPEIC) in preventing DD after gastrointestinal surgery in children. Methods: In this double-blinded, single-center RCT, 30 patients under three years of age undergoing gastrointestinal surgery were randomized 1:1 to prevention using PPEIC or Panthenol cream (PC). The creams were applied after each diaper change for four weeks postoperatively. At two and four weeks, two observers evaluated photographs of the perianal region for the presence and severity of DD. The primary outcome was the severity of DD four weeks after surgery. Results: From November 2020 to March 2023, 30 patients were included. Two patients withdrew directly after randomization, resulting in 13 PPEIC and 15 PC patients. In total, nineteen patients (73.1%) developed DD—eight (66.7%) in the PPEIC group and 11 (78.6%) in the PC group (p = 0.665)—of whom twelve (63.2%) suffered severe DD. All DD cases developed within the first two weeks, resulting in half of the patients discontinuing the preventive cream before the four-week endpoint. Conclusions: This study highlights the significant issue of DD after gastrointestinal surgery, which affects 73.1% of diapered children despite prevention with PPEIC or PC. Although the study was unable to identify a superior preventive method, it offers valuable insights and goals for future research. Full article

The identification of unmarked graves is important in archaeology, forensics, and cemetery management, but invasive methods are often restricted due to ethical or cultural concerns. This necessitates the use of non-invasive geophysical techniques. Our study demonstrates the potential of induced polarization (IP) imaging as a non-invasive remote sensing technique specifically suited for detecting and characterizing unmarked graves. IP leverages changes in the electrical properties of soil and pore water, influenced by the accumulation of organic matter from decomposition processes. Measurements were conducted at an inactive cemetery using non-invasive textile electrodes to map a documented grave from the early 1990s, with a survey design optimized for high spatial resolution. The results reveal a distinct polarizable anomaly at a 0.75–1.0 m depth with phase shifts exceeding 12 mrad, attributed to organic carbon from wooden burial boxes, and a plume-shaped conductive anomaly indicating the migration of dissolved organic matter. While electrical conductivity alone yielded diffuse grave boundaries, the polarization response sharply delineated the grave, aligning with photographic documentation. These findings underscore the value of IP imaging as a non-invasive, data-driven approach for the accurate localization and characterization of graves. The methodology presented here offers a promising new tool for archaeological prospection and forensic search operations, expanding the geophysical toolkit available for remote sensing in culturally and legally sensitive contexts. Full article

Fish coloration plays an important role in reproduction and camouflage, yet capturing color variation under field conditions remains challenging. We present a standardized, semi-automated protocol for measuring body coloration in the popular model fish threespine stickleback (Gasterosteus aculeatus). Individuals are photographed in a controlled light box within minutes of capture, and color is sampled from eight anatomically defined standard sites in human-perception-based CIELAB space. Analyses combine univariate color metrics, multivariate statistics, and the ΔE* perceptual difference index to detect subtle shifts in hue and brightness. Validation on pre-spawning fish shows the method reliably distinguishes males and females well before full breeding colors develop. Although it currently omits ultraviolet signals and fine-scale patterning, the approach scales efficiently to large sample sizes and varying lighting conditions, making it well suited for population-level surveys of camouflage dynamics, sexual dimorphism, and environmental influences on coloration in sticklebacks. Full article

Attentional biases seem to play an important role in anorexia nervosa (AN). The objective of this study was to measure visual attention patterns toward female bodies in adolescents and adults with and without AN in order to explore developmental and disease-specific aspects. Female adult and adolescent patients with AN (n = 38) and control participants (n = 39) viewed standardized photographic stimuli showing women’s bodies from five BMI categories. The fixation times on the bodies and specific body parts were analyzed. Differences between participants with and without AN did not emerge: All participants showed increased attention toward the body, while adolescents displayed shorter fixation times on specific areas of the body than adults. Increased visual attention toward areas indicative of weight (e.g., hips, thighs, abdomen, buttocks) and a shorter fixation time on unclothed body parts were observed in all participants. There is evidence for the developmental effect of differential viewing patterns when looking at women’s bodies. The attention behavior of patients with AN seems to be similar to that of the control groups, which is partly consistent with, and partly contradictory to, previous studies. Full article

Background: Chronic wounds represent a persistent clinical challenge and impose a considerable burden on healthcare systems. These lesions often require multidisciplinary management due to underlying factors such as microbial colonization, impaired immunity, and vascular insufficiencies. Regenerative therapies, particularly autologous approaches, have emerged as promising strategies to enhance wound healing. Adipose tissue-derived stem cells (ADSCs) and platelet-rich plasma (PRP) may improve outcomes through paracrine effects and growth factor release. Methods: A prospective observational study was conducted on 31 patients with chronic wounds that were unresponsive to conservative treatment for over six weeks. Clinical and photographic evaluations were employed to monitor healing. All patients underwent surgical debridement, with adjunctive interventions—negative pressure wound therapy, grafting, or flaps—applied as needed. PRP infiltration and/or autologous adipose tissue transfer were administered based on wound characteristics. Wound area reduction was the primary outcome measure. Results: The cohort included 17 males and 14 females (mean age: 59 years). Etiologies included venous insufficiency (39%), diabetes mellitus (25%), arterial insufficiency (16%), and trauma (16%). Most lesions (84%) were located on the lower limbs. All patients received PRP therapy; five underwent combined PRP and fat grafting. Over the study period, 64% of the patients exhibited >80% wound area reduction, with complete healing in 48.3% and a mean healing time of 49 days. Conclusions: PRP therapy proved to be a safe, effective, and adaptable treatment, promoting substantial healing in chronic wounds. Autologous adipose tissue transfer did not confer additional benefit. PRP may warrant inclusion in national treatment protocols. Full article

The present paper deals with an inhabited, creeping mountainous landmass with profound surface deformation that affects the local community. The scope of the paper is to gather surficial and subsurface information in order to understand the parameters of this creeping mass, which is usually affected by several parameters, such as its geometry, subsurface water, and shear zone. Therefore, a combined aerial and surface investigation has been conducted. The aerial investigation involves UAV’s LiDAR acquisition for the terrain model and a comparison of historical aerial photographs for land use changes. The multi-technique surface investigation included resistivity (ERT) and seismic (SRT, MASW) measurements and density determination of geological formations. This combination of methods proved to be fruitful since several aspects of the landslide were clarified, such as water flow paths, the internal geological structure of the creeping mass, and its geometrical extent. The depth of the shear zone of the creeping mass is delineated at the first five to ten meters from the surface, especially from the difference in diachronic resistivity change. Full article

Background: Wound healing and scar management remain significant challenges in dermatology and aesthetic medicine. Recent advances in regenerative medicine have introduced plant-derived exosome-like nanoparticles (PDENs) as potential therapeutic agents due to their bioactive properties. This study examines the clinical application of rose stem cell exosomes (RSCEs) in combination with established treatments for managing different types of scars. Methods: A case series of four patients with different scar etiologies (dog bite, hot oil burn, forehead trauma, and facial laser treatment complications) was treated with RSCEs in combination with microneedling (Dermapen 4.0, 0.2–0.4 mm depth) and/or thulium laser therapy (Lutronic Ultra MD, 8–14 J), or as a standalone topical treatment. All cases underwent sequential treatments over periods ranging from two to four months, with comprehensive photographic documentation of the progression. The efficacy was assessed through clinical photography and objective evaluation using the modified Vancouver Scar Scale (mVSS) and the Patient and Observer Scar Assessment Scale (POSAS), along with assessment of scar appearance, texture, and coloration. Results: All cases demonstrated progressive improvement throughout the treatment course. The dog bite scar showed significant objective improvement, with a 71% reduction in modified Vancouver Scar Scale score (from 7/13 to 2/13) and a 61% improvement in Patient and Observer Scar Assessment Scale scores after four combined treatments. The forehead trauma case exhibited similar outcomes, with a 71% improvement in mVSS score and 55–57% improvement in POSAS scores. The hot oil burn case displayed the most dramatic improvement, with a 78% reduction in mVSS score and over 70% improvement in POSAS scores, resulting in near-complete resolution without visible scarring. The facial laser complication case showed a 75% reduction in mVSS score and ~70% improvement in POSAS scores using only topical exosome application without device-based treatments. Clinical improvements across all cases included reduction in elevation, improved texture, decreased erythema, and better integration with surrounding skin. No adverse effects were reported in any of the cases. Conclusions: This preliminary case series suggests that plant-derived exosome-like nanoparticles, specifically rose stem cell exosomes (RSCEs), may enhance scar treatment outcomes when combined with microneedling and laser therapy, or even as a standalone topical treatment. The documented objective improvements, measured by standardized scar assessment scales, along with clinical enhancements in scar appearance, texture, and coloration across different scar etiologies—dog bite, burn, traumatic injury, and iatrogenic laser damage—suggest that this approach may offer a valuable addition to the current armamentarium of scar management strategies. Notably, the successful treatment of laser-induced complications using only topical exosome application demonstrates the versatility and potential of this therapeutic modality. Full article

Background and Objectives: General-purpose multimodal large language models (LLMs) are increasingly used for medical image interpretation despite lacking clinical validation. This study evaluates the diagnostic reliability of ChatGPT-4o and Claude 2 in photographic assessment of adolescent idiopathic scoliosis (AIS) against radiological standards. This study examines two critical questions: whether families can derive reliable preliminary assessments from LLMs through analysis of clinical photographs and whether LLMs exhibit cognitive fidelity in their visuospatial reasoning capabilities for AIS assessment. Materials and Methods: A prospective diagnostic accuracy study (STARD-compliant) analyzed 97 adolescents (74 with AIS and 23 with postural asymmetry). Standardized clinical photographs (nine views/patient) were assessed by two LLMs and two orthopedic residents against reference radiological measurements. Primary outcomes included diagnostic accuracy (sensitivity/specificity), Cobb angle concordance (Lin’s CCC), inter-rater reliability (Cohen’s κ), and measurement agreement (Bland–Altman LoA). Results: The LLMs exhibited hazardous diagnostic inaccuracy: ChatGPT misclassified all non-AIS cases (specificity 0% [95% CI: 0.0–14.8]), while Claude 2 generated 78.3% false positives. Systematic measurement errors exceeded clinical tolerance: ChatGPT overestimated thoracic curves by +10.74° (LoA: −21.45° to +42.92°), exceeding tolerance by >800%. Both LLMs showed inverse biomechanical concordance in thoracolumbar curves (CCC ≤ −0.106). Inter-rater reliability fell below random chance (ChatGPT κ = −0.039). Universal proportional bias (slopes ≈ −1.0) caused severe curve underestimation (e.g., 10–15° error for 50° deformities). Human evaluators demonstrated superior bias control (0.3–2.8° vs. 2.6–10.7°) but suboptimal specificity (21.7–26.1%) and hazardous lumbar concordance (CCC: −0.123). Conclusions: General-purpose LLMs demonstrate clinically unacceptable inaccuracy in photographic AIS assessment, contraindicating clinical deployment. Catastrophic false positives, systematic measurement errors exceeding tolerance by 480–1074%, and inverse diagnostic concordance necessitate urgent regulatory safeguards under frameworks like the EU AI Act. Neither LLMs nor photographic human assessment achieve reliability thresholds for standalone screening, mandating domain-specific algorithm development and integration of 3D modalities. Full article

To overcome the complexity of yarn color measurement using spectrophotometry with yarn winding techniques and to enhance consistency with human visual perception, a yarn color measurement method based on digital photography is proposed. This study employs a photographic colorimetry system to capture digital images of single yarns. The yarn and background are segmented using the K-means clustering algorithm, and the centerline of the yarn is extracted using a skeletonization algorithm. Spectral reconstruction and colorimetric principles are then applied to calculate the color values of pixels along the centerline. Considering the nonlinear characteristics of human brightness perception, the final yarn color is obtained through a nonlinear texture-adaptive weighted computation. The method is validated through psychophysical experiments using six yarns of different colors and compared with spectrophotometry and five other photographic measurement methods. Results indicate that among the seven yarn color measurement methods, including spectrophotometry, the proposed method—based on centerline extraction and nonlinear texture-adaptive weighting—yields results that more closely align with actual visual perception. Furthermore, among the six photographic measurement methods, the proposed method produces most similar to those obtained using spectrophotometry. This study demonstrates the inconsistency between spectrophotometric measurements and human visual perception of yarn color and provides methodological support for developing visually consistent color measurement methods for textured textiles. Full article

Background/Objectives: Oral cavity wound recovery presents unique challenges due to constant moisture exposure and functional mechanical stresses. Nanoscale extracellular vesicles (exosomes) with regenerative properties offer promising therapeutic potential for tissue regeneration, contributing to improved health outcomes. This study evaluated human exosomal preparations in promoting oral mucosal regeneration. Methods: We established standardized full-thickness wounds in the buccal mucosa of SD rats and divided subjects into experimental (receiving 50 billion human exosomes) and control (receiving carrier solution only) groups. Comprehensive wound assessment occurred at predetermined intervals (days 0, 3, 7, and 10) through photographic documentation, histological examination, and quantitative measurement. Results: Exosomal-treated tissues demonstrated statistically significant acceleration in closure rates (p < 0.05), achieving 87.3% reduction by day 10 versus 64.1% in the controls. Microscopic analysis revealed superior epithelial development, reduced inflammatory infiltration, and enhanced collagen architectural organization in exosomal-treated specimens. Semi-quantitative evaluation confirmed consistently superior healing metrics in the experimental group across all assessment timepoints. Conclusions: These findings demonstrate that human exosome preparations significantly enhance oral mucosal regeneration in SD rats, suggesting potential clinical applications for accelerating recovery following oral surgical procedures. Full article

Background/Objectives: Discrepancies in diabetic retinopathy (DR) grading are well-documented, with retinal non-perfusion (RNP) quantification posing greater challenges. This study assessed intergrader agreement in DR evaluation, focusing on qualitative severity grading and quantitative RNP measurement. We aimed to improve agreement through structured consensus meetings. Methods: A retrospective analysis of 100 comparisons from 50 eyes (36 patients) was conducted. Two paired medical retina fellows graded ultra-widefield color fundus photographs (CFP) and fundus fluorescein angiography (FFA) images. CFP assessments included DR severity using the International Clinical Diabetic Retinopathy (ICDR) grading system, DR Severity Scale (DRSS), and predominantly peripheral lesions (PPL). FFA-based RNP was defined as capillary loss with grayscale matching the foveal avascular zone. Weekly adjudication by a senior specialist resolved discrepancies. Intergrader agreement was evaluated using Cohen’s kappa (qualitative DRSS) and intraclass correlation coefficients (ICC) (quantitative RNP). Bland–Altman analysis assessed bias and variability. Results: After eight consensus meetings, CFP grading agreement improved to excellent: kappa = 91% (ICDR DR severity), 89% (DRSS), and 89% (PPL). FFA-based PPL agreement reached 100%. For RNP, the non-perfusion index (NPI) showed moderate overall ICC (0.49), with regional ICCs ranging from 0.40 to 0.57 (highest in the nasal region, ICC = 0.57). Bland–Altman analysis revealed a mean NPI difference of 0.12 (limits: −0.11 to 0.35), indicating acceptable variability despite outliers. Conclusions: Structured consensus training achieved excellent intergrader agreement for DR severity and PPL grading, supporting the clinical reliability of ultra-widefield imaging. However, RNP measurement variability underscores the need for standardized protocols and automated tools to enhance reproducibility. This process is critical for developing robust AI-based screening systems. Full article

Image-assisted digital shade guides are increasingly popular for shade matching; however, research on their accuracy remains limited. This study aimed to compare the accuracy and reliability of color coordination in image-assisted digital shade guides constructed using calibrated images of their shade tabs captured by a mirrorless camera (Canon, Tokyo, Japan) (MC-DSG) and a smartphone camera (Samsung, Seoul, Korea) (SC-DSG), using a spectrophotometer as the reference standard. Twenty-nine VITA Linearguide 3D-Master shade tabs were photographed under controlled settings with both cameras equipped with cross-polarizing filters. Images were calibrated using Adobe Photoshop (Adobe Inc., San Jose, CA, USA). The L* (lightness), a* (red-green chromaticity), and b* (yellow-blue chromaticity) values, which represent the color attributes in the CIELAB color space, were computed at the middle third of each shade tab using Adobe Photoshop. Specifically, L* indicates the brightness of a color (ranging from black [0] to white [100]), a* denotes the position between red (+a*) and green (–a*), and b* represents the position between yellow (+b*) and blue (–b*). These values were used to quantify tooth shade and compare them to reference measurements obtained from a spectrophotometer (VITA Easyshade V, VITA Zahnfabrik, Bad Säckingen, Germany). Mean color differences (∆E₀₀) between MC-DSG and SC-DSG, relative to the spectrophotometer, were compared using a independent t-test. The ∆E₀₀ values were also evaluated against perceptibility (PT = 0.8) and acceptability (AT = 1.8) thresholds. Reliability was evaluated using intraclass correlation coefficients (ICC), and group differences were analyzed via one-way ANOVA and Bonferroni post hoc tests (α = 0.05). SC-DSG showed significantly lower ΔE₀₀ deviations than MC-DSG (p < 0.001), falling within acceptable clinical AT. The L* values from MC-DSG were significantly higher than SC-DSG (p = 0.024). All methods showed excellent reliability (ICC > 0.9). The findings support the potential of smartphone image-assisted digital shade guides for accurate and reliable tooth shade assessment. Full article

Background: Reliable and non-invasive methods for assessing welfare in poultry are essential for improving evidence-based welfare monitoring and advancing management practices in commercial production systems. The iris-to-pupil (IP) ratio, previously validated by our group in primates and cattle, reflects autonomic nervous system balance and may serve as a physiological indicator of stress in laying hens. This study evaluated the utility of the IP ratio under field conditions across diverse commercial layer housing systems. Materials and Methods: In total, 296 laying hens (Lohmann Brown, n = 269; White Leghorn, n = 27) were studied across four locations in Canada housed under different systems: Guelph (indoor; pen), Spring Island (outdoor and scratch; organic), Ottawa (outdoor, indoor and scratch; free-range), and Toronto (outdoor and hobby; free-range). High-resolution photographs of the eye were taken under ambient lighting. Light intensity was measured using the light meter app. The IP ratio was calculated using NIH ImageJ software (Version 1.54p). Statistical analysis included one-way ANOVA and linear regression using GraphPad Prism (Version 5). Results: Birds housed outdoors had the highest IP ratios, followed by those in scratch systems, while indoor and pen-housed birds had the lowest IP ratios (p < 0.001). Subgroup analyses of birds in Ottawa and Spring Island farms confirmed significantly higher IP ratios in outdoor environments compared to indoor and scratch systems (p < 0.001). The IP ratio correlated weakly with ambient light intensity (r² = 0.25) and age (r² = 0.05), indicating minimal influence of these variables. Although White Leghorn hens showed lower IP ratios than Lohmann Browns, this difference was confounded by housing type; all White Leghorns were housed in pens. Thus, housing system but not breed was the primary driver of IP variation. Conclusions: The IP ratio is a robust, non-invasive physiological marker of welfare assessment in laying hens, sensitive to housing environment but minimally influenced by light or age. Its potential for integration with digital imaging technologies supports its use in scalable welfare assessment protocols. Full article