Search Results (505)

Automated medical report generation (MRG) faces a critical hurdle in seamlessly integrating detailed visual evidence with accurate clinical diagnoses. Current approaches often rely on static knowledge transfer, overlooking the complex interdependencies among pathological findings and their nuanced alignment with visual evidence, often yielding reports that are linguistically sound but clinically misaligned. To address these limitations, we propose a novel graph-driven medical report generation framework with adaptive knowledge distillation. Our architecture leverages a dual-phase optimization process. First, visual–semantic enhancement proceeds through the explicit correlation of image features with a structured knowledge network and their concurrent enrichment via cross-modal semantic fusion, ensuring that generated descriptions are grounded in anatomical and pathological context. Second, a knowledge distillation mechanism iteratively refines both global narrative flow and local descriptive precision, enhancing the consistency between images and text. Comprehensive experiments on the MIMIC-CXR and IU X-Ray datasets demonstrate the effectiveness of our approach, which achieves state-of-the-art performance in clinical efficacy metrics across both datasets. Full article

Introduction: The management of neovascular age-related macular degeneration (nAMD) is constrained by diminishing therapeutic options for retina specialists and their patients when the disease reaches its end stages. Methods: Clinical insights emerge from two case narratives in which patients benefitted from discontinuation of anti-VEGF therapy. Results: Long-term management of nAMD with intravitreal injections of agents targeting vascular endothelial growth factor (VEGF) is crucial for slowing progression of the disease and is generally well-tolerated. However, vision often declines as the disease progresses over time, even with treatment. This article presents strategies for aligning therapeutic goals with their expected visual outcome when an eye has reached end-stage disease. It addresses considerations for how and when to stop treatment when vision becomes limited, taking into consideration the visual status of the fellow eye and incorporating input from low vision specialists who can better assess best-corrected visual acuity (BCVA) and optimize the visual function of patients. We also acknowledge the potential benefits of switching either the dose or the agent that targets VEGF to alter the long-term visual outcome of treatment. Finally, we discuss the importance of taking into consideration related manifestations of the disease, such as macular scarring, geographic atrophy, or other retinal or optic nerve diseases which may limit vision and thus the utility of continued nAMD treatment. Conclusions: Building a strong patient–physician relationship is essential for navigating the shared decision-making process of when to stop treatment for nAMD. Full article

Food labels are common elements of everyday life. However, from the point of view of communication researchers (especially visual communication), they are incredibly interesting cultural artifacts, located at the intersection of communication, design, technology, and regulation. This article analyzes the evolution of the labels of Muszynianka, a leading mineral water brand in Poland, from the perspective of media archaeology. It treats labels as dual artifacts—media (information carriers, regulatory objects) and artistic (elements of applied art, design). This article emphasizes the importance of materiality, the non-linearity of history and the analysis of the technological–regulatory “archive.” It develops concepts of labels as complex, multimodal messages, especially in a historical context. The authors conducted a visual analysis of the evolution of Muszynianka’s labels, placing them within broader design trends. To explore recurring visual and narrative motifs, a topoi analysis method was used to identify three basic topoi: Topos of Nature/Mountain Origin, Topos of Health/Vitality/Purity, and Topos of Modernity/Technology. Full article

The breach of an interspecies barrier by RNA viruses has facilitated the emergence of lethal hCoVs, particularly SARS-CoV-2, resulting in significant socioeconomic setbacks and public health risks globally in recent years. Moreover, the high evolutionary plasticity of hCoVs has led to the continuous emergence of diverse variants, complicating clinical management and public health responses. Studying the evolutionary trajectory of hCoVs, which provides a molecular roadmap for understanding viruses’ adaptation, tissue tropism, spread, virulence, and immune evasion, is crucial for addressing the challenges of zoonotic spillover of viruses. Tracing the evolutionary trajectory of lethal hCoVs provides essential genomic insights required for risk stratification, variant/sub-variant classification, preparedness for outbreaks and pandemics, and the identification of critical viral elements for vaccine and therapeutic development. Therefore, this review examines the evolutionary landscape of the three known lethal hCoVs, presenting a focused narrative on SARS-CoV-2 variants under monitoring (VUMs) as of May 2025. Using advanced bioinformatics approaches and data visualization, the review highlights key spike protein substitutions, particularly within the receptor-binding domain (RBD), which drive transmissibility, immune escape, and potential resistance to therapeutics. The article highlights the importance of real-time genomic surveillance and intervention strategies in mitigating emerging variant/sub-variant risks within the ongoing COVID-19 landscape. Full article

Aquaculture has rapidly become a vital sector for ensuring global food security by meeting the growing demand for animal protein. Bangladesh, one of the world’s leading aquaculture producers, recorded a production of 4.91 million MT in 2022–2023, largely driven by inland farming systems. Despite this remarkable growth, the sector is highly vulnerable to disease outbreaks, which are aggravated by different factors. Pathogens such as bacteria, viruses, fungi, and parasites cause significant losses, while conventional disease diagnosis in Bangladesh still depends mainly on visual assessment and basic laboratory techniques, limiting early detection. This narrative review highlights recent advances in diagnostics as molecular tools, immunodiagnostics, nanodiagnostics, machine learning, and next-generation sequencing (NGS) that are widely applied globally but remain limited in Bangladesh due to infrastructure gaps, lack of skilled manpower, and resource constraints. Current treatment strategies largely rely on antibiotics and aquaculture medicinal products (AMPs), often misused without proper diagnosis, contributing to antimicrobial resistance (AMR). Promising alternatives, including probiotics, immunostimulants, vaccines, and enhanced biosecurity, require greater adoption and farmer awareness. The near-term priorities for Bangladesh include standardized disease and AMR surveillance, prudent antibiotic stewardship, phased adoption of validated rapid diagnostics, and investment in diagnostic and human capacity. Policy-level actions, including a national aquatic animal health strategy, stricter antimicrobial regulation, strengthening diagnostic infrastructure in institution, are crucial to achieve sustainable disease management and ensure long-term resilience of aquaculture in Bangladesh. Full article

Audiovisual Entrainment (AVE) is a non-invasive, non-pharmacological neuromodulation approach that aims to align brain activity with externally delivered auditory and visual rhythms. This review surveys AVE’s historical development, technical parameters (e.g., frequency, phase, waveform, color, intensity, presentation mode), components and delivery methods, reported clinical applications, and safety considerations. Given the heterogeneity of AVE protocols and terminology, we conducted a structured narrative review (PubMed, Scopus, Google Scholar; earliest records to July 2025), including human and animal studies that met an operational definition of regulated AVE and consistent administration of specified auditory and visual frequencies, with critical methodological details reported. We highlight AVE’s accessibility and versatility, outline a stepwise parameter reporting framework to support standardization, and discuss putative mechanisms via sensory and oscillatory pathways. However, current findings are heterogeneous and include null or limited effects. Mechanistic understanding and parameter optimization remain insufficiently developed, and premature claims of efficacy are not warranted. Rigorous, standardized, and adequately controlled studies are needed before AVE can be considered a reliable therapeutic tool. Full article

Background: Perianal Crohn’s disease (pCD) is one of the most disabling complications of inflammatory bowel disease, characterized by fistulas and abscesses that demand precise imaging for diagnosis, treatment planning, and follow-up. Magnetic resonance imaging (MRI) is considered the reference standard, but endoanal ultrasound (EAUS) with high-frequency 360° probes provide a readily available, cost-effective, and repeatable alternative. Methods: We performed a narrative review of the literature, evaluating studies on the EAUS technique, diagnostic applications, distinguishing features of Crohn’s-related fistulas, and comparative analyses with MRI. Consensus documents and structured reporting initiatives were also included. Results: EAUS provides high-resolution visualization of the anal sphincter complex and intersphincteric space, enabling the reliable detection of fistulas and abscesses. Characteristic features such as tract width > 4 mm, bifurcation, hyperechoic debris, the Crohn’s Ultrasound Fistula Sign (CUFS), and the rosary sign assist in differentiating Crohn’s from cryptoglandular fistulas. EAUS is well-suited for serial monitoring, perioperative seton guidance, and therapeutic decision-making. Emerging tools such as Doppler and shear wave elastography provide additional information on activity and fibrosis. MRI remains indispensable for supralevator disease, deep pelvic sepsis, and standardized activity indices. Comparative studies indicate similar sensitivity for simple fistulas, with MRI superior in complex cases; combining both modalities maximizes accuracy. Conclusions: EAUS is a practical and repeatable imaging tool that complements MRI in the multidisciplinary management of perianal Crohn’s disease. Advances such as 3D imaging, contrast enhancement, and elastography may enable validated activity scoring—for example, a future PEACE (Perianal Endosonographic Activity in Chron’s Evaluation) Index—further strengthening its role in longitudinal care. Full article

Nonintrusive load monitoring (NILM) relies on high-resolution sensor data to disaggregate total building energy into end-use load components, for example HVAC, ventilation, and appliances. On the ADRENALIN corpus, simple NaN handling with forward fill and mean substitution reduced average NMAE from 0.82 to 0.76 for the Bayesian baseline, from 0.71 to 0.64 for BI-LSTM, and from 0.59 to 0.53 for the Time–Frequency Mask (TFM) model, across nine buildings and four temporal resolutions. However, many NILM models still show degraded accuracy due to unresolved data-quality issues, especially missing values, timestamp irregularities, and sensor inconsistencies, a limitation underexplored in current benchmarks. This paper presents a fully automated data-quality assurance pipeline for time-series energy datasets. The pipeline performs multivariate profiling, statistical analysis, and threshold-based diagnostics to compute standardized quality metrics, which are aggregated into an interpretable Building Quality Score (BQS) that predicts NILM performance and supports dataset ranking and selection. Explainability is provided by SHAP and a lightweight large language model, which turns visual diagnostics into concise, actionable narratives. The study evaluates practical quality improvement through systematic handling of missing values, linking metric changes to downstream error reduction. Using random-forest surrogates, SHAP identifies missingness and timestamp irregularity as dominant drivers of error across models. Core contributions include the definition and validation of BQS, an interpretable scoring and explanation framework for time-series quality, and an end-to-end evaluation of how quality diagnostics affect NILM performance at scale. Full article

Cataract surgery is the most common eye operation worldwide and is regarded as one of the safest procedures in medicine. Yet, despite its low complication rates, it generates a disproportionate share of litigation. The gap between excellent safety profiles and rising medico-legal claims is driven less by surgical outcomes than by patient expectations, often shaped by healthcare marketing and the promise of risk-free recovery. This narrative review explores the clinical and legal dimensions of cataract surgery, focusing on complications, perioperative risk factors, and medico-legal concepts of predictability and preventability. Particular emphasis is given to European frameworks, with the Italian Gelli-Bianco Law (Law No. 24/2017) providing a model of accountability that balances innovation and patient safety. Analysis shows that liability exposure spans all phases of surgery: preoperative (inadequate consent, poor documentation), intraoperative (posterior capsule rupture, zonular instability), and postoperative (endophthalmitis, poor follow-up). Practical strategies for risk reduction include advanced imaging such as macular OCT, rigorous adherence to updated guidelines, systematic video recording, and transparent perioperative communication. Patient-reported outcomes further highlight that satisfaction depends more on visual quality and dialogue than on spectacle independence. By translating legal principles into clinical strategies, this review offers surgeons actionable “surgical–legal pearls” to improve outcomes, strengthen patient trust, and reduce medico-legal vulnerability in high-volume cataract surgery. Full article

The 4th and 5th centuries marked a pivotal phase in the development of the Goguryeo regime. Its tomb murals epitomize the visual strategies of state-building, serving to establish a “sacred theater” of power. Taking Tomb No. 4 of the Wukui complex as a case in point, the murals reveal localized adaptations of the Fuxi–Nüwa imagery, blending the Central Plains’ sun-deity worship with Goguryeo’s ancestral mythology through the symbol of the sun-centered Three-Legged Crow, thereby legitimizing the sacred lineage of royal authority. The function of the Four Symbols (Sishen) imagery evolved from mere directional markers into guardians of sovereignty, reflecting deeper cultural transformations. The diachronic evolution of mural themes traces the trajectory of political change: in the 4th century, murals centered on wrestling and banqueting scenes, reinforcing ethnic identity and consolidating tribal alliances through ritualized displays of strength and hierarchical banquet etiquette. By the 5th century, the themes shifted to hunting, processions, and Buddhist rituals, where military metaphors and ceremonial norms underscored the rise of a centralized bureaucratic system and the imperatives of territorial expansion. Through three interlocking mechanisms—symbolic reconfiguration, spatial narrative, and sensory manipulation—Goguryeo tomb murals constructed a closed value system linking worldly authority to posthumous order, serving as material testimony to the enduring “covenant between humans and deities.” Full article

Background/Objectives: Hybrid Angio-CT suites have emerged in response to the growing demands for innovation and procedural complexity in minimally invasive therapies. It is hypothesized that enhanced image guidance capabilities enabled by multimodality imaging can improve procedural safety, accuracy, and efficacy. However, due to the current lack of sufficient data to support a systematic review, the objective of this article is to present a comprehensive synthesis of the existing literature through a narrative review. Methods: This narrative review is based on purposefully identified research reports, their critical evaluation, and synthesis by a group of experienced users. The analysis covers three key areas: (1) current state of available technologies and functionalities, (2) novel perspectives through ‘Direct Intravascular Contrast media Injection CT’ (DICI-CT), and (3) the role of Angio-CT in established and emerging image-guided procedures. Results: The review presents typical configurations and room layouts for Angio-CT systems and discusses further technological improvement potential. Selected literature is complemented by expert experience to report on the current state of the art and demonstrate its use and efficiency. Based on our expert experience, it is demonstrated how DICI-CT can be used to reduce contrast dose and improve lesion visualization, targeting, and endpoint determination. Furthermore, in this review the advantages, including survival benefit (i.e., in trans-arterial chemoembolization and in blunt trauma) and cost-effectiveness (i.e., in emergency care), are reviewed with reference to oncologic and non-oncologic applications in both elective and emergency medicine. Conclusions: Hybrid Angio-CT suites can provide significant additional imaging information with the potential to improve image-guided procedures. This perspective is increasingly supported by retrospective data in interventional oncology and beyond. Provided that further technological advancements are achieved and prospective clinical data substantiates the anticipated clinical and economical benefits, hybrid Angio-CT suites are anticipated to play a key role in the multimodality interventional suite of the future. Full article

Background and Objectives: Partial nephrectomy is the standard treatment for small renal tumors, balancing cancer control with renal function preservation. Robot-assisted partial nephrectomy (RAPN) has improved surgical precision and reduced morbidity. Near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) improves intraoperative visualization of renal vasculature and tissue perfusion, potentially enabling selective arterial clamping to reduce ischemic injury. This study updates contemporary evidence on NIRF/ICG-guided RAPN, focusing on intraoperative, perioperative, and renal function outcomes. Materials and Methods: We systematically queried PubMed, Scopus, and Web of Science databases up to June 2025 for controlled prospective and retrospective studies comparing NIRF/ICG-guided RAPN (selective clamping or zero-ischemia) versus conventional RAPN with main artery clamping in adults with renal masses. Data were synthesized narratively, and random-effects meta-analyses were performed on warm ischemia time (WIT), operative time, estimated blood loss, transfusion rate, length of hospital stay, complication rate, positive surgical margins, and variation in renal function. Results: Eleven studies (10 full-text and one abstract), including two randomized controlled trials, encompassing a patient population of 893 patients (403 NIRF/ICG-guided RAPN and 490 conventional RAPN), were included. Ischemia strategies varied between no clamping, selective or super-selective clamping for NIRF/ICG, and main artery clamping for controls. ICG doses ranging from 3 to 7.5 mg or 0.5–7 mL. Most evidence was classified as level 2b or 3b, indicating a moderate to serious risk of bias. Meta-analysis showed that compared to conventional RAPN, NIRF/ICG-guided RAPN was associated with a shorter WIT (MD: −1.30 min, 95% CI: −2.51 to −0.09; p = 0.039), with no differences in other outcomes. Renal function favored NIRF/ICG at discharge and short-term follow-up, although the difference was not statistically significant. Conclusions: NIRF/ICG reduces WIT during RAPN without increasing perioperative risks. The technique shows promise for better preserving functional outcomes. However, further well-designed, large-scale trials with longer follow-up are needed to confirm these benefits and define clinical indications. Full article

Virtual reality (VR) technology has emerged as a promising alternative to conventional perimetry for assessing visual fields. However, the clinical validity of commercially available VR-based perimetry devices remains uncertain due to variability in hardware, software, and testing protocols. A systematic review was conducted following PRISMA guidelines to evaluate the validity of VR-based perimetry compared to the Humphrey Field Analyzer (HFA). Literature searches were performed across MEDLINE, Embase, Scopus, and Web of Science. Studies were included if they assessed commercially available VR-based visual field devices in comparison to HFA and reported visual field outcomes. Devices were categorized by regulatory status (FDA, CE, or uncertified), and results were synthesized narratively. Nineteen studies were included. Devices such as Heru, Olleyes VisuALL, and the Advanced Vision Analyzer showed promising agreement with HFA metrics, especially in moderate to advanced glaucoma. However, variability in performance was observed depending on disease severity, population type, and device specifications. Limited dynamic range and lack of eye tracking were common limitations in lower-complexity devices. Pediatric validation and performance in early-stage disease were often suboptimal. Several VR-based perimetry systems demonstrate clinically acceptable validity compared to HFA, particularly in certain patient subgroups. However, broader validation, protocol standardization, and regulatory approval are essential for widespread clinical adoption. These devices may support more accessible visual field testing through telemedicine and decentralized care. Full article

This article offers a new perspective on Miriam’s red jewel in Nathaniel Hawthorne’s The Marble Faun (1860), interpreting it as a symbol of Jewish femininity, diasporic memory, and aesthetic resistance. Although the jewel has received little critical attention, this study suggests that it plays a central role in shaping Miriam’s identity and in articulating broader cultural anxieties around gender, ethnicity, and visibility. Through intertextual readings of Shakespeare’s Jessica and Walter Scott’s Rebecca and Rowena, the essay situates Miriam within a literary tradition of Jewish women whose identities are mediated through symbolic adornments. In addition to literary analysis, the article draws on visual art history—particularly Carol Ockman’s interpretation of Jean-Auguste-Dominique Ingres’s 1848 portrait of Baronne de Rothschild—to explore how 19th-century visual culture contributed to the eroticization and exoticization of Jewish women. By placing Hawthorne’s portrayal of Miriam in dialogue with such visual representations, the essay highlights how the red jewel functions as a site of encoded cultural meaning. The analysis is further informed by feminist art theory (Griselda Pollock) and postcolonial critique (Edward Said), offering an interdisciplinary approach to questions of identity, marginalization, and symbolic resistance. While not claiming to offer a definitive reading, this article aims to open new interpretive possibilities by foregrounding the jewel’s narrative and symbolic significance. In doing so, it contributes to ongoing conversations in Hawthorne studies, Jewish cultural history, and the intersections of literature and visual art. Full article

Background: Rhegmatogenous retinal detachment (RRD), the most common type of retinal detachment, requires prompt surgery to reattach the retina and avoid permanent vision loss. While surgical treatment is adapted to each individual case, one frequent option is pars plana vitrectomy (PPV) with silicone oil (SO) tamponade. Despite achieving anatomical success (complete retinal attachment), concerns persist regarding potential microvascular alterations in the retina and choroid, with a negative impact on visual function. Optical coherence tomography angiography (OCTA) allows detailed, in-depth imaging of retinal and choroidal circulation, whereas microperimetry makes it possible to accurately assess macular function. This review aims to strengthen the existing evidence on vascular and functional alterations at the macular level after SO tamponade in cases of RRD. Methods: A narrative review was conducted using a structured approach, utilizing a PubMed search from January 2000 up to April 2025. Twenty-three studies on OCTA and microperimetry after SO tamponade for RRD were included. Data on vessel densities, choroidal vascular index (CVI), foveal avascular zone (FAZ) size, and retinal sensitivity were extracted and qualitatively analyzed. Results: Studies consistently reported a reduction in the vessel density within the superficial capillary plexus (SCP) under SO tamponade, with partial but incomplete reperfusion post-removal. Choroidal perfusion and CVI were also decreased, exhibiting a negative correlation with the duration of SO tamponade. Microperimetry demonstrated significant reductions in retinal sensitivity (~5–10 dB) during SO tamponade, which modestly improved (~1–2 dB) following removal but generally remaining below normal levels. Conclusions: SO tamponade causes substantial retinal and choroidal vascular impairment and measurable macular dysfunction, even after anatomical reattachment of the retina. It is recommended to perform early SO removal (~3–4 months) and implement routine monitoring by OCTA and microperimetry with the aim of optimizing patient outcomes. Future research should focus on investigating protective strategies and enhancing visual rehabilitation following RRD repair. Full article