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Photodynamic therapy (PDT) has shown potentially beneficial results in treating port-wine stain, but its benefit-risk profile remains undefined. This study aimed to evaluate the efficacy and safety of PDT conducted with hemoporfin and a 532 nm continuous wave laser to treat port-wine stain clinically. This randomized clinical trial was conducted in eight hospitals in China. Participants were adolescent and adult patients (age range: 14-65 years old) with port-wine stain. During stage 1 (day 1 to week 8) all patients were randomized at a 3:1 ratio to treatment (532 nm laser irradiation (96-120 J/cm2) with hemoporfin (5mg/kg; PDT-hemoporfin, n = 330)) or placebo groups (irradiation with placebo (PDT-placebo, n = 110)); during stage 2 (week 8 to 16) patients in both groups were offered treatment. Clinician-evaluators, who were blind to the study, classified each case on the following four-level scale according to assessment of before and after standardized pictures of the lesion area: no improvement: <20%; some improvement: 20-59%; great improvement: 60-89%; or nearly completely resolved: ≥90%. The primary efficacy endpoint was proportion of patients achieving at least some improvement at week 8. The secondary efficacy endpoints were proportion of patients achieving nearly completely resolved or at least great improvement at week 8, proportion of patients achieving early completely resolved, at least great improvement, or at least some improvement at week 16, and the corresponding satisfaction of the investigators and the patients (designated as 'excellent', 'good', 'moderate', or 'ineffective') at weeks 8 and 16. Compared to the PDT-placebo group, the PDT-hemoporfin group showed a significantly higher proportion of patients that achieved at least some improvement (89.7% [n = 295; 95% CI, 85.9%-92.5%] vs. 24.5% [n = 27; 95% CI, 17.4%-33.3%]) at week 8 (P < 0.0001) and higher improvements for all secondary efficacy endpoints. Treatment reactions occurred in 99.5% (n = 731; 95% CI, 98.7%-99.8%) of the PDT-hemoporfin treatments (n = 735). Hyperpigmentation occurred in 22.9 per 100 patient-treatments (n = 168; 95% CI, 20.0-26.0) in the PDT-hemoporfin treated patients. Hemoporfin-mediated PDT is an effective and safe treatment option for adolescent and adult patients with port-wine stain. Chinese Clinical Trial Registry ChiCTR-TRC-08000213.

Color change was compared through artificial and outdoor weathering tests according to wood species and stain type. In the artificial weathering tests, the color change DE was the highest for the initial 200 hour, and teak solvent-based stain was the most effective in preventing color change. Outdoor weathering tests also showed a rapid color change until the initial 60 days, and the uncoated larch specimens exhibited graying after 120 days. Teak solvent-based stain had the highest preventing color effect, whereas water-based white semi-transparent stain had the highest contact angle. It is difficult to check the color change of wood due to the addition of pigment in teak, as its resistance to moisture is rapidly reduced and its surface protection effect is poor. Water-based white semi-transparent stain prevented color change and maintained a contact angle of 57.1° for up to 150 days, confirming the effect of moisture resistance. This study aimed to provide basic data on weather resistance by wood species and to suggest that the development direction of outdoor exposed wood is a water-based semi-transparent stain.

Blood and semen stains are the most common biological stains encountered at crime scenes. The washing of biological stains is a common application that perpetrators use to spoil the crime scene. With a structured experiment approach, this study aims to investigate the effects of washing with various chemicals on the ATR-FTIR detection of blood and semen stains on cotton. On cotton pieces, a total of 78 blood and 78 semen stains were applied, and each group of six stains was immersed or mechanically cleaned in water, 40% methanol, 5% sodium hypochlorite solution, 5% hypochlorous acid solution, 5 g/L soap dissolved pure water, and 5 g/L dishwashing detergent dissolved water. ATR-FTIR spectra gathered from all stains and analyzed with chemometric tools. According to performance parameters of developed models, PLS-DA is a powerful tool for discrimination of washing chemical for both washed blood and semen stains. Results from this study show that FTIR is promising for use in detecting blood and semen stains that have become invisible to the naked eye due to washing of the findings. Our approach allows blood and semen to be detected on cotton pieces using FTIR combined with chemometrics, even though it is not visible to the naked eye. Washing chemicals also can be distinguished via FTIR spectra of stains. [Display omitted] •Blood and semen stains can be discriminated based on FTIR spectra with PLS-DA.•Washed blood and semen stains can be identified via FTIR.•Washing chemicals can be discriminated based on FTIR spectra of biological stains with PLS-DA.

Port-wine stains (PWSs) are congenital capillary malformations with the incidence of in newborns of to 2.1%. Hematoporphyrin monomethyl ether-mediated photodynamic therapy (HMME-PDT) has been widely applied in China for PWS. However, there remains substantial room for improvement in both the phototherapeutic selectivity coefficient (PSC) and pain management. We investigated the feasibility of modulating transcutaneous oxygen delivery during photodynamic therapy of PWS to enhance therapeutic efficacy and reduce pain. A three-dimensional (3D) computational biophysical model was employed to elucidate the mechanisms through which transcutaneous oxygen modulation enhances the therapeutic efficacy of HMME-PDT and improves pain management. The model was constructed to simulate the light propagation, photosensitizer kinetics, oxygen diffusion, and reactive oxygen species (ROS) generation. A treatment optimization strategy based on epidermal oxygen regulation was proposed and evaluated in computational studies. The spatiotemporal distributions of singlet oxygen under normoxic, hypoxic, and anoxic conditions were evaluated, and their effects on treatment-induced pain and lesion-targeted cytotoxicity were analyzed. Computational analysis showed that compared with normoxic conditions, hypoxia and anoxia significantly enhanced PSC, with improvements of 48% and 61%, respectively. Furthermore, these oxygen-modulated regimens attenuated treatment-associated pain, reducing photochemical pain duration of 17% (hypoxia) and 30% (anoxia). Choosing the right combination of light source irradiance and surface oxygen supply rate amplified therapeutic performance and patient comfort, achieving a 213% increase in PSC and a 57% reduction in photochemical pain duration. These findings establish a mechanistic framework for advancing precision PDT protocols with minimized iatrogenic discomfort. Established in this computational study, strategic epidermal oxygen restriction critically augments PDT PSC while improving patient tolerance. Computational modeling demonstrates that controlled epidermal hypoxia spatially redistributes oxygen gradients, thereby suppressing superficial ROS generation in nontargeted epidermal layers and selectively concentrating ROS within PWS vasculature. This dual mechanism-simultaneously enhancing therapeutic precision and attenuating treatment-induced pain-presents a pioneering strategy centered on an active oxygen control strategy for enhancing HMME-PDT clinical outcomes. Future research will progress from preclinical validation in animal models to clinical studies to evaluate the therapeutic efficacy and translational potential of this strategy.

Valid and reliable outcome measures are needed to determine and compare treatment results of port wine stain (PWS) studies. Besides, uniformity in outcome measures is crucial to enable inter-study comparisons and meta-analyses. This study aimed to assess the heterogeneity in reported PWS outcome measures by mapping the (clinical) outcome measures currently used in prospective PWS studies. OVID MEDLINE, OVID Embase, and CENTRAL were searched for prospective PWS studies published from 2005 to May 2020. Interventional studies with a clinical efficacy assessment were included. Two reviewers independently evaluated methodological quality using a modified Downs and Black checklist. In total, 85 studies comprising 3,310 patients were included in which 94 clinician/observer-reported clinical efficacy assessments had been performed using 46 different scoring systems. Eighty-one- studies employed a global assessment of PWS appearance/improvement, of which -82% was expressed as percentage improvement and categorized in 26 different scoring systems. A wide variety of other global and multi-item scoring systems was identified. As a result of outcome heterogeneity and insufficient data reporting, only 44% of studies could be directly compared. A minority of studies included patient-reported or objective outcomes. Thirteen studies of good quality were found. Clinical PWS outcomes are highly heterogeneous, which hampers study comparisons and meta-analyses. Consensus-based development of a core outcome-set would benefit future research and clinical practice, especially considering the lack of high-quality trials.

Port wine stain (PWS) is a congenital vascular malformation involving human skin. Approximately 15–20% of children a facial PWS involving the ophthalmic (V1) trigeminal dermatome are at risk for Sturge Weber syndrome (SWS), a neurocutaneous disorder with vascular malformations in the cerebral cortex on the same side of the facial PWS lesions. Recently, evidence has surfaced that advanced our understanding of the pathogenesis of PWS/SWS, including discoveries of somatic genetic mutations (GNAQ, PI3K), MAPK and PI3K aberrant activations, and molecular phenotypes of PWS endothelial cells. In this review, we summarize current knowledge on the etiology and pathology of PWS/SWS based on evidence that the activation of MAPK and/or PI3K contributes to the malformations, as well as potential futuristic treatment approaches targeting these aberrantly dysregulated signaling pathways. Current data support that: (1) PWS is a multifactorial malformation involving the entire physiological structure of human skin; (2) PWS should be pathoanatomically re-defined as “a malformation resulting from differentiation-impaired endothelial cells with a progressive dilatation of immature venule-like vasculatures”; (3) dysregulation of vascular MAPK and/or PI3K signaling during human embryonic development plays a part in the pathogenesis and progression of PWS/SWS; and (4) sporadic low frequency somatic mutations, such as GNAQ, PI3K, work as team players but not as a lone wolf, contributing to the development of vascular phenotypes. We also address many crucial questions yet to be answered in the future research investigations.

Background Histological images show strong variance (e.g. illumination, color, staining quality) due to differences in image acquisition, tissue processing, staining, etc. This can impede downstream image analysis such as staining intensity evaluation or classification. Methods to reduce these variances are called image normalization techniques. Methods In this paper, we investigate the potential of CycleGAN (cycle consistent Generative Adversarial Network) for color normalization in hematoxylin-eosin stained histological images using daily clinical data with consideration of the variability of internal staining protocol variations. The network consists of a generator network G B that learns to map an image X from a source domain A to a target domain B , i.e. G B : X A → X B . In addition, a discriminator network D B is trained to distinguish whether an image from domain B is real or generated. The same process is applied to another generator-discriminator pair ( G A , D A ), for the inverse mapping G A : X B → X A . Cycle consistency ensures that a generated image is close to its original when being mapped backwards ( G A ( G B ( X A ))≈ X A and vice versa). We validate the CycleGAN approach on a breast cancer challenge and a follicular thyroid carcinoma data set for various stain variations. We evaluate the quality of the generated images compared to the original images using similarity measures. In addition, we apply stain normalization on pathological lymph node data from our institute and test the gain from normalization on a ResNet classifier pre-trained on the Camelyon16 data set. Results Qualitative results of the images generated by our network are compared to original color distributions. Our evaluation indicates that by mapping images to a target domain, the similarity training images from that domain improves up to 96%. We also achieve a high cycle consistency for the generator networks by obtaining similarity indices greater than 0.9. When applying the CycleGAN normalization to HE-stain images from our institute the kappa-value of the ResNet-model that is only trained on Camelyon16 data is increased more than 50%. Conclusions CycleGANs have proven to efficiently normalize HE-stained images. The approach compensates for deviations resulting from image acquisition (e.g. different scanning devices) as well as from tissue staining (e.g. different staining protocols), and thus overcomes the staining variations in images from various institutions.The code is publicly available at https://github.com/m4ln/stainTransfer_CycleGAN_pytorch . The data set supporting the solutions is available at https://doi.org/10.11588/data/8LKEZF .

Background Acquired port‐wine stains (APWS) are rare vascular malformations that share the same clinical and histological features as their congenital counterparts. Rare cases of AWPS secondary to trauma or in association with medications have been reported in the literature. Patients and Methods We report two cases of APWS. One case appeared at the age of 2 months, the earliest reported in the literature and continued to evolve till the age of 3 years presenting with multifocal distribution mainly affecting the lower face. The second case developed during oral isotretinoin intake and persisted after discontinuation of the treatment. Results and Conclusions The second patient declined treatment, but the first patient had a remarkable improvement following treatment with the pulsed dye laser, which remains the standard of care for capillary malformations on the face.

Stain detection is crucial for robotic sweepers, enabling them to assess environmental hygiene and execute precise cleaning tasks. However, in complex indoor scenarios, highly accurate stain detection remains a significant challenge, as the visual features of stains are often obscured by ambient light, background textures, and specular reflections. Most existing deep learning methods rely predominantly on standard Red-Green-Blue (RGB) images, which lack sufficient discriminative features to robustly distinguish stains from complex backgrounds or accurately classify diverse contaminants. To address these limitations, we propose a deep learning stain detection framework integrated with a multispectral polarization optical system. First, to extract discriminative optical features, we design a lightweight multispectral polarization optical module tailored for integration into robotic sweepers. It captures rich spectral and polarization features while effectively suppressing specular reflections. Second, to enhance feature representation capabilities, we develop a multispectral polarization (MP)-based stain detector, named MP-stain-detector, which fuses spectral composition data with polarization texture features. Third, to support rigorous model training and evaluation, we construct a comprehensive dataset, the MP-Stain-dataset, collected in real-world home scenarios. Experiments on the MP-Stain-dataset demonstrate that our method improves the overall mean accuracy by 2.44%, and by 5.72% for the challenging light-colored liquid category compared to conventional approaches.

This study aims at exploring the clinical efficacy and sonographic changes of photodynamic therapy (PDT) using Hematoporphyrin Monomethyl Ether (HMME) for the treatment of port-wine stains (PWS). Forty-five patients with PWS were recruited between March 2017 and June 2018 from the Department of Dermatology of The Third Affiliated Hospital of Soochow University. Five cases were of the pink type, thirty-nine cases were of the purple-red type, and one case was of the thickened type. All patients received three treatment sessions of PDT. After covering normal skin outside the treated area, patients received an intravenous injection of 5 mg/kg HMME within 20 minutes. The affected areas were exposed to a 532 nm LED light and were kept vertically at a distance of 10 cm. The irradiation energy density was set between 80 and 110 J/cm2 in 15-minute sessions. Intermittent power density adjustment was performed at a rate of 5 mW/cm2, and the treatment was withheld when the endpoint reaction appeared. Three follow-ups were performed before and after treatment, respectively, and the efficacy, thickness, and density of skin before and after treatment were evaluated with high-frequency ultrasound. The overall efficacy rate was 97.78% in forty-five cases after treatment for three sessions. Efficacy was related to age (P=0.029) and lesion severity (P<0.001). There were significant differences in the efficacy between the groups of <18 years old, 18-29 years old, and >29 years old (P=0.029). A marked decrease in the numbers of distorted enlarged blood vessels per unit of the lesion was observed under high-frequency ultrasound. There were significant differences in skin thickness and skin density before and after treatment (F=14.528, 5.428, P<0.001). The swelling was reported to varying degrees in the treated areas in 23 patients with cheek lesion and in 6 frontal lesions. Hyperpigmentation after inflammation was observed in four patients that faded spontaneously after two months. In conclusion, photodynamic therapy for the treatment of PWS using HMME is effective and safe with few adverse reactions. Moreover, monitoring the changes in skin thickness and density of lesion tissue using high-frequency ultrasound can objectively evaluate the clinical efficacy of HMME photodynamic therapy and provide the basis for the formulation of individualized photodynamic therapy.