Computational analysis on altered micro-nano-textural attributes of the oral mucosa may provide precise diagnostic information about oral potentially malignant disorders (OPMDs) instead of an existing handful of qualitative reports. This study evaluated micro-nano-textural features of oral epithelium from scanning electron microscopic (SEM) images and the sub-epithelial connective tissue from light microscopic (LM) and atomic force microscopic (AFM) images for normal and OPMD (namely oral sub-mucous fibrosis, i.e., OSF). Objective textural descriptors, namely discrete wavelet transform, gray-level co-occurrence matrix (GLCM), and local binary pattern (LBP), were extracted and fed to standard classifiers. Best classification accuracy of 87.28 and 93.21%; sensitivity of 93 and 96%; specificity of 80 and 91% were achieved, respectively, for SEM and AFM. In the study groups, SEM analysis showed a significant (p < 0.01) variation for all the considered textural descriptors, while for AFM, a remarkable alteration (p < 0.01) was only found in GLCM and LBP. Interestingly, sub-epithelial collagen nanoscale and microscale textural information from AFM and LM images, respectively, were complementary, namely microlevel contrast was more in normal (0.251) than OSF (0.193), while nanolevel contrast was more in OSF (0.283) than normal (0.204). This work, thus, illustrated differential micro-nano-textural attributes for oral epithelium and sub-epithelium to distinguish OPMD precisely and may be contributory in early cancer diagnostics.

The performance of 65 patients with complicated mild–severe traumatic brain injury was evaluated on the Verbal and Design Fluency subtests of the Delis-Kaplan Executive Function System (D-KEFS), and compared with that of 65 demographically matched healthy controls. There were statistically significant group differences on Letter Fluency and Category Switching but not on any of the Design Fluency tasks. Combined, these two Verbal Fluency subtests had a classification accuracy of 65.39%, associated with a likelihood ratio of 1.87. The impact of length of coma on Letter Fluency performance but not Category Switching was mediated at least in part by processing speed. The findings suggest modest criterion validity of some of the D–KEFS Verbal Fluency subtests in the assessment of patients with complicated mild–severe traumatic brain injury. (JINS, 2011, 17, 230–237)