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Context: Widespread digital retouching of advertising imagery in the fashion, beauty, and other consumer industries promotes unrealistic beauty standards that have harmful effects on public health. In particular, exposure to misleading beauty imagery is linked with greater body dissatisfaction, worse mood, poorer self-esteem, and increased risk for disordered eating behaviors. Moreover, given the social, psychological, medical, and economic burden of eating disorders, there is an urgent need to address environmental risk factors and to scale up prevention efforts by increasing the regulation of digitally altered advertising imagery., Methods: This manuscript summarizes the health research literature linking digital retouching of advertising to increased risk of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction in consumers, followed by a review of global policy initiatives designed to regulate digital retouching to reduce health harms to consumers. Next, we turn to the US legal context, reporting on findings generated through legal research via Westlaw and LexisNexis, congressional records, federal agency websites, law review articles, and Supreme Court opinions, in addition to consulting legal experts on both tax law and the First Amendment, to evaluate the viability of various policy initiatives proposed to strengthen regulation on digital retouching in the United States., Findings: Influencing advertising practices via tax incentives combined with corporate social responsibility initiatives may be the most constitutionally feasible options for the US legal context to reduce the use of digitally alternated images of models' bodies in advertising., Conclusions: Policy and corporate initiatives to curtail use of digitally altered images found to be harmful to mental and behavioral health of consumers could reduce the burden of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction and thereby improve population health in the United States.

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

After the discovery of skeletonized human remains, the estimation of stature is an important element of the so-called "biological profile". Typically, long bone lengths are used in regression formulas. If long bones are not available, predictions of stature cannot be made. Human skulls are often the subject of forensic osteological examination, sometimes even detached. Therefore, it seems reasonable to search for skull measurements that have a sufficiently good correlation to stature. The aim of the study presented was to measure odonto-stomatological parameters using post-mortem CT data to check whether the esti- mation of stature was possible on this basis. Three classic tooth dimensions (MD, BL, ZL), two diagonal tooth dimensions (MBDL, DBML) first described by Lund and Mörnstad in 1999, two tooth dimensions defined for the first time in this study (MKDO, DKMO), the mesiodistal index (MDS) and also the palatal arch dimensions (arch length, arch width, molar length and dental length) - each at maxilla and mandible - were digitally measured on a total of 799 teeth of 48 virtual 3-D-reconstructed skulls (33 males and 15 females). For most of the aforementioned measurements no statistically significant relation to stature was found. There were positive correlations by Pearson at a significance level of 99 % (2-sided) at three measurements: ZL 15, MKDO 14 and MKDO 15. Positive correlations by Pearson at a significance level of 95 % (2-sided) could be determined for eight measurements, but an applicable regression formula could not be calculated for any of the parameters. Despite a statistical correlation of a few teeth parameters with body length, they must be considered unsuitable for estimating stature.

Many women struggle with poor body image and eating disorders due, in part, to images of very thin women and photoshopped bodies in the media and advertisements. In 2013, Israel's Act Limiting Weight in the Modelling Industry, 5772-2012, came into effect. Known as the Photoshop Law, it requires all models in Israel who are over 18 years old to have a body mass index of 18.5 or higher. The Israeli government was the first government in the world to legislate on this issue. Australia has a voluntary Code of Conduct that is similar to the Photoshop Law. This article argues that the Australian government should follow Israel's lead and pass a law similar to the Photoshop Law because the Code is not sufficiently binding.

This paper is devoted to the novel computer technologies employed in the studies of histological preparations. These technologies allow to visualize digital images, structurize the data obtained and store the results in computer memory. The authors emphasize the necessity to properly document digital images obtained during forensic-histological studies and propose the procedure for the formulation of electronic documents in conformity with the relevant technical and legal requirements. It is concluded that the use of digital images as a new study object permits to obviate the drawbacks inherent in the work with the traditional preparations and pass from descriptive microscopy to their quantitative analysis.

As with phrenology and the polygraph, society is again confronted with a device that the media claims is capable of reading our minds. Functional magnetic resonance imaging ("fMRI"), along with other types of functional brain imaging technologies, is currently being introduced at various stages of a criminal trial as evidence of a defendant's past mental state. This Article demonstrates that functional brain images should not currently be admitted as evidence into courts for this purpose. Using the analytical framework provided by Federal Rule of Evidence 403 as a threshold to a Daubert/Frye analysis, we demonstrate that, when fMRI methodology is properly understood, brain images are only minimally probative of a defendant's past mental states and are almost certainly more unfairly prejudicial than probative on balance. Careful and detailed explanation of the underlying science separates this Article from others, which have tended to paint fMRI with a gloss of credibility and certainty for all courtroom-relevant applications. Instead, we argue that this technology may present a particularly strong form of unfair prejudice in addition to its potential to mislead jurors and waste the court's resources. Finally, since fMRI methodology may one day improve such that its probative value is no longer eclipsed by its extreme potential for unfair prejudice, we offer a nonexhaustive checklist that judges and counsel can use to authenticate functional brain images and assess the weight these images are to be accorded by fact finders.

Background: This paper is composed of two parts, the first one addresses the issue of legal grounds for teleconsultation and telemedicine in Poland, the other tries to answer the questions whether the provision of health services with use of telemedical tools does not breach medical professional secrecy or personal data protection., Material and Methods: The material comprised a whole set of Polish and European legal acts that could have any impact on the legal basis of telemedicine in Poland. The method applied was of interpretative nature, and the texts of above-mentioned acts were thoroughly analyzed, providing the first comprehensive study on this subject., Results: The medical professional secrecy is not violated if the range of transmitted data is limited to those, which are absolutely necessary in the diagnostic and therapeutic process. This rule involves the transmission of indispensable personal and medical data, however, sharing the patient's appearance should be preceded by his/her informed consent., Conclusions: The achievements of information technology greatly contribute to the quality of diagnostic and therapeutic processes. Due to the rapid development of modern means of telemedicine we face the need to establish legal regulations, specifying the principles of distant exchange of medical data.

Background: Telemedicine means the delivery of medical service without personal contact between the patient and physician. Although Polish legal regulations do not prohibit so called "distant medical treatment", they do not specify clear and ambiguous terms of such a service. The practitioner faces numerous doubts concerning the telediagnosis and teleconsultation. The authors discuss the problems of acceptability of telediagnosis and teleconsultation in Poland., Material and Methods: The material comprised a whole set of legal acts of the Polish and European origin that could have any impact on the legal basis of telemedicine in Poland. The method applied was of interpretative nature, and the texts of above-mentioned acts were thoroughly analyzed, providing the first comprehensive study on this subject., Results: The results applied to practitioners of numerous medical specializations, but it should be stated that the examples studied and analyzed focused on teleconsultations in occupational medicine. The analysis revealed that current legal regulations do not specify the exact form the medical consultations should acquire. Nevertheless, it should be admitted that "distant consultation"; via the Internet, phone or other means of IT is not prohibited. The authors emphasize, however, that the distant consultations should be treated as an exception to the rule, which says that the patient should be personally consulted by the physician., Conclusions: The achievements of information technology greatly contributes to the quality of diagnostic and therapeutic processes. The existence of many unclear and ambiguous rules and opinions makes it necessary to establish legal regulations specifying the principles of distant exchange of medical data.

In this digital age it is easy to obtain images of wounds without permission from the owner or patient. A debate is needed to clarify who rightfully owns clinical images and the implications for patient consent of using them in different media.

Digital image technology has advanced considerably in recent years and it has never been simpler to capture digital images or send them around the world. This new technology can bring tremendous benefits to healthcare but, if used inappropriately, will compromise patient confidentiality and increase the risk of litigation to the health providers. It is now time to assess the risks and agree safeguards which will promote the safe use of digital technology in the healthcare environment.

This study aims to compare the integrity and reproducibility of measurements created from uncompressed and compressed digital images in order to implement compliance with 21 CFR Part 11 for image analysis studies executed using 21 CFR Part 58 compliant capture systems. Images of a 400-mesh electron microscope grid and H&E stained rat liver tissue were captured on an upright microscope with digital camera using commercially available analysis software. Digital images were stored as either uncompressed TIFFs or in one of five different levels of JPEG compression. The grid images were analyzed with automatic detection of bright objects while the liver images were segmented using color cube-based morphometry techniques, respectively, using commercially-available image analysis software. When comparing the feature-extracted measurements from the TIFF uncompressed to the JPEG compressed images, the data suggest that JPEG compression does not alter the accuracy or reliability to reproduce individual data point measurements in all but the highest compression levels. There is, however, discordance if the initial measure was obtained with a TIFF format and subsequently saved as one of the JPEG levels, suggesting that the use of compression must precede feature extraction. It is a common practice in software packages to work with TIFF uncompressed images. However, this study suggests that the use of JPEG compression as part of the analysis work flow was an acceptable practice for these images and features. Investigators applying image file compression to other organ images will need to validate the utility of image compression in their work flow. A procedure to digitally acquire and JPEG compress images prior to image analysis has the potential to reduce file archiving demands without compromising reproducibility of data.

Aim: To present examples of radiographic image reconstructions in endodontic treatment, to discuss the potential problems arising from the use of image processing software and to mention some current methods to prevent such counterfeit utilization of digital endodontic radiographs., Summary: Conventional Ultra-Speed periapical films of root canal treatment were digitized with flatbed scanner (Umax Powerlook II, Umax Technologies, Inc., Taiwan). Digital images were altered with PHOTOSHOP 6.0 software (Adobe Corporation, San Jose, CA, USA). Carious lesions, periapical pathoses, fake root canals and artificial fillings were created, and inadequate treatment was corrected by application of various image manipulation functions of the software., Key Learning Points: Digital endodontic images can be altered with image processing software. The use of digital radiographic data inevitably raises concerns about security, reliability and the potential for fraud.

The DICOM standard offers the possibilities to generate electronic signatures, valid according to German laws. This enhances the reliability of the correlation between image and patient data. However, only so called qualified electronic signatures--conveniently issued by an accredited supplier--are permissible and not rejectable as evidence in German jurisdiction and are completely equivalent to the handwritten signatures. These qualified electronic signatures can be executed only by individuals, whereas the former are not applicable to technical apparatus like image generating modalities. In consequence, a modality is able to provide its pictures with a "common or advanced signature" solely. This limits the use of the digital signature of the DICOM standard for further applications, e.g. the verifiability within the teleradiology.

The aim of this study was to evaluate the ability of trained observers to identify altered radiographic images after modifications using an image-editing software. Based on implantology in 10 radiographs, eight panoramic and one linear tomograph were modified while one tomograph was untouched. Implants were placed or removed and bone levels were altered, and seventy dentists were invited to identify these alterations. The results showed that the percentage of the correct answers was 12.5% or 2 identifications per examiner. The rate of false positives in relation to correct answers was at a level of 6:1. We concluded that the professionals have difficulty in identifying altered radiographs after using an image-editing software and that the seriousness of this situation demands that dentists be warned of the dangers of the use and abuse of this technology.

Rapidly progressing computer technology, ever-increasing expectations of patients, and a confusing medicolegal environment requires a clarification of the role of computer imaging/applications. Advances in computer technology and its applications are reviewed. A brief historical discussion is included for perspective. Improvements in both hardware and software with the advent of digital imaging have allowed great increases in speed and accuracy in patient imaging. This facilitates doctor-patient communication and possibly realistic patient expectations. Patients seeking cosmetic surgery now often expect preoperative imaging. Although society in general has become more litigious, a literature search up to 1998 reveals no lawsuits directly involving computer imaging. It appears that conservative utilization of computer imaging by the facial plastic surgeon may actually reduce liability and promote communication. Recent advances have significantly enhanced the value of computer imaging in the practice of facial plastic surgery. These technological advances in computer imaging appear to contribute a useful technique for the practice of facial plastic surgery. Inclusion of computer imaging should be given serious consideration as an adjunct to clinical practice.

Many facial plastic surgeons have set up their own personal World Wide Web (WWW) pages with an electronic mail link to communicate with and educate prospective patients. The possible dilemma is in that these services are provided without actually meeting patients face to face. Also, despite the growing popularity of computer imaging systems, it is not clear whether the medical and legal advantages of using such a system outweigh the disadvantages. The purpose of this article is to evaluate these aspects and to provide some protective guidelines. An examination of possible causes of actions arising from computer imaging suggests that surgeons who follow a few simple guidelines, and who use computer imaging responsibly and cautiously, minimize their legal liability. Issues surrounding Internet discussion groups, posted medical advice, intellectual property, and the use of an electronic mail link are also discussed.

Although plastic surgeons are increasingly incorporating computer imaging techniques into their practices, many fear the possibility of legally binding themselves to achieve surgical results identical to those reflected in computer images. Computer imaging allows surgeons to manipulate digital photographs of patients to project possible surgical outcomes. Some of the many benefits imaging techniques pose include improving doctor-patient communication, facilitating the education and training of residents, and reducing administrative and storage costs. Despite the many advantages computer imaging systems offer, however, surgeons understandably worry that imaging systems expose them to immense legal liability. The possible exploitation of computer imaging by novice surgeons as a marketing tool, coupled with the lack of consensus regarding the treatment of computer images, adds to the concern of surgeons. A careful analysis of the law, however, reveals that surgeons who use computer imaging carefully and conservatively, and adopt a few simple precautions, substantially reduce their vulnerability to legal claims. In particular, surgeons face possible claims of implied contract, failure to instruct, and malpractice from their use or failure to use computer imaging. Nevertheless, legal and practical obstacles frustrate each of those causes of actions. Moreover, surgeons who incorporate a few simple safeguards into their practice may further reduce their legal susceptibility.

Dealing with telemedicine including telediagnosis and teleassistance, we have to assess the legal and ethical components of medical liability. With medical telediagnosis, the dispersion of medical liabilities is the main risk: how can we ensure a clear identification of the medical liabilities involved in case of damage? From a legal point of view, the dispersion of the liabilities is not authorized and the use of telediagnosis must ensure a total transparence. As we cannot presently establish a separate amount for a medical act based on the cost of the image records and the cost of image interpretation, it is necessary to establish a contract. Today the most convenient is a contract similar to the usual contract between laboratories which implies that the liability belongs to the practitioner who has received the sample. In the future, other legal obligations may appear when telediagnosis develops. Indeed, the increase in reliability due to telediagnosis could be normally required as a part of the medical obligation to use the latest technology. On the opposite, the excessive use of teleassistance, when there is neither emergency nor medical isolation, is dangerous because it affects the integrity and the quality of the medical act. A medical practice without any clinical examination of the patient is contrary to medical ethics.

This paper outlines the legal issues that arise in digital image management and communication systems (IMACS). At the heart of this study is the digital image which is manipulated, processed, communicated, stored, compressed and archived, and which is difficult to ascertain from a legal point of view because of its intangible nature. On the one hand, personal data protection and the patient's right to privacy need to be protected through a data protection and security policy. This is particularly important in view of the capacity of IMACS to integrate with other systems such as HIS and RIS, since the information generated by the totality of these systems offers a very complete picture of any patient. On the other hand, the evanescent nature of the digital image creates legal uncertainties as to questions of evidence, of procedural and legal admissibility and acceptability and of liability.