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Background Managing a child's anxiety is most critical for the success of treatment in the pediatric dental setup. Present trend advocates the use of non-aversive behavior management techniques. Aim and objective To compare and evaluate the efficacy of aromatherapy using orange essential oil with that of music distraction in the management of anxious pediatric dental patients. Design One hundred and fifty children of the age 6-8 years were divided into three groups of 50 each and performed restorative treatment under aromatherapy, with music distraction, without aromatherapy, or music distraction, respectively. Venham's picture test and facial image scale (FIS), pulse rate, respiratory rate, and oxygen saturation were recorded before and after the procedure. Results Compared with controls, both the aromatherapy group and music distraction group showed significant posttreatment change in anxiety levels with respect to Venham's picture test and FIS, along with the reduction in pulse rate and respiratory rate. When compared between music distraction and aromatherapy, it did not yield statistical significance, though music distraction showed better results compared to aromatherapy. Conclusion Both music distraction and aromatherapy using orange essential oil are effective in anxiety management of which music distraction presents a comparatively better result. Either these non-invasive techniques alone or a combination of both may be employed in the dental setup of pediatric dentists for molding cooperative patients. How to cite this article James J, Retnakumari N, Vadakkepurayil K, e t a l. Effectiveness of Aromatherapy and Music Distraction in Managing Pediatric Dental Anxiety: A Comparative Study. Int J Clin Pediatr Dent 2021;14(2):249-253.

Introduction: Dental fear and anxiety pose a significant problem for the practice of dentistry, especially in children. Therefore, it is necessary to identify and quantify this anxiety, to implement, and to monitor the effectiveness of treatment interventions. Materials and Methods: A cross-sectional study was conducted on children in the age group of 3–14 years. The children who had sound health and visited outpatient department of a Dental College, Lucknow, India with their parents for dental care were considered for study purposes. Children’s dental fear and anxiety were measured by using three scales. Result: Out of the total 220 respondents, 118 (53.6%) were males and 102 (46.4%) females. The outcome of the study showed that the dental fear among children was 13.3%, 22.9%, 7.8%, respectively, in existence measured by the three scales, viz., (a) facial image scale (FIS), (b) dental fear scale (DFS), and (c) children’s fear survey schedule-dental subscale (CFSS-DS). About 70.2% of the children showed Frankl’s behavior rating of 3, i.e. positive. Conclusion: Dental fear and anxiety are the most common problems of children and because of this, they are afraid of undergoing any dental treatment. By using the above scale, we can know about those factors which can enhance their fear so that we can modify our treatment approach. Altering in a treatment modality not only leads the children to get the treatment done easily but also removes the fear for dental treatment in the future.

PurposeThe main purpose of this study is to create a reliable and valid scale to assess the destination food image perceived by the tourists regarding the food in Turkey within the cognitive and affective image component framework. In line with this purpose, both scale development and scale adaptation studies are conducted, and measurement invariance of the scale for gender is analyzed.Design/methodology/approachThis study uses the survey model among quantitative research methods. Scale development processes are used to assess the cognitive image; the construct validity is analyzed with exploratory factor analysis (n = 328), confirmatory factor analysis (n = 425) and convergent and discriminant validity. Scale adaptation processes are followed to assess the affective image, and construct validity is tested with confirmatory factor analysis (n = 425). The reliability of both scales is investigated with Cronbach's alpha. Cochran–Mantel–Haenszel (CMH) analysis is conducted for measurement invariance for gender.FindingsConstruct validity and reliability provided the desired values in all processes. Measurement invariance results proved that the scale does not change according to genders.Research limitations/implicationsThe data obtained in this study have geographical limitations, and the data represent tourists visiting Antalya, an important tourism destination in Turkey.Practical implicationsThe scale will provide concrete information about the destination food image and help practitioners to test the model and develop future strategies for the destination.Originality/valueThis study presents an integrated approach to understanding the destination food image and expands theoretical and empirical evidence by creating a scale that measures both cognitive and affective image component. Scale-invariant shows that there is no item bias for analyzed gender and contributes to generalizability.

Aim: To assess changes in trait and state anxiety of children during sequential phases of dental treatment. Methods: Three hundred children, aged between 3 to < 6 years, who reported for their first dental visit were included. Both parents and children were evaluated over five sequential phases of dental treatment. Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Modified Dental Anxiety Scale (MDAS) were used to assess child’s trait anxiety. Children’s Emotional Manifestation Scale (CEMS) and Facial Image Scale (FIS) were used to assess child’s state anxiety. Child’s behavior was rated using Frankl’s Behavior Rating Scale (FBRS). Paired sample t-test, Pearson’s Correlation coefficient and Spearman’s Rank Correlation coefficient was performed. Results: Mean CFSS-DS and CEMS scores decreased significantly from the first (26.55; 10.25) to the fifth visit (24.74; 8.1) (p

Introduction The diversity in the public image about nurses, the nursing profession, and the comprehension about the true functions and domains of nurses’ job engagement is one of the powerful contrivances that impact nurses’ self-esteem and authority, and recruitment and retention in the health industry.Objective This study aims at identifying the difference between nurses’ perception about the different stakeholders’ image of a nurse.Methods Self-reports on nurses’ perception about doctors’ image of a nurse, patients’ image of a nurse, other hospital staffs’ image of a nurse, and self-perception about a nurse were collected from a sample of 749 registered nurses selected using stratified random sampling from different settings across the state. Data were collected using an adapted version of the Porter Nursing Image Scale.Results Data were tested for the mean and standard deviation (SD); and within-subjects difference using the general linear model and repeated measures analysis of variance indicated a difference in the nurses’ perception about image of a nurse with respect to doctors (mean = 53.22; SD = 6.5), patients (mean = 51.91; SD = 6.9), other hospital staff (mean = 53.05; SD = 6.8), and self (mean = 58.36; SD = 6.9), with F(2.625, 1963.5) = 352.656, p < 0.000, and R 2 = 0.32.Conclusion The findings indicate a difference in the nurses’ perception about the stakeholders’ image of a nurse. This research suggests the need for strategies toward promoting positive nurse image among stakeholders.

While many researchers have documented the characteristics of China's growing tourism market, a comprehensive image scale of city brand for tourism has not yet been developed. This study investigat...

Aim To evaluate the effectiveness of three different behavioral modification techniques: tell-play-do (TPD), film modeling, and use of smartphone dental app in the management of child behavior. Settings and design Seventy-five children aged between 6 years and 9 years who were on their first dental visit were randomly divided into three groups. The study was conducted into two visits. Materials and methods First visit: group I-children watched a film containing various dental procedures performed on a child model followed by oral prophylaxis; group II-TPD techniques were introduced with dental instruments imitating various playing objects followed by oral prophylaxis; group III-children were asked to use mobile dental application followed by oral prophylaxis. Second visit: After 7 days interval, all the children were subjected to class I restorative treatment using glass-ionomer cement. In both visits, the heart rate (HR), facial image scale (FIS) score, and Venham's pictorial index (VPI) score were evaluated before the intervention, after the intervention of behavior modification technique, and during the dental procedure. Statistical analysis used One-way ANOVA test followed by the post hoc Tukey test was used to compare HR and the Kruskal-Wallis test was used to compare the FIS and VPI of all three groups. Results The average HR, FIS, and VPI scores were significantly lower among children who received TPD intervention compared to those who received film modeling intervention and mobile dental application. Conclusion Tell-play-do technique is more effective in reducing children's fear and anxiety for dental treatment. Tell-play-do can be a functional alternative method to tell-show-do (TSD) and modeling techniques during dental treatment. How to cite this article Kevadia MV, B Sandhyarani, Patil AT, et al. Comparative Evaluation of Effectiveness of Tell-Play-Do, Film Modeling and Use of Smartphone Dental Application in the Management of Child Behavior. Int J Clin Pediatr Dent 2020;13(6):682-687.

Introduction: Dental fear and anxiety poses a significant problem in child patient management as such patients are more likely to avoid or delay seeking dental treatment, cancel dental appointments, and are considered to be the main barrier for successful completion of the dental treatment. Thus, early recognition and management of dental fear are imperative and the key to deliver effective dental treatment to the child patient. Aim: The aim of this study was to evaluate dental fear among children aged 4–12 years and parental anxiety using validated assessment scales. Methods: The study was conducted on 288 children who visited the Department of Pedodontics and Preventive Dentistry at Post Graduate Institute of Dental Sciences, Rohtak. The dental fear among children was measured using validated dental fear assessment scales, i.e., facial image scale and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Parental anxiety was assessed using Norman Corah's Dental Anxiety Scale (C-DAS). Children dental fear was compared with parental anxiety. The factors associated with dental fear (age, gender, parent gender, previous dental experience, socioeconomic status, and background area), and also, the first dental visit age was assessed. Results: A total of 288 children showed CFSS-DS of 25.36 ± 6.130, 105 were girls (36.5%) and 183 were boys (63.5%) with CFSS-DS of 25.56 ± 6.102 and 25.25 ± 6.160, respectively. This showed that there were no significant differences in fear between boys and girls. According to the facial image scale, 0.3% of children were reported to have dental fear. Parental anxiety showed C-DAS of 7.53 ± 4.674, 163 were female (56.6%) and 125 were male (43.4%) with C-DAS 9.53 ± 5.183 and 4.94 ± 1.852, respectively. Conclusion: Parental anxiety was not associated with children's dental fear. Among factors, age, previous dental experience, and socioeconomic status were associated with children's dental fear. The most common first dental visit age among the three groups was 5 years.

Aim and objective To assess the efficacy of the new Carisolv system and Polymer bur (SmartbursII®) for selective caries removal in primary molars clinically and microbiologically, compared with the conventional mechanical method. Materials and methods Sixty children with class I active carious lesions were selected. The children were randomly allocated to three groups (n = 20) according to the caries removal method. Under rubber dam isolation, dentin samples were taken before and after caries removal for microbial culture. Time spent in each technique was recorded. The clinical efficacy of caries removal was verified using caries detector dye. Patient satisfaction toward the treatment was evaluated using a facial image scale. Results The median of caries detector dye scores was significantly lower in the conventional group compared to others (p value < 0.05). The mean time for caries removal was the longest with Carisolv (p value < 0.05). The median of facial image scale scores was significantly higher in the conventional group compared with others (p value < 0.05). The mean total viable bacterial count after caries removal was significantly higher in polymer bur group compared with others (p value < 0.05). While, there was no significant difference between Carisolv and conventional groups (p value > 0.05). Conclusion The clinical efficacy of caries removal was highest with the mechanical method. Carisolv took the longest time for caries removal. Patient satisfaction was higher with Carisolv and polymer bur than the mechanical method. The antimicrobial efficacy of Carisolv and the mechanical method was higher than the polymer bur. Clinical significance Carisolv is a viable alternative to the mechanical method in the management of dental caries, especially in children. Further studies are needed to assess the efficacy of caries removal by SmartbursII®. How to cite this article Asal MA, Abdellatif AM, Hammouda HE. Clinical and Microbiological Assessment of Carisolv and Polymer Bur for Selective Caries Removal in Primary Molars. Int J Clin Pediatr Dent 2021;14(3):357–363.

The urban landscape can be improved to reduce the stress experienced by citizens. Therefore, stress-relieving buildings constitute a crucial topic and a future trend in architecture and design. In this study, different architectural styles were investigated to explore design methods for and characteristics of stress-relieving building shapes and to identify indicators for measuring participant stress relief while viewing buildings. To understand stress relief from architecture, we performed semi-structured interviews with 60 participants who viewed images of 30 buildings. The semantic differential method with a 7-point image scale was used to rate stress relief from different architectural styles. The study results revealed that the participants perceived curvilinear buildings as interesting but do not relieve stress. The participants identified as feeling high pressure considering rectilinear patterns to relieve more stress. To support this observation, we identified three principles—city image, identity, and spiritual atmosphere—as fundamental loci of designing cities for livability. We illustrate the three principles with several cases that facilitate a detailed understanding of their applicability in biodesign practices.

Bu araştırma, öğretmenlik mesleğinin imajını ortaya çıkarmaya yönelik bir ölçek geliştirme ve uygulama çalışmasıdır. Araştırma kapsamında öğretmenlik mesleğinin imajını ölçecek geçerli ve güvenilir bir ölçme aracı geliştirmek ve bu ölçek ile öğretmenlerin görüşlerine göre öğretmenlik mesleğinin imajını ortaya çıkarmak hedeflenmiştir. “Öğretmenlik mesleği imaj ölçeği” olarak adlandırılan ölçek beş boyuttan ve 28 maddeden oluşmaktadır. Ölçek toplam varyansın %54,9’unu açıklamaktadır ve Cronbach Alpha değeri ,813 olarak hesaplanmıştır. Ölçeğin Eskişehir ilinde daha büyük bir örnekleme uygulanması ile elde edilen sonuçlara göre öğretmenler, öğretmenlik mesleğinin imajının orta düzeyde olduğunu; “mesleki ve kişisel özellikler”, “mesleki cazibe” ve “statü” boyutlarında meslek imajının iyi düzeyde olduğunu; “toplumsal algı” ve “medya” boyutlarında ise düşük düzeyde olduğunu belirtmektedirler. Bu sonuçlara göre mesleğin imajının iyileştirilmesine yönelik ve toplumsal algıyı iyileştirecek çalışmalar yapılması önerilmiştir.

Background: Inferior alveolar nerve block (IANB) anesthesia is a painful procedure & many attempts are made to render the injection painless, especially in children. Aim: To assess discomfort expressed during modified two-stage IANB injection versus one-stage injection in 8-10 years old children. Subjects & Methods: Sixty children were randomly & equally allocated to either intervention group (two-stage) or control group (one-stage). For all patients, topical anesthesia gel was applied. Intervention group: A short needle was used for the initial piercing & deposition of the local anesthesia (LA), the needle was inserted for 4mm & 0.4ml of the solution was deposited, then withdrawn. After 5 min, a long needle (gauge 27) was advanced till the point of LA drug deposition & bone touching & the rest of the LA solution was deposited. Control group: A long needle was inserted, dropping 0.4 ml of the solution incrementally till the point of LA drug deposition & bone touching & the rest of the LA solution was deposited. The overall patients’ levels of discomfort were assessed using Face Legs Activity Cry Consolability scale (FLACC) & Facial Image Scale (FIS). Results were tabulated & statistically analyzed. Results: For FLACC scale, the post-anesthetic values recorded a median=1 (range=0-3) in two-stages group, & a median=2 (range=0-4) in one-stage group; with statistically significant difference between them (p=0.00). For FIS, a median=2 (range=1-4) in the two-stage group & a median = 3 (range=1-5) in one-stage group; the difference between groups was statistically significant (p=0.017). Conclusion: The two-stage IANB injection technique is a simple & an effective method of reducing the overall discomfort in children.

Dental fear and anxiety (DFA) serves as significant problem in child patient management as it leads to greater prevalence and increased severity of the disease associated with delayed dental visits. Therefore, it is necessary to effectively predict children dental behaviour and identify children at risk of Behaviour Management problems. Study of factors influencing DFA and its association with behaviour in children during first dental visit. The study included 209 children (5-14 years). DFA levels were assessed using 3 standardised questionnaires i.e. Facial Image Scale (FIS), Dental Anxiety Scale (DAS), Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS). The behaviour of the child was then assessed using Frankl’s Behaviour Rating Scale (FBRS). The data were analysed, and a correlation was established between DFA and behaviour using statistical analysis. Presence of DFA according to FIS is 13.4%, according to DAS is 15.2% and according to CFSS-DS is 17.7%. Maximum participants showed positive behaviour (81.8%) according to FBRS. Factors causing maximum Dental anxiety according to DAS was anticipation of treatment (26.30%) and factor which caused maximum dental fear according to CFSS-DS was injections (45.4%). There is association between DFA and behaviour in children during first dental visit. This study will help assess the factors which lead to dental fear and anxiety in children and also find a correlation between dental fear and anxiety and behaviour management problems which can help the Paedodontist to predict various behaviour management problems and to avoid the factors which lead to them before the initiation of the dental treatment. This can lead to a decrease in the fear and anxiety levels of children which will further lead to better treatment and in turn better case management.

The aim of the work is to increase the efficiency of selection of objects of different nature in digital monochrome images formed in remote sensing systems. For this purpose, algorithms for the formation of features of objects with respect to which boundary values are specified are introduced into the structure of multi-threshold processing. New schemes of multi-threshold processing and selection of objects of interest with threshold setting based on selection results are proposed. Algorithms of multi-threshold selection of objects by area and other scale-invariant geometric features, such as the elongation coefficient of the perimeter of the object and the elongation coefficient of the main axis of the describing ellipse, are obtained and tested. The binarization threshold is set for each of the selected objects based on the extremum of the applied geometric criterion. The new invariant geometric features used are different for round and elongated objects and provide independence of characteristics with changes in the image scale. Results of processing of typical models of images, and also results of selection of objects on the real television and infrared images showing efficiency of the proposed selection method are presented.

The anxiety in children when visiting a dentist results in children not wanting to check the condition of their oral cavity to the dentist, therefore it causes many problems with their oral and dental health. Children who visit a dentist experience an anxiety level of 5% to 52%. The behavioral problem in the children with excessive anxiety tends to have multifactorial, one of which is the parenting. This research to investigate the correlation between parenting and the anxiety levels of children aged 6-12 years in the tooth extraction. This research was analytical survey research using a cross sectional design. The subjects of this research were children patients and their parents, who visit Private Dental Clinics for tooth extraction, as many as 47 respondents. Sampling used the accidental sampling technique. The research instrument used questionnaires to see their parenting, and also used the Facial Image Scale to see the level of anxiety. The parenting method showed the democratic parenting as much as 40.4%. The children’s anxiety level showed the anxiety level of anxious as much as 55.3%. The analysis results of the Lambda test analysis showed the democratic parenting with the level of child anxiety was 0.07, permissive parenting with the level of child anxiety was 0.008 and authoritarian parenting with the level of child anxiety was 0.007. Parents with democratic parenting is not related to children's anxiety level, authoritarian and permissive parenting are related to children's anxiety level.

Introduction: Dental anxiety is a kind of fear exerted due to threatening stimuli. Assessing a child's dental anxiety level is very important to perform a particular treatment. The aim of this study is to examine the various factors that determine the anxiety levels in children and evaluate their anxiety levels. Materials and Methods: A total of 50 children participated in the survey conducted. Each participant had fulfilled the inclusion and exclusion criteria to answer the questionnaire. It included questions regarding their habits, fears, and dental visit experience. Evaluation of their anxiety levels was done using the facial image scale (FIS) and the modified dental anxiety scale and was correlated with various factors using the Statistical Package for Social Science Software. Results: Female children are more anxious than male children toward dental treatment. About 38% were anxious and 16% refused while undergoing radiographic examination and showed significant anxiety levels (P = 0.012). About 16% of the population were highly uncooperative and were necessary to implement behavioral shaping techniques on them. It influences the FIS anxiety score before initiation of the treatment (P = 0.003). About 48% of children had maintained a good rapport with the dentist and showed strong significance with the child's anxiety (P = 0.025). Conclusion: Gender and behavior of the child while diagnosis and radiographic examination, implementation of behavioral shaping techniques, and rapport developed between child and dentist are all influencing factors of dental anxiety. The number of visits to the dental clinic, socioeconomic status, kind of amount of consumption of sugars, and type of treatment being done do not contribute to a child's anxiety level.

Objective(s): To assess the effect of three behavior guidance techniques on anxiety indicators of children undergoing diagnosis and preventive dental care. Study Design: Sixty-three subjects (7–9 years) were divided into three groups as per the behavior guidance technique namely tell-show-do, live and filmed modeling (using Tablet Computer) to receive diagnostic (Oral examination & radiographic assessment using intraoral periapical radiographs) and preventive dental care (Oral prophylaxis and topical fluoride application). Anxiety indicators–Facial Image Scale (FIS) scores and heart rate were recorded before, during and after diagnosis/preventive treatment. Three-way repeated measures ANOVA with post-hoc analysis was performed at significance of p-value < 0.05. Results: There was a statistically significant difference in the anxiety indicators of children under the influence of different behavior guidance approaches undergoing diagnosis/preventive treatments except for mean heart rate of children while oral examination. Multiple comparison results reveal that the mean FIS scores and heart rate of children with modeling techniques were significantly better as compared to tell-show-do technique with no significant difference between the two modeling techniques. Conclusion: This study suggests that the modeling techniques (filmed and live) seem to be an efficient behavioral guidance approach for children aged 7–9 years undergoing routine diagnosis and preventive dental care as compared to tell-show-do technique.

Aim: The aim of the study was to assess the prevalence of dental fear and anxiety among children aged 4–13 years using three fear scales, i.e., facial image scale (FIS), Nepalese version of Children's Fear Survey Schedule–Dental Subscale (CFSS-DS), and Modified Child Dental Anxiety Scale (MCDAS). Materials and Methods: The study was conducted on 300 children (4–13 years) who visited the Department of Pedodontics and Preventive Dentistry. The fear and anxiety levels were measured using three fear measurement scales, i.e., FIS, Nepalese version of CFSS-DS, and MCDAS. The dental behavior observed was rated according to the Frankl's Behavior Rating Scale (FBRS). Results: The prevalence of dental fear according to FIS was 11.9% as evident from children having FIS 4 and 5 scores. Dental fear with CFSS-DS ≥38 was identified in 49 children (21 [12.5%] male and 28 [21.21%] female). In assessment of the behavior of children in the clinics through FBRS, it was observed that the maximum number of respondents (70.6%) showed Frankl's rating 3, i.e., positive. Conclusion: The Nepalese versions of the CFSS-DS and the MCDAS are both reliable and valid scales for evaluating dental anxiety and fear in young children. Assessing dental anxiety and fear is useful, as behavior management can be designed accordingly for child patients.

First Order Locally Orderless Registration (FLOR) is a scale-space framework for image density estimation used for defining image similarity, mainly for Image Registration. The Locally Orderless Registration framework was designed in principle to use zeroth-order information, providing image density estimates over three scales: image scale, intensity scale, and integration scale. We extend it to take first-order information into account and hint at higher-order information. We show how standard similarity measures extend into the framework. We study especially Sum of Squared Differences (SSD) and Normalized Cross-Correlation (NCC) but present the theory of how Normalised Mutual Information (NMI) can be included.

Cosmetics are essential items in the daily life of modern women. With the improvement of living standards, people have higher and higher requirements for cosmetics. Color is the most sensitive part of people's visual experience. Color design plays an important role in many fields. For successful product packaging, the perfect combination of physical and psychological functions perfectly reflects the characteristics of the product and can attract consumers' attention. In the face of fierce competition, only outer packaging with clear visual characteristics can attract consumers. This research mainly studies the color design of cosmetic packaging design from the perspective of female consumers, and analyzes and summarizes the color design of Korean cheap cosmetics packaging. Use the KSCA program to analyze the color design of the brand, and then perform further analysis by displaying the extracted color values on the IRI image scale. After selecting the cosmetic brand to be studied, use the KSCA program to analyze the color design of the brand, and then perform further analysis by displaying the extracted color values on the IRI image scale. The research results show that: (1) There is no significant difference in the packaging color design of the three brands, and the essence is the brand concept. The color vision rate is not high. The three brands are mainly large and bright background colors, and are designed with fresh green, yellow and orange to bring consumers a clean, natural and bright feeling. The design of these three cosmetics brands has left a deep impression on consumers through the design and impression of cosmetics. (2) In terms of vision and wisdom, the most common color scheme of Korean cosmetics brands is to separate colors similar to complementary colors. Mainly used in warm color series. According to different series, different colors are designed, and the young series usually use bright and bright colors as the primary colors, giving people a fresh, cute, natural and soft feeling. Series emphasizing individuality and efficiency usually use dark colors such as black, red and purple as primary colors, giving people a sense of elegance, mystery and nobility. These color designs can help consumers intuitively choose the attributes of their products through color.

Background To evaluate the level of stress during dental care in children and preadolescents with cerebral palsy through biological and psychological parameters. Material and Methods A total of 38 children aged 7 to 12 years were divided into two groups: one with 18 children with cerebral palsy and the other with 20 healthy children (control group). Saliva was noninvasively collected before and after dental care to analyze salivary biomarkers. The Frankl Behavior Scale and the Facial Image Scale were applied. Results After the dental procedure, cortisol levels were significantly higher (p = 0.02) in the cerebral palsy group than in the control group. Salivary alpha-amylase was not significantly different between groups. Regarding psychological parameters, anxiety was significantly higher (p = 0.00012) in the cerebral palsy group than in the control group. Conclusions There was a change in physiological parameters (salivary cortisol and salivary alpha-amylase) and in psychological parameters (Frankl Behavioral Scale and Facial Image Scale) in patients with cerebral palsy, who exhibited higher stress and anxiety levels than did children without cerebral palsy. Key words:Ortisol, physiological stress, dental care, cerebral palsy, dental treatment anxiety.

Intracellular organelles such as the endoplasmic reticulum, mitochondria, and the cell nucleus exhibit complex structures and diverse morphologies. These intracellular structures (ICSs) play important roles in serving essential physiological functions of cells. Their accurate segmentation is crucial to many important life sciences and clinical applications. When using deep learning-based segmentation models to extract ICSs in fluorescence microscopy images (FLMIs), we find that U-Net provides superior performance, while other well-designed models such as DeepLabv3+ and SegNet perform poorly. By investigating the relative importance of the features learned by U-Net, we find that low-level features play a dominant role. Therefore, we develop a simple strategy that modifies general-purpose segmentation models by fusing low-level features via a decoder architecture to improve their performance in segmenting ICSs from FLMIs. For a given segmentation model, we first use a group of convolutions at the original image scale as the input layer to obtain low-level features. We then use a decoder to fuse the multi-scale features, which directly passes information of low-level features to the prediction layer. Experimental results on two custom datasets, ER and MITO, and a public dataset NUCLEUS, show that the strategy substantially improves the performance of all the general-purpose models tested in segmentation of ICSs from FLMIs. Data and code of this study are available at https://github.com/cbmi-group/icss-segmentation.