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OpenAI, Google, and Microsoft have recently developed popular large language models (LLMs) with incredible clinical applications. LLMs specific to neurosurgery, such as AtlasGPT, have also been recently released. However, the comparative neurosurgical diagnostic capabilities of these models are not well studied. The aim of this study was to evaluate and compare the ability of LLMs to diagnose neurosurgical pathologies. Clinical vignettes (n = 148) extracted from a common neurosurgery case-based review textbook were stratified by subspecialty. OpenAI's ChatGPT-3.5 and ChatGPT-4, Google's Gemini, Microsoft Copilot, and AtlasGPT were prompted to provide a diagnosis: "Provide a neurosurgical diagnosis given the following history…[vignette]." Imaging was inputted for capable LLMs, and all queries were run in May 2024. Diagnoses were compared with the textbook for accuracy and errors were categorized appropriately. ChatGPT-4 was the most accurate model (74% correct), followed by AtlasGPT (63% correct), ChatGPT-3.5 (53% correct), Microsoft Copilot (48% correct), and Gemini (36% correct). Chi-square comparisons demonstrated that ChatGPT-4 was more accurate in providing clinical diagnoses than its counterparts (p = 0.005). Across all vignettes and LLMs, most errors were due to an inability to attribute a key piece of information (generally imaging data) to the diagnostic process while otherwise using logical stepwise reasoning. ChatGPT-4 offered the most accurate diagnoses when given established clinical vignettes. Adding imaging processing capabilities and relevant data significantly increased the accuracy of LLM diagnoses. LLMs can offer accurate assessments of common neurosurgical conditions but necessitate detailed prompting from clinicians. Artificial intelligence has incredible clinical potential; however, practitioners must be cautious and think critically while using them for diagnostic purposes.

Metal-organic frameworks (MOFs) are represented as the potential candidates of photo and electro-catalytic CO2 reduction due to their incredible surface area, phenotypic structures, varied porosity and defined morphologies. Nevertheless, experimental usage of pristine MOFs in the reduction of CO2 is difficult, as they are inherently low-conductive in electricity, unstable in their makeup, and experience weak metal-oxygen interaction. The core concepts of photo and electro-catalytic CO2 reduction are first described in this review to give the background to the understanding of MOF-based catalytic systems. It then critically discusses the structural properties of MOFs and its derivatives and identifies the key shortcomings which limit catalytic performance. To address these issues, the recent developments of MOF-based composite catalysts have been discussed, such as MOF@graphene, MOF@metal oxides, MOF@MXene, and MOF@layered double hydroxide (LDH). These composites exhibit better conductivity, greater stability, better metaloxygen interactions and better catalytic strength than pristine MOFs. Finally, the development of the area occurs currently is summarized, and the future prospects are given, with rational designing of effective, durable, and scalable MOF-based composite catalysts towards sustainable CO2 reduction.

Solid protonic electrolytes are a promising avenue for advanced solid-state proton batteries, offering enhanced safety, long-term cycling stability, and high energy density. However, achieving high proton conductivity under ambient conditions remains a formidable challenge. In this study, we demonstrate a highly robust zwitterionic vinylene-linked covalent organic framework (COF) engineered with sulfobetaine functionalities that promote efficient proton dissociation and migration, enabling superior proton conduction under ambient conditions and setting a new benchmark in the COF field. The solid protonic electrolyte comprising phosphoric acid-modified zwitterionic COFs achieved the highest proton conductivity (5.34 × 10-2 S cm-1) under ambient conditions among all reported COF-based protonic electrolytes, along with incredible long-term stability. Furthermore, solid-state proton batteries assembled using the solid electrolyte delivered a record-high specific capacity (108.5 mAh g-1 at 1.0 A g-1), good cycling durability (90% capacity retention after 2000 charge-discharge cycles at 1.0 A g-1), and excellent rate capability. This study presents a viable and effective strategy for constructing high-performance COF-based protonic electrolytes tailored for advanced solid-state proton battery technologies.

We describe the radical modernization of a radiation oncology department in a developing country, Guatemala, from 2015 to the beginning of 2024. The Instituto de Cancerología y Hospital Dr. Bernardo del Valle S (INCAN) is the only public radiotherapy clinic serving patient referrals from the Ministry of Public Health and Social Assistance program. We describe the state of the radiation oncology department in 2015 versus 2024 while chronicling its gradual transformation. This multifaceted collaboration involved academic centers, government agencies, International Atomic Energy Agency (IAEA), industry, and nonprofits and continues to this day. We analyze the infrastructure, staff, radiotherapy equipment, physics equipment, patient careCo-60 decommissioning, and educational initiatives. We graphically illustrate the impact of these changes in treatment delivery time, consults, follow-up visits, CT simulations, new patients treated in each linear accelerator, new patients treated with 2D, 3D, IMRT/VMAT, and superficial techniques, new patients treated with 2D LDR, 2D HDR, or 3D techniques, causes of linear accelerator downtime, and weekly patients on treatment. We provide a figure of the various sequential and parallel steps to modernize a radiation oncology department. We describe the complexities of radioisotope repatriation and safe disposal. We provide a comprehensive table of wisdom pearls regarding project governance, team, education, finances, culture, and language. We also discuss the impact of artificial intelligence in contouring. The transformation of the INCAN radiation oncology department in Guatemala is a testimony to many's hard work, vision, and perseverance for the betterment of Guatemalan patients while facing incredible financial hardship. We hope that what we have learned in the past nine years will help others achieve even greater success in a shorter time.

The complexity of metabolic crosstalk between the liver and pancreas, which controls glucose and homeostasis levels, has been intriguing for models based on conventional in vitro systems. However, the 3D bioprinting path has created an incredible platform of multicellular and spatially concerted microtissues that mimic the interaction of the pancreas. This discovery contributes important insights into metabolic organization, regenerative strategies, and disease mechanisms. Therefore, our review delves into recent advancements in 3D bioprinted crosstalk between liver and pancreas constructs, with focus on biomaterial scaffolds, engineered microenvironments, and how dynamic perfusion systems imitate signaling between hepatocytes, stromal components, and pancreatic β-cells. The relevance of nutrient flow, coculture geometry, and bioink composition to improve insulin responsiveness, lipid metabolic processes, and glucose uptake has taken the focal point, while the integration of microfluidic bioreactors and biosensing scaffolds provides real-time metabolic monitoring and testing of drugs. Persistent threats still exist in preserving tissue viability, functional connectivity, and vascularization. Future research could delve into creation of vascularized multiorgan chips and evaluate therapies, stem cell-based cell lines, and AI-backed bioprinting for customized disease modeling. Integrating bioengineering and endocrine biology in 3D bioprinting of the liver‒pancreas system could improve scientific knowledge of interorgan crosstalk in metabolic disorders.

Molybdenum disulfide (MoS2)/lead sulfide (PbS) heterostructures exhibit exceptional potential because of their strong light-matter interactions and high carrier mobility. Critically, bandgap engineering can further optimize the light-absorption range for next-generation phototransistors. However, the bandgap engineering capability for MoS2/PbS heterojunctions formed by conventional transfer-after-chemical vapor deposition (CVD) fabrication is typically inherently restricted due to solely vertical interlayer coupling. Here, to realize wafer-scale bandgap-tunable MoS2/PbS phototransistors, we investigate the band structure of vertical and lateral MoS2/PbS heterojunctions via ab initio calculations and find that lateral heterojunctions in heterostructures dominate the bandgap tunability via tuning of the Type-II band alignment. To achieve wafer-scale uniformity, we investigated how plasma treatment modulates the thin-film surface energy, and the results substantially improved fabrication scaling of MoS2/PbS heterojunctions from traditional micro-scale level to an incredible 4-inch wafer-scale with near-ideal yields (97%) and enabled bandgap tunability (from 1.24 to 0.61 eV). The resulting phototransistors exhibit a maximum responsivity of 88 A/W, specific detectivity of 4.77  ×  1012 Jones, and a typical on/off ratio of 3.16  ×  107. This work establishes a pathway for developing wafer-scale bandgap-tunable optoelectronics.

Considering the incredible impact of 2D materials on emerging technologies, hydrogenated borophene (borophane) has attracted significant interest not only as a tunable platform for electronic and optoelectronic applications but also for its promising catalytic behavior. Here, we present a systematic density functional theory investigation of the structural, electronic, and optical properties of the 6,6 and 5,7 borophane polymorphs with distinct point-group symmetries. The calculated electronic band structures and density of states confirm the semimetallic characteristics of all structures, consistent with previous reports. The complex dielectric function spectra further reveal how structural motifs and hydrogenation patterns influence the onset of optical absorption. For the 5,7 HB monolayers, the first major absorption feature shifts markedly toward the far-infrared region compared with the 6,6 HB, indicating a stronger low-energy electronic response and a more pronounced metallic character. The optical spectra of 6,6 HB also show qualitative agreement with the available experimental UV-vis data. These results provide a comprehensive understanding of how symmetry and bonding topologies govern the electronic and optical behavior of borophane monolayers, offering useful guidance for the design of boron-based 2D optoelectronic materials.

There is no medical field where the impact of medical evolution is more palpable than in kidney transplantation. The pioneers of this procedure, 70 years ago, laid out the foundation for organ transplantation in general and kidney transplantation in particular. Despite the incredible advancements that have been made since, huge differences exist worldwide in terms of access, equity and quality of care. Nowhere are these disparities more prominent than in developing countries with limited resources, underfunded healthcare systems and transplantation infrastructures, particularly the Western Balkans. This position paper delineates the biggest barriers hindering the development of kidney transplantation in the Western Balkans, put forth and agreed upon by a group of regional experts on the field, based on the Modified Delphi Method. Limitations in training, infrastructure, restrictive and outdated legislative practices, lack of a centralized coordination network and fragmented regional collaboration, emerged as the principal challenges. Endorsed by European Society for Organ Transplantation (ESOT), this paper outlines a pragmatic and practical framework to overcome these obstacles, towards building robust and sustainable transplantation programs that ensure high-quality and equitable access to kidney transplantation, for all patients in this region.

Pigmentation patterns are central to animal biology-shaping camouflage, signaling, and mate selection-and uncovering the mechanisms driving their diversification is key to understanding the evolutionary principles that generate this fundamental dimension of biodiversity. Reef fishes exhibit an incredible variety of patterns, from simple spots to intricate designs. To date, the underlying evolutionary processes that govern their diversification remain unclear. Here, we investigate the relationship between pigmentation pattern diversity, species richness, and geography across six iconic reef fish families. We provide evidence for a positive correlation between pattern diversity and species richness, with a high divergence of pigmentation patterns in every biogeographic region. Then, by using a suit of phylogenetically informed comparative analyses, we demonstrate that the evolution of pigmentation patterns is characterized by a combination of rapid and constrained phenotypic diversification. Overall, our findings illuminate factors that explain pigmentation pattern diversity in living reef fishes, revealing that speciation events have driven constant high levels of pigmentation pattern disparity within subclades and across globally variable reef fish assemblages.

Plants secrete a heterogenous population of membrane-enclosed extracellular vesicles that harbour an incredible diversity of molecular cargo. It is the complexity of the molecular cargo encapsulated by plant extracellular vesicles (PEVs) which facilitates the fundamental role PEVs play in mediating communication and signalling. PEV molecular cargo is composed of a diverse mixture of lipids, metabolites, proteins, and nucleic acids. Among the nucleic acids, the microRNA (miRNA) class of small regulatory RNA can be viewed as one of the most biologically relevant. Plant miRNAs regulate the expression of genes essential for all aspects of development as well as to control the gene expression changes required to drive the adaptive and defensive responses of plants to environmental stress and pathogen attack. Furthermore, recent research has shown that specific miRNA cohorts are selectively packaged into PEVs as part of the molecular-level response of a plant to its growth environment. For example, PEVs are loaded with a specific miRNA population for their targeted delivery to sites of pathogen infection in the host plant, or for cross-kingdom delivery of host-plant-encoded miRNAs to the pathogen itself. Here we outline PEV physical properties, compare PEV biogenesis pathways, detail the composition of PEV molecular cargo, and go on to provide detailed commentary on the role of PEV-delivered miRNAs in plant development, environmental stress adaptation, and pathogen defence. We conclude this article with a proposal for the potential future use of PEVs and their miRNA cargo in agriculture and aquaculture.

Melanoma, a highly aggressive type of skin cancer, has undergone incredible developments in immunotherapy, particularly in modulating T-cell immunity. T cells are essential components of the antitumor immune response and can undoubtedly influence the effectiveness of melanoma treatment. This review will evaluate the roles of the different T cell subsets (CD8+, CD4+, and Tregs) in melanoma immunity. CD8+ T cells are important effectors, as they primarily recognize and kill tumor cells. However, CD8+ T cells are often dysfunctional due to exhaustion driven by chronic antigen exposure and dysfunctional immune checkpoint pathways, specifically PD-1 and CTLA-4. On the other hand, CD4+ T cells, also known as T helper cells, play a crucial role in coordinating both pro- and antitumor immune responses. In contrast to T cells, Tregs, which are often present in the tumor microenvironment, lead to immune suppression through their activity, limiting T cell activity. This review will also examine the mechanisms of T-cell exhaustion, metabolic reprogramming within the tumor microenvironment (TME) of T-cell subsets, and the role of immune checkpoint pathways, such as CTLA-4 and PD-1, in T-cell immunity. Adoptive cell therapies (ACT), specifically Tumor-Infiltrating Lymphocyte (TIL) therapy and Chimeric Antigen Receptor (CAR) T-cell therapy, have shown the ability to rejuvenate T-cells to enhance clinical outcomes. However, several resistance mechanisms and the suppressive TME presents difficulties. Future efforts will focus on combination therapies, metabolic interventions, and novel engineering techniques to overcome barriers to T-cell function exhaustion and T-cell persistence. Evaluating biomarkers associated with early prediction for therapeutic benefit and associated toxicity is important for personalizing a particular treatment. Ultimately, this review highlights the potential of targeting T-cell exhaustion to enhance the effectiveness of T-cell-based therapies in improving outcomes for melanoma patients.

Chimeric antigen receptor (CAR) T cells have demonstrated remarkable ability to render multiple relapsed and refractory patients into a deep and often durable remission. Since initial FDA approval of tisagenlecleucel in 2017, real-world data have shown the benefit of this therapy, even among historically complex populations, such as infants, children with Down syndrome, and those with extramedullary leukemia. Despite the success of CAR T cell therapy, nearly half of patients tend to show relapsed disease, demanding ongoing advancements. Furthermore, the incorporation of the bispecific T cell engager, blinatumomab, into B cell acute lymphoblastic leukemia (B-ALL) therapy has fundamentally shifted the treatment paradigm, calling for a reevaluation of the optimal application of CAR T cells. In this review, we describe the current usage of CAR T cells in children, adolescents, and young adults (CAYAs) with B-ALL and discuss anticipated changes to CAR T cell therapy and post-infusion management. Upfront use of blinatumomab will require novel approaches to relapsed disease, including the use of CAR T cells earlier in therapy. Limited durability of the currently approved CAR T cells will require novel constructs along with improved toxicity mitigation and refinements in post-CAR disease surveillance and therapy. While CAR T cells have made an incredible impact on the field, there is much work due to improve outcomes for CAYAs with B-ALL.

Parental care in animals consists of an incredible diversity of forms, providing powerful opportunities for studying the proximate basis of behavior. Three-spined stickleback fish, a classic model system in ecology, evolution, and behavior, are good subjects for studying the neurobiological basis of paternal care as male sticklebacks are solely responsible for providing care to their developing offspring. Here we review what is known about the neural, neuroendocrine, genetic, and molecular basis of paternal care in sticklebacks, highlighting the ways in which natural phenotypic variation within and among populations has been leveraged to improve our understanding of the proximate basis of behavioral variation. For example, diversity in care among populations, including the complete evolutionary loss of parental care in the so-called "white" sticklebacks, provides insight into the proximate mechanisms by which highly divergent behavior in whites diverged so rapidly and dramatically from the ancestral care-giving form. Moreover, comparisons within populations across stages of care reveal deeply conserved neural, genomic, and neuroendocrine mechanisms regulating paternal and maternal behavior across vertebrates. Moving forward, improved neuroscientific tools and resources for sticklebacks will enable functional manipulations and in vivo studies, opening up novel opportunities to address outstanding questions about the origin of behavioral diversity.