Search Results (40)

DIALOGUE (DIagnostic AI Learning through Objective Guided User Experience) is a generative artificial intelligence (GenAI)-based training program designed to enhance diagnostic communication skills in medical students. In this single-arm pre–post study, we evaluated whether DIALOGUE could improve students’ ability to disclose a type 2 diabetes mellitus (T2DM) diagnosis with clarity, structure, and empathy. Thirty clinical-phase students completed two pre-test virtual encounters with an AI-simulated patient (ChatGPT, GPT-4o), scored by blinded raters using an eight-domain rubric. Participants then engaged in ten asynchronous GenAI scenarios with automated natural-language feedback. Seven days later, they completed two post-test consultations with human standardized patients, again evaluated with the same rubric. Mean total performance increased by 36.7 points (95% CI: 31.4–42.1; p < 0.001), and the proportion of high-performing students rose from 0% to 70%. Gains were significant across all domains, most notably in opening the encounter, closure, and diabetes specific explanation. Multiple regression showed that lower baseline empathy (β = −0.41, p = 0.005) and higher digital self-efficacy (β = 0.35, p = 0.016) independently predicted greater improvement; gender had only a marginal effect. Cluster analysis revealed three learner profiles, with the highest-gain group characterized by low empathy and high digital self-efficacy. Inter-rater reliability was excellent (ICC ≈ 0.90). These findings provide empirical evidence that GenAI-mediated training can meaningfully enhance diagnostic communication and may serve as a scalable, individualized adjunct to conventional medical education. Full article

Background: Central precocious puberty (CPP), defined as the onset of secondary sexual characteristics before age 8 in girls, is increasingly prevalent worldwide. CPP is often caused by early activation of the HPG axis, leading to accelerated growth and bone maturation. However, the diagnostic accuracy of standard bone age (BA) methods remains uncertain in this context. Objective: To compare the diagnostic accuracy of the Greulich–Pyle atlas (GPA) and Tanner–Whitehouse 3 (TW3) methods in estimating skeletal age in girls with CPP and to assess the predictive value of serum hormone levels for estimating chronological age (CA). Methods: An observational, cross-sectional diagnostic study was conducted, involving n = 109 girls aged 6–12 years with confirmed CPP (Ethics Committee approval: CHUC_2023_86; 13 July 2023). Left posteroanterior hand–wrist (PA–HW) radiographs were assessed using the GPA and TW3 methods. Anthropometric measurements were recorded, and serum concentrations of estradiol, LH, FSH, DHEA-S, cortisol, TSH, and free T4 were obtained. Comparisons between CA and BA estimates were conducted using repeated-measures ANOVA, and ANCOVA was applied to examine the hormonal predictors of CA. Results: Both GPA and TW3 overestimated CA between 7 and 12 years, with the GPA showing larger deviations (up to 4.8 months). The TW3 method provided more accurate estimations, particularly at advanced pubertal stages. Estradiol (η²_p = 0.188–0.197), LH (η²_p = 0.061–0.068), and FSH (η²_p = 0.008–0.023) emerged as the strongest endocrine predictors of CA, significantly enhancing the explanatory power of both radiological methods. Conclusions: The TW3 method demonstrated superior diagnostic accuracy over GPA in girls with CPP, especially between 7 and 12 years. Integrating estradiol, LH, and FSH into BA assessment significantly improved the accuracy, supporting a more individualized and physiologically grounded diagnostic approach. Full article

Background: Betulinic acid (BA) and some derivatives are well-known antiproliferative compounds. Literature precedents suggest that incorporating triphenylphosphonium (TPP⁺) salts on this triterpenoid scaffold enhances its biological activity. In the present study, we carried out a simple synthesis of C-28 ester derivatives of this triterpenoid conjugated with TPP⁺ bromide salts through 4- to 6-carbon chains via nucleophilic substitution of the corresponding ω-TPP⁺bromoalkanes. Tests for antiproliferative activity in nine cancer cell lines and normal human fibroblasts showed that TPP⁺ incorporation enhanced the potency of BA by more than an order of magnitude, up to 100-fold. BA-C₄-TPP⁺Br⁻, with a four-carbon chain separating the TPP⁺ moiety from the BA, showed remarkable antiproliferative effects, sometimes more potent than the reference drug (Etoposide). This compound exhibited the strongest mitochondrial uncoupling effect in human cancer cells. No significant LDH release was noted in colorectal carcinoma cells at low micromolar concentrations of BA-C₄-TPP⁺Br⁻, and sub-micromolar concentrations were sufficient for inducing apoptosis. The in silico prediction of pharmacokinetic properties suggested high oral absorption (88%), as well as a non-inhibitor and non-substrate profile vs. cytochrome isoenzymes. These results point to this compound as a promising lead for the development of novel anticancer drugs. Full article

Bariatric surgery (BS) is an effective intervention for obesity, inducing significant neurobiological and gut microbiota changes that influence hunger, appetite, taste perception, and long-term metabolic health. This narrative review examines these alterations by analyzing recent findings from clinical and preclinical studies, including neuroimaging, microbiome sequencing, and hormonal assessments. BS modulates appetite-regulating hormones, reducing ghrelin while increasing glucagon-like peptide-1 (GLP-1) and peptide tyrosine-tyrosine (PYY), leading to enhanced satiety and decreased caloric intake. Neuroimaging studies reveal structural and functional changes in brain regions involved in reward processing and cognitive control, contributing to reduced cravings and altered food choices. Additionally, BS reshapes the gut microbiota, increasing beneficial species such as Akkermansia muciniphila, which influence metabolic pathways through short-chain fatty acid production and bile acid metabolism. These findings highlight the complex interplay between the gut and the brain in post-surgical metabolic regulation. Understanding these mechanisms is essential for optimizing post-operative care, including nutritional strategies and behavioral interventions. Future research should explore how these changes impact long-term outcomes, guiding the development of targeted therapies to enhance the recovery and quality of life for BS patients. Full article

In the quest for more sensitive gas sensors, researchers have studied how heating the sensors, using UV light, and thermally annealing sensors improve performance. During thermal annealing, the heating process can improve the crystallinity of the material while also increasing the electrode and sensing material interactions to create more available active sites and thus improve sensor performance. Hexadecafluorinated iron (II) phthalocyanine (FePcF₁₆) nanowires have high sensitivity towards NH₃ selectively, and thermally annealing the NWs after the deposition can further improve the sensing response and recovery. For this reason, the effect of annealing FePcF₁₆ NWs at different temperatures was studied to optimize these systems. In this work, FePcF₁₆ NWs were synthesized using physical vapor deposition (PVD) to deposit on interdigitated electrodes. The NWs were characterized by SEM, EDS, PXRD, FTIR, and Raman spectroscopy to confirm their purity. The sensors were annealed at different temperatures, inserted into a gas sensing chamber, and exposed to 1 ppm NH₃ in air, and the electrical current was measured. The results show that the optimized FePcF₁₆ NWs have excellent sensing properties, with a 58% increase in response towards NH₃ after a stepwise annealing at 300 °C confirming these systems are good prospective candidates for sensing NH₃ at room temperature. Full article

Background: As metabolic diseases continue to rise globally, there is a growing need to improve risk assessment strategies beyond traditional measures such as BMI and waist circumference, which may fail to identify individuals at risk. This study develops and validates a novel metabolic risk classification system that incorporates body fat percentage (%BF), waist circumference (WC), and grip strength (GS) in Mexican adults. It aims to improve risk stratification and evaluate the association with metabolic syndrome. Methods: This cross-sectional study involved 300 young adults (18–22 years) from a university in Mexico City, utilizing body composition (%BF) and anthropometric measures (WC, GS) to categorize them into four risk groups: protective, low risk, increased risk, and high risk. A retrospective cohort of 166 adults (18–65 years) with complete clinical records was used for validation. Results: The inclusion of GS in the risk assessment significantly shifted the distribution in the young adult cohort, reducing the “no risk” category (15.5% males, 11.6% females) and expanding the higher-risk categories (70.2% males, 69% females). Metabolic parameters such as fasting glucose, triglycerides, HDL cholesterol, and blood pressure worsened progressively across the risk categories (p < 0.001). The high-risk group exhibited a markedly increased odds ratio for metabolic syndrome at 28.23 (10.83–73.6, p < 0.001), with no cases in the protective and low-risk groups. Conclusions: Integrating grip strength with %BF and WC into a risk classification system substantially enhances metabolic risk stratification, identifies at-risk individuals not previously detected, and confirms a protective group. This validated system provides a robust tool for early detection and targeted interventions, improving public health outcomes in metabolic health. Full article

Background/Objectives: Bone age assessments are essential for evaluating the growth and skeletal development of children and adolescents, influenced by factors such as genetics, ethnicity, culture, and nutrition. Clinical standards for these assessments must be adapted to the specific populations under study. This study validates the use of the Tanner–Whitehouse 3 method for determining bone age in pediatric and adolescent populations in the Canary Islands. Methods: This cross-sectional study analyzed 214 posteroanterior radiographs of the left hand and wrist from 80 females and 134 males, aged between 5 and 18 years. The radiographs were independently evaluated by three raters: a Radiologist Specialist (Rater 1), a General Practitioner (Rater 2), and a Medical Student (Rater 3). Intra- and inter-rater reliability were assessed using intraclass correlation coefficients (ICCs). Accuracy was evaluated by comparing estimated bone age with chronological age, stratified by sex and developmental stage. Results: Strong intra-rater reliability was observed across all raters. Raters 1 and 2 demonstrated excellent consistency (ICCs: 0.990–0.996), while Rater 3 exhibited slightly lower yet robust reliability (ICCs: 0.921–0.976). Inter-rater agreement was high between Raters 1 and 2 but decreased with Rater 3, reflecting the influence of experience (ICCs: 0.812–0.912). Bone age was underestimated in preschool children (mean difference: 3.712 mos.; 95% CI: 1.290–6.130; p = 0.199) and school-age males (mean difference: 3.978 mos.; 95% CI: −12.550 to 4.590; p = 0.926), with minimal discrepancies in females. In teenagers, the Tanner–Whitehouse 3 method slightly overestimated bone age (mean difference: −0.360 mos.; 95% CI: −0.770 to −0.954; p = 0.299). Conclusions: In conclusion, the Tanner–Whitehouse 3 method demonstrates overall precision and reliability but requires caution, as it underestimates bone age in preschool children and school-age males, while slightly overestimating it in adolescents. Full article

Bone age assessments measure the growth and development of children and adolescents by evaluating their skeletal maturity, which is influenced by various factors like heredity, ethnicity, culture, and nutrition. The clinical standards for this assessment should be up to date and appropriate for the specific population being studied. This study validates the GP-Canary Atlas for accurately predicting bone age by analyzing posteroanterior left hand and wrist radiographs of healthy children (80 females and 134 males) from the Canary Islands across various developmental stages and genders. We found strong intra-rater reliability among all three raters, with Raters 1 and 2 indicating very high consistency (intra-class coefficients = 0.990 to 0.996) and Rater 3 displaying slightly lower but still strong reliability (intra-class coefficients = 0.921 to 0.976). The inter-rater agreement was excellent between Raters 1 and 2 but significantly lower between Rater 3 and the other two raters, with intra-class coefficients of 0.408 and 0.463 for Rater 1 and 0.327 and 0.509 for Rater 2. The accuracy analysis revealed a substantial underestimation of bone age compared to chronological age for preschool- (mean difference = 17.036 months; p < 0.001) and school-age males (mean difference = 13.298 months; p < 0.001). However, this was not observed in females, where the mean difference was minimal (3.949 months; p < 0.239). In contrast, the Atlas showed greater accuracy for teenagers, showing only a slight overestimation (mean difference = 3.159 months; p = 0.823). In conclusion, the GP-Canary Atlas demonstrates overall precision but requires caution as it underestimates the BA in preschool children and overestimates it in school-age girls and adolescents. Full article

Neurotransmission is critical for brain function, allowing neurons to communicate through neurotransmitters and neuropeptides. RVD-hemopressin (RVD-Hp), a novel peptide identified in noradrenergic neurons, modulates cannabinoid receptors CB1 and CB2. Unlike hemopressin (Hp), which induces anxiogenic behaviors via transient receptor potential vanilloid 1 (TRPV1) activation, RVD-Hp counteracts these effects, suggesting that it may block TRPV1. This study investigates RVD-Hp’s role as a TRPV1 channel blocker using HEK293 cells expressing TRPV1-GFP. Calcium imaging and patch-clamp recordings demonstrated that RVD-Hp reduces TRPV1-mediated calcium influx and TRPV1 ion currents. Molecular docking and dynamics simulations indicated that RVD-Hp interacts with TRPV1’s selectivity filter, forming stable hydrogen bonds and van der Waals contacts, thus preventing ion permeation. These findings highlight RVD-Hp’s potential as a therapeutic agent for conditions involving TRPV1 activation, such as pain and anxiety. Full article

Switching elements are crucial components in electrical and electronic systems that undergo severe degradation due to the electrical arc that is generated during breaking. Understanding the behavior of the electrical arc and modifying its characteristics via proper electrode design can significantly improve durability while also promoting optimal performance, reliability, and safety in circuit breakers. This work evaluates the feasibility of carbon nanotube (CNT)-reinforced silver and copper metal matrix composites (MMCs) as switching electrodes and the influence of CNT concentration on the characteristics of the arcs generated. Accordingly, three different concentrations per MMC were manufactured via powder metallurgy. The MMCs and reference materials were subjected to a single break operation and the electrical arcs generated using 100 W and 200 W resistive loads were analyzed. The proposed MMCs displayed promising results for application in low-voltage switches. The addition of CNTs improved performance by maintaining the arc’s energy in the silver MMCs and reducing the arc’s energy in the copper MMCs. Moreover, a CNT concentration of at least 2 wt.% is required to prevent unstable arcs in both metallic matrices. Increased CNT content further promotes the splitting of the electrical arc due to a more complex phase distribution, thereby reducing the arc’s spatial energy density. Full article

The rise in electrification has considerably increased the demand for high-efficiency and durable electrical contact materials. Carbon nanoparticles (CNP) are a promising coating material due to their intrinsic transport properties (thus minimizing the impact on conductivity), their proven solid lubricity (potentially improving tribological performance), and their hydrophobic wetting behavior (potentially providing atmospheric protection). In this study, carbon nanotube and nanohorn coatings are produced via electrophoretic deposition on silver-plated surfaces, followed by tribo-electrical and wetting characterization. The proposed coatings do not negatively affect the conductivity of the substrate, showing resistance values on par with the uncoated reference. Tribo-electrical characterization revealed that the coatings reduce adhesive wear during fretting tests while maintaining stable and constant electrical contact resistance. Furthermore, CNP-coated surfaces show a hydrophobic wetting behavior toward water, with graphite and carbon nanotube (CNT) coatings approaching super-hydrophobicity. Prolonged exposure to water droplets during sessile drop tests caused a reduction in contact angle (CA) measurement; however, CNT coatings’ CA reduction after five minutes was only approximately 5°. Accordingly, CNP (specifically CNT) coatings show auspicious results for their application as wear and atmospheric protective barriers in electrical contacts. Full article

Aim: The aim was to identify, evaluate, and summarize the findings of relevant individual studies on the precision and accuracy of radiological BA assessment procedures among children from different ethnic groups. Materials and Methods: A qualitative systematic review was carried out following the MOOSE statement and previously registered in PROSPERO (CRD42023449512). A search was performed in MEDLINE (PubMed) (n = 561), the Cochrane Library (n = 261), CINAHL (n = 103), Web of Science (WOS) (n = 181), and institutional repositories (n = 37) using MeSH and free terms combined with the Booleans “AND” and “OR”. NOS and ROBINS-E were used to assess the methodological quality and the risk of bias of the included studies, respectively. Results: A total of 51 articles (n = 20,100) on radiological BA assessment procedures were precise in terms of intra-observer and inter-observer reliability for all ethnic groups. In Caucasian and Hispanic children, the Greulich–Pyle Atlas (GPA) was accurate at all ages, but in youths, Tanner–Whitehouse radius–ulna–short bones 3 (TW3-RUS) could be an alternative. In Asian and Arab subjects, GPA and Tanner–Whitehouse 3 (TW3) overestimated the BA in adolescents near adulthood. In African youths, GPA overestimated the BA while TW3 was more accurate. Conclusion: GPA and TW3 radiological BA assessment procedures are both precise but their accuracy in estimating CA among children of different ethnic groups can be altered by racial bias. Full article

Knowledge is limited about the level of bioactive compounds and antioxidant activity of seeds from bred lines of common beans developed from interspecific crosses using four different Phaseolus species (P. vulgaris L., P. coccineus L., P. acutifolius A. Gray. Gray., and P. dumosus). In this study, differences in the nutritional quality of seeds among 112 bean genotypes were evaluated by measuring the levels of phenolic compounds, pigments, antioxidant activity, and sugars. The bean genotypes were grown under high temperatures and acid soil conditions in the Amazon region of Colombia. Five typology groups of bean genotypes were identified based on the level of bioactive compounds and their functional capacity: (1) highly bioactive and functional (HBF); (2) moderately bioactive and functional (MBF); (3) moderate antioxidant content with pigment influence (MACP); (4) moderately antinutritional with limited antioxidant potential (MALAP); and (5) antinutritional, low bioactive, and functional (ALBF). We developed a nutritional quality index (NQI) with values ranging from 0 to 1 based on the nutritional and anti-nutritional balance of each genotype and the higher values of the NQI of a genotype indicating greater nutritional quality. We found three interspecific bred lines (SER 212, SER 213, and RRA 81), with NQI values higher than 0.8. These three lines belong to the typology group of HBF. The superior nutritional quality of these three interspecific bred lines is attributed to a greater level of bioactive compounds and antioxidant capacity. These three bred lines may serve as useful parents to develop nutritionally superior and stress-resilient beans from bean breeding programs. Further research is needed to explore the role of testa color in improving the nutritional quality of seeds of common bean genotypes grown under different climatic conditions. Full article

Carbon nanotube (CNT)-reinforced silver and copper metal matrix composites—at three different reinforcement phase concentrations (0.5 wt.%, 0.75 wt.%, and 1 wt.%)—were produced via powder metallurgy and sintered via hot uniaxial pressing. Optical and electron microscopy techniques were used to characterize the powder mixtures and sintered composites. The latter were also electrically characterized via load-dependent electrical contact resistance (ECR) and surface fatigue tests. Particle size and morphology play a crucial role in CNT deposition onto the metallic powder. CNT were deposited exceptionally well onto the dendritic copper powder regardless of its larger size (compared with the silver flakes) due to the higher surface area caused by the grooves and edges of the dendritic structures. The addition of CNT to the metallic matrices improved their electrical performance, in general outperforming the reference material. Higher CNT concentrations produced consistently low ECR values. In addition, high CNT concentrations (i.e., 1 wt.%) show exceptional contact repeatability due to the elastic restitutive properties of the CNT. The reproducibility of the contact surface was further evaluated by the fatigue tests, where the composites also showed lower ECR than the reference material, rapidly reaching steady-state ECR within the 20 fatigue cycles analyzed. Full article

The second wave of COVID-19 occurred in South America in early 2021 and was mainly driven by Gamma and Lambda variants. In this study, we aimed to describe the emergence and local genomic diversity of the SARS-CoV-2 Lambda variant in Argentina, from its initial entry into the country until its detection ceased. Molecular surveillance was conducted on 9356 samples from Argentina between October 2020 and April 2022, and sequencing, phylogenetic, and phylogeographic analyses were performed. Our findings revealed that the Lambda variant was first detected in Argentina in January 2021 and steadily increased in frequency until it peaked in April 2021, with continued detection throughout the year. Phylodynamic analyses showed that at least 18 introductions of the Lambda variant into the country occurred, with nine of them having evidence of onward local transmission. The spatial–-temporal reconstruction showed that Argentine clades were associated with Lambda sequences from Latin America and suggested an initial diversification in the Metropolitan Area of Buenos Aires before spreading to other regions in Argentina. Genetic analyses of genome sequences allowed us to describe the mutational patterns of the Argentine Lambda sequences and detect the emergence of rare mutations in an immunocompromised patient. Our study highlights the importance of genomic surveillance in identifying the introduction and geographical distribution of the SARS-CoV-2 Lambda variant, as well as in monitoring the emergence of mutations that could be involved in the evolutionary leaps that characterize variants of concern. Full article