Conformity of ChatGPT recommendations with the AUA/SUFU guideline on postprostatectomy urinary incontinence.

INTRODUCTION: Artificial intelligence (AI) shows immense potential in medicine and Chat generative pretrained transformer (ChatGPT) has been used for different purposes in the field. However, it may not match the complexity and nuance of certain medical scenarios. This study evaluates the accuracy of ChatGPT 3.5 and 4 in providing recommendations regarding the management of postprostatectomy urinary incontinence (PPUI), considering The Incontinence After Prostate Treatment: AUA/SUFU Guideline as the best practice benchmark. MATERIALS AND METHODS: A set of questions based on the AUA/SUFU Guideline was prepared. Queries included 10 conceptual questions and 10 case-based questions. All questions were open and entered into the ChatGPT with a recommendation to limit the answer to 200 words, for greater objectivity. Responses were graded as correct (1 point); partially correct (0.5 point), or incorrect (0 point). Performances of versions 3.5 and 4 of ChatGPT were analyzed overall and separately for the conceptual and the case-based questions. RESULTS: ChatGPT 3.5 scored 11.5 out of 20 points (57.5% accuracy), while ChatGPT 4 scored 18 (90.0%; p = 0.031). In the conceptual questions, ChatGPT 3.5 provided accurate answers to six questions along with one partially correct response and three incorrect answers, with a final score of 6.5. In contrast, ChatGPT 4 provided correct answers to eight questions and partially correct answers to two questions, scoring 9.0. In the case-based questions, ChatGPT 3.5 scored 5.0, while ChatGPT 4 scored 9.0. The domains where ChatGPT performed worst were evaluation, treatment options, surgical complications, and special situations. CONCLUSION: ChatGPT 4 demonstrated superior performance compared to ChatGPT 3.5 in providing recommendations for the management of PPUI, using the AUA/SUFU Guideline as a benchmark. Continuous monitoring is essential for evaluating the development and precision of AI-generated medical information.

Endothelial cells require functional FLVCR1a during developmental and adult angiogenesis.

The Feline Leukemia Virus Subgroup C Receptor 1a (FLVCR1a) is a transmembrane heme exporter essential for embryonic vascular development. However, the exact role of FLVCR1a during blood vessel development remains largely undefined. Here, we show that FLVCR1a is highly expressed in angiogenic endothelial cells (ECs) compared to quiescent ECs. Consistently, ECs lacking FLVCR1a give rise to structurally and functionally abnormal vascular networks in multiple models of developmental and pathologic angiogenesis. Firstly, zebrafish embryos without FLVCR1a displayed defective intersegmental vessels formation. Furthermore, endothelial-specific Flvcr1a targeting in mice led to a reduced radial expansion of the retinal vasculature associated to decreased EC proliferation. Moreover, Flvcr1a null retinas showed defective vascular organization and loose attachment of pericytes. Finally, adult neo-angiogenesis is severely affected in murine models of tumor angiogenesis. Tumor blood vessels lacking Flvcr1a were disorganized and dysfunctional. Collectively, our results demonstrate the critical role of FLVCR1a as a regulator of developmental and pathological angiogenesis identifying FLVCR1a as a potential therapeutic target in human diseases characterized by aberrant neovascularization.

Two Spinning Black Holes Balanced by Their Synchronized Scalar Hair.

General relativity minimally coupled to a massive, free, complex scalar field, is shown to allow asymptotically flat solutions, nonsingular on and outside the event horizon, describing two spinning black holes (2sBHs) in equilibrium, with coaxial, aligned angular momenta. The 2sBHs configurations bifurcate from solutions describing dipolar spinning boson stars. The BHs emerge at equilibrium points diagnosed by a test particle analysis and illustrated by a Newtonian analog. The individual BH "charges" are mass and angular momentum only. Equilibrium is due to the scalar environment, acting as a (compact) dipolar field, providing a lift against their mutual attraction, making the 2sBHs (h)airborne. We explore the 2sBHs domain of solutions and its main features.

Clinical and Urodynamic results of the Argus T® sling in moderate and severe male stress urinary incontinence after radical prostatectomy - a 5 year prospective study.

PURPOSE: Sling as a therapeutic option for male stress urinary incontinence (SUI) has been reviewed in the last two decades, as it is a relatively simpliest surgery compared to artificial urinary sphincter and has the ability to modulate urethral compression. This study aims to evaluate the efficacy, rate of complications, quality of life and the effects on bladder emptying of the Argus T® compressive and ajustable sling in moderate and severe male SUI treatment. MATERIALS AND METHODS: Men eligible for stress urinary incontinence treatment after radical prostatectomy were recruited and prospectively evaluated, from March 2010 to November 2016. It was selected outpatient men with moderate and severe SUI, after 12 months of radical prostatectomy, who have failed conservative treatment. All patients had a complete clinical and urodynamic pre and post treatment evaluation, by means of clinical history, physical examination, urine culture, 1-hour pad test and ICIq-SF questionnaire. The UDS was performed after 12, 18 and 24 months postoperatively. RESULTS: Thirty-seven men underwent sling surgery, 19 patients (51.4%) with moderate and 18 (48.6%) with severe SUI. The minimum follow-up time was 5 years. Overall, we had a success rate of 56.7% at 60 months follow-up. After surgery, we did not observe significant changes in the urodynamic parameters evaluated during the follow-up. No patient had urodynamic bladder outlet obstruction (BOO) after sling implantation. Readjustment of the Argus T® sling was performed in 16 (41%) of the patients and 51% of the patients reported some adverse event. CONCLUSION: We demonstrate a long-term efficacy and safety of Sling Argus T® as an alternative to moderate and severe male SUI treatment. Furthermore, in our study bulbar urethra compression does not lead to bladder outlet obstruction.

Type I multivariate zero-inflated COM-Poisson regression model.

In this paper, we present the Type I multivariate zero-inflated Conway-Maxwell-Poisson distribution, whose development is based on the extension of the Type I multivariate zero-inflated Poisson distribution. We developed important properties of the distribution and present a regression model. The AIC and BIC criteria are used to select the best fitted model. Two real data sets have been used to illustrate the proposed model. Moreover, we conclude by stating that the Type I multivariate zero-inflated Conway-Maxwell-Poisson distribution produces a better fitted model for multivariate count data with excess of zeros.

Spin-Induced Scalarized Black Holes.

It was recently shown that a scalar field suitably coupled to the Gauss-Bonnet invariant G can undergo a spin-induced linear tachyonic instability near a Kerr black hole. This instability appears only once the dimensionless spin j is sufficiently large, that is, j≳0.5. A tachyonic instability is the hallmark of spontaneous scalarization. Focusing, for illustrative purposes, on a class of theories that do exhibit this instability, we show that stationary, rotating black hole solutions do indeed have scalar hair once the spin-induced instability threshold is exceeded, while black holes that lie below the threshold are described by the Kerr solution. Our results provide strong support for spin-induced black hole scalarization.

Polydopamine nanofilms for high-performance paper-based electrochemical devices.

Since the discovery of polydopamine (PDA), there has been a lot of progress on using this substance to functionalize many different surfaces. However, little attention has been given to prepare functionalized surfaces for the preparation of flexible electrochemical paper-based devices. After fabricating the electrodes on paper substrates, we formed PDA on the surface of the working electrode using a chemical polymerization route. PDA nanofilms on carbon were characterized by contact angle (CA) experiments, X-ray photoelectron spectroscopy, scanning electron microscopy, atomic force microscopy (topography and electrical measurements) and electrochemical techniques. We observed that PDA introduces chemical functionalities (RNH2 and RC═O) that decrease the CA of the electrode. Moreover, PDA nanofilms did not block the heterogeneous electron transfer. In fact, we observed one of the highest standard heterogeneous rate constants (ks ) for electrochemical paper-based electrodes (2.5 ± 0.1) × 10-3  cm s-1 , which is an essential parameter to obtain larger currents. In addition, our results suggest that carbonyl functionalities are ascribed for the redox activity of the nanofilms. As a proof-of-concept, the electrooxidation of nicotinamide adenine dinucleotide showed remarkable features, such as, lower oxidation potential, electrocatalytic peak currents more than 30 times higher when compared to unmodified paper-based electrodes and electrocatalytic rate constant (kobs ) of (8.2 ± 0.6) × 102  L mol-1  s-1 .

Robotic rectal surgery: Outcomes of the first 102 totally robotic cases handled using the single-docking technique in a reference institution.

BACKGROUND AND OBJECTIVE: Rectal cancer is often surgically treated, but it is still associated with morbidity rates. Minimally invasive techniques are increasingly being used to reduce complications, and the use of such techniques can be found in the literature. This study aims to report our experience in a reference oncology center. METHODS: A retrospective cohort study was performed on a prospective database of patients who underwent robotic surgery for rectal cancer using the single-docking technique from September 2014 to April 2018. Clinical and surgical variables, as well as morbidity and mortality rates, were analyzed. RESULTS: One hundred and two patients underwent robotic surgery. Intraoperative complications occurred in six patients (4.9%), and postoperative complications in 24 patients (23.5%), of which anastomotic fistula represented 3.9%. The conversion rate was 1.96%. Two cases (1.9%) faced death within 30 days. The median length of hospitalization was 3 days. The median number of lymph nodes dissected was 15. Clinical and surgical data were correlated with postoperative complications, and no statistically significant differences were found. CONCLUSION: Robotic surgery is a safe and feasible approach to manage rectal cancer. The method presents satisfactory results with regard to the rate of operative complications, conversion rate, oncologic outcomes, and length of hospitalization.

A photoelectrochemical enzyme biosensor based on functionalized hematite microcubes for rutin determination by square-wave voltammetry.

A photoelectrochemical biosensing strategy for the highly sensitive detection of the flavonoid rutin was developed by synergizing the photoelectrocatalytic properties of hematite (α-Fe2O3) decorated with palladium nanoparticles (PdNPs) and the biocatalysis towards laccase-based reactions. The integration of α-Fe2O3.PdNPs with a polyphenol oxidase as a biorecognition element yields a novel biosensing platform. Under visible light irradiation, the photoactive biocomposite can generate a stable photocurrent, which was found to be directly dependent upon the concentration of rutin. Under the optimal experimental conditions, the cathodic photocurrent, measured at 0.33 V vs. Ag/AgCl, from the square-wave voltammograms presented a linear dependence on the rutin concentration within the range of 0.008-30.0 × 10-8 mol L-1 (sensitivity: 1.7 µA·(× 10-8 M-1)·cm-2), with an experimental detection limit (S/N = 3) of 8.4 × 10-11 mol L-1. The proposed biosensor device presented good selectivity towards rutin in the presence of various organic compounds and inorganic ions, demonstrating the potential application of this biosensing platform in complex matrices. This bioanalytical device also exhibited excellent operational and analytical properties, such as intra-day (standard deviation, SD = 0.21%) and inter-day (SD = 1.30%) repeatability, and long storage stability (SD = 2.80% over 30 days).Graphical abstract.

Stationary Black Holes and Light Rings.

The ringdown and shadow of the astrophysically significant Kerr black hole (BH) are both intimately connected to a special set of bound null orbits known as light rings (LRs). Does it hold that a generic equilibrium BH must possess such orbits? In this Letter we prove the following theorem. A stationary, axisymmetric, asymptotically flat black hole spacetime in 1+3 dimensions, with a nonextremal, topologically spherical, Killing horizon admits, at least, one standard LR outside the horizon for each rotation sense. The proof relies on a topological argument and assumes C^{2} smoothness and circularity, but makes no use of the field equations. The argument is also adapted to recover a previous theorem establishing that a horizonless ultracompact object must admit an even number of nondegenerate LRs, one of which is stable.

Spontaneously Scalarized Kerr Black Holes in Extended Scalar-Tensor-Gauss-Bonnet Gravity.

We construct asymptotically flat, spinning, regular on and outside an event horizon, scalarized black holes (SBHs) in extended scalar-tensor-Gauss-Bonnet models. They reduce to Kerr BHs when the scalar field vanishes. For an illustrative choice of nonminimal coupling, we scan the domain of existence. For each value of spin, SBHs exist in an interval between two critical masses, with the lowest one vanishing in the static limit. Non-uniqueness with Kerr BHs of equal global charges is observed; the SBHs are entropically favoured. This suggests that SBHs form dynamically from the spontaneous scalarization of Kerr BHs, which are prone to a scalar-triggered tachyonic instability, below the largest critical mass. Phenomenologically, the introduction of BH spin damps the maximal observable difference between comparable scalarized and vacuum BHs. In the static limit, (perturbatively stable) SBHs can store over 20% of the spacetime energy outside the event horizon; in comparison with Schwarzschild BHs, their geodesic frequency at the ISCO can differ by a factor of 2.5 and deviations in the shadow areal radius may top 40%. As the BH spin grows, low mass SBHs are excluded, and the maximal relative differences decrease, becoming of the order of a few percent for dimensionless spin j≳0.5. This reveals a spin selection effect: non-GR effects are only significant for low spin. We discuss if and how the recently measured shadow size of the M87 supermassive BH constrains the length scale of the Gauss-Bonnet coupling.

Spontaneous Scalarization of Charged Black Holes.

Extended scalar-tensor Gauss-Bonnet (ESTGB) gravity has been recently argued to exhibit spontaneous scalarization of vacuum black holes (BHs). A similar phenomenon can be expected in a larger class of models, which includes, e.g., Einstein-Maxwell scalar (EMS) models, where spontaneous scalarization of electrovacuum BHs should occur. EMS models have no higher curvature corrections, a technical simplification over ESTGB models that allows us to investigate, fully nonlinearly, BH scalarization in two novel directions. First, numerical simulations in spherical symmetry show, dynamically, that Reissner-Nordström (RN) BHs evolve into a perturbatively stable scalarized BH. Second, we compute the nonspherical sector of static scalarized BH solutions bifurcating from the RN BH trunk. Scalarized BHs form an infinite (countable) number of branches and possess a large freedom in their multipole structure. Unlike the case of electrovacuum, the EMS model admits static, asymptotically flat, regular on and outside the horizon BHs without spherical symmetry and even without any spatial isometries, which are thermodynamically preferred over the electrovacuum state. We speculate on a possible dynamical role of these nonspherical scalarized BHs.

Ticks (Acari: Ixodidae) of the state of Amazonas, Brazil.

The tick fauna of Brazil is currently composed by 72 species. The state of Amazonas is the largest of Brazil, with an area of ≈ 19% of the Brazilian land. Besides its vast geographic area, only 19 tick species have been reported for Amazonas. Herein, lots containing ticks from the state of Amazonas were examined in three major tick collections from Brazil. A total of 5933 tick specimens were examined and recorded, comprising 2693 males, 1247 females, 1509 nymphs, and 484 larvae. These ticks were identified into the following 22 species: Amblyomma cajennense sensu lato, Amblyomma calcaratum, Amblyomma coelebs, Amblyomma dissimile, Amblyomma dubitatum, Amblyomma geayi, Amblyomma goeldii, Amblyomma humerale, Amblyomma latepunctatun, Amblyomma longirostre, Amblyomma naponense, Amblyomma oblongoguttatum, Amblyomma ovale, Amblyomma rotundatum, Amblyomma scalpturatum, Amblyomma varium, Dermacentor nitens, Haemaphysalis juxtakochi, Ixodes cf. Ixodes fuscipes, Ixodes luciae, Rhipicephalus microplus, Rhipicephalus sanguineus sensu lato. Ticks were collected from 17 (27.4%) out of the 62 municipalities that currently compose the state of Amazonas. The following four species are reported for the first time in the state of Amazonas: A. coelebs, A. dubitatum, H. juxtakochi, and Ixodes cf. I. fuscipes. The only tick species previously reported for Amazonas and not found in the present study is Amblyomma parvum. This study provides a great expansion of geographical and host records of ticks for the state of Amazonas, which is now considered to have a tick fauna composed by 23 species. It is noteworthy that we report 1391 Amblyomma nymphs that were identified to 13 different species.

Dynamical Formation of Kerr Black Holes with Synchronized Hair: An Analytic Model.

East and Pretorius have successfully evolved, using fully nonlinear numerical simulations, the superradiant instability of the Kerr black hole (BH) triggered by a massive, complex vector field. Evolutions terminate in stationary states of a vector field condensate synchronized with a rotating BH horizon. We show that these end points are fundamental states of Kerr BHs with synchronized Proca hair. Motivated by the "experimental data" from these simulations, we suggest a universal (i.e., field-spin independent), analytic model for the subset of BHs with synchronized hair that possess a quasi-Kerr horizon, applicable in the weak hair regime. Comparing this model with fully nonlinear numerical solutions of BHs with a synchronized scalar or Proca hair, we show that the model is accurate for hairy BHs that may emerge dynamically from superradiance, whose domain we identify.

Light-Ring Stability for Ultracompact Objects.

We prove the following theorem: axisymmetric, stationary solutions of the Einstein field equations formed from classical gravitational collapse of matter obeying the null energy condition, that are everywhere smooth and ultracompact (i.e., they have a light ring) must have at least two light rings, and one of them is stable. It has been argued that stable light rings generally lead to nonlinear spacetime instabilities. Our result implies that smooth, physically and dynamically reasonable ultracompact objects are not viable as observational alternatives to black holes whenever these instabilities occur on astrophysically short time scales. The proof of the theorem has two parts: (i) We show that light rings always come in pairs, one being a saddle point and the other a local extremum of an effective potential. This result follows from a topological argument based on the Brouwer degree of a continuous map, with no assumptions on the spacetime dynamics, and, hence, it is applicable to any metric gravity theory where photons follow null geodesics. (ii) Assuming Einstein's equations, we show that the extremum is a local minimum of the potential (i.e., a stable light ring) if the energy-momentum tensor satisfies the null energy condition.

Static Einstein-Maxwell Black Holes with No Spatial Isometries in AdS Space.

We explicitly construct static black hole solutions to the fully nonlinear, D=4, Einstein-Maxwell-anti-de Sitter (AdS) equations that have no continuous spatial symmetries. These black holes have a smooth, topologically spherical horizon (section), but without isometries, and approach, asymptotically, global AdS spacetime. They are interpreted as bound states of a horizon with the Einstein-Maxwell-AdS solitons recently discovered, for appropriate boundary data. In sharp contrast to the uniqueness results for a Minkowski electrovacuum, the existence of these black holes shows that single, equilibrium, black hole solutions in an AdS electrovacuum admit an arbitrary multipole structure.

Clinical characteristics of women diagnosed with carcinoma who tested positive for cervical and anal high-risk human papillomavirus DNA and E6 RNA.

High-risk human papillomavirus (hrHPV) is an essential cause of cervical carcinoma and is also strongly related to anal cancer development. The hrHPV E6 oncoprotein plays a major role in carcinogenesis. We aimed to evaluate the frequency of hrHPV DNA and E6 oncoprotein in the anuses of women with cervical carcinoma. We analyzed 117 women with cervical cancer and 103 controls for hrHPV and the E6 oncogene. Positive test results for a cervical carcinoma included 66.7 % with hrHPV-16 and 7.7 % with hrHPV-18. One case tested positive for both HPV variants (0.9 %). The samples from the anal canal were positive for HPV-16 in 59.8 % of the cases. Simultaneous presence of HPV in the cervix and anal canal was found in 53.8 % of the cases. Regarding expression of E6 RNA, positivity for HPV-16 in the anal canal was found in 21.2 % of the cases, positivity for HPV-16 in the cervix was found in 75.0 %, and positivity for HPV-18 in the cervix was found in 1.9 %. E6 expression in both the cervix and anal canal was found in 19.2 % of the cases. In the controls, 1 % tested positive for HPV-16 and 0 % for HPV-18. Anal samples from the controls showed a hrHPV frequency of 4.9 % (only HPV16). The presence of hrHPV in the anal canal of women with cervical cancer was detected at a high frequency. We also detected E6 RNA expression in the anal canal of women with cervical cancer, suggesting that these women are at risk for anal hrHPV infection.

Shadows of Kerr Black Holes with Scalar Hair.

Using backwards ray tracing, we study the shadows of Kerr black holes with scalar hair (KBHSH). KBHSH interpolate continuously between Kerr BHs and boson stars (BSs), so we start by investigating the lensing of light due to BSs. Moving from the weak to the strong gravity region, BSs-which by themselves have no shadows-are classified, according to the lensing produced, as (i) noncompact, which yield not multiple images, (ii) compact, which produce an increasing number of Einstein rings and multiple images of the whole celestial sphere, and (iii) ultracompact, which possess light rings, yielding an infinite number of images with (we conjecture) a self-similar structure. The shadows of KBHSH, for Kerr-like horizons and noncompact BS-like hair, are analogous to, but distinguishable from, those of comparable Kerr BHs. But for non-Kerr-like horizons and ultracompact BS-like hair, the shadows of KBHSH are drastically different: novel shapes arise, sizes are considerably smaller, and multiple shadows of a single BH become possible. Thus, KBHSH provide quantitatively and qualitatively new templates for ongoing (and future) very large baseline interferometry observations of BH shadows, such as those of the Event Horizon Telescope.

Kerr black holes with scalar hair.

We present a family of solutions of Einstein's gravity minimally coupled to a complex, massive scalar field, describing asymptotically flat, spinning black holes with scalar hair and a regular horizon. These hairy black holes (HBHs) are supported by rotation and have no static limit. Besides mass M and angular momentum J, they carry a conserved, continuous Noether charge Q measuring the scalar hair. HBHs branch off from the Kerr metric at the threshold of the superradiant instability and reduce to spinning boson stars in the limit of vanishing horizon area. They overlap with Kerr black holes for a set of (M, J) values. A single Killing vector field preserves the solutions, tangent to the null geodesic generators of the event horizon. HBHs can exhibit sharp physical differences when compared to the Kerr solution, such as J/M^{2}>1, a quadrupole moment larger than J^{2}/M, and a larger orbital angular velocity at the innermost stable circular orbit. Families of HBHs connected to the Kerr geometry should exist in scalar (and other) models with more general self-interactions.

Effects of spin-orbit coupling on the Berezinskii-Kosterlitz-Thouless transition and the vortex-antivortex structure in two-dimensional Fermi gases.

We investigate the Berezinskii-Kosterlitz-Thouless (BKT) transition in a 2D Fermi gas with spin-orbit coupling (SOC), as a function of the two-body binding energy and a perpendicular Zeeman field. By including a generic form of the SOC, as a function of Rashba and Dresselhaus terms, we study the evolution between the experimentally relevant equal Rashba-Dresselhaus (ERD) case and the Rashba-only (RO) case. We show that in the ERD case, at a fixed nonzero Zeeman field, the BKT transition temperature T(BKT) is increased by the presence of SOC for all values of the binding energy. We also find a significant increase in the value of the Clogston limit compared to the case without SOC. Furthermore, we demonstrate that the superfluid density tensor becomes anisotropic (except in the RO case), leading to an anisotropic phase-fluctuation action that describes elliptic vortices and antivortices, which become circular in the RO limit. This deformation constitutes an important experimental signature for superfluidity in a 2D Fermi gas with ERD SOC. Finally, we show that the anisotropic sound velocities exhibit anomalies at low temperatures, in the vicinity of quantum phase transitions between topologically distinct uniform superfluid phases.