Exploring the use of ChatGPT in predicting anterior circulation stroke functional outcomes after mechanical thrombectomy: a pilot study.

BACKGROUND: Accurate prediction of functional outcomes is crucial in stroke management, but this remains challenging. OBJECTIVE: To evaluate the performance of the generative language model ChatGPT in predicting the functional outcome of patients with acute ischemic stroke (AIS) 3 months after mechanical thrombectomy (MT) in order to assess whether ChatGPT can used to be accurately predict the modified Rankin Scale (mRS) score at 3 months post-thrombectomy. METHODS: We conducted a retrospective analysis of clinical, neuroimaging, and procedure-related data from 163 patients with AIS undergoing MT. The agreement between ChatGPT's exact and dichotomized predictions and actual mRS scores was assessed using Cohen's κ. The added value of ChatGPT was measured by evaluating the agreement of predicted dichotomized outcomes using an existing validated score, the MT-DRAGON. RESULTS: ChatGPT demonstrated fair (κ=0.354, 95% CI 0.260 to 0.448) and good (κ=0.727, 95% CI 0.620 to 0.833) agreement with the true exact and dichotomized mRS scores at 3 months, respectively, outperforming MT-DRAGON in overall and subgroup predictions. ChatGPT agreement was higher for patients with shorter last-time-seen-well-to-door delay, distal occlusions, and better modified Thrombolysis in Cerebral Infarction scores. CONCLUSIONS: ChatGPT adequately predicted short-term functional outcomes in post-thrombectomy patients with AIS and was better than the existing risk score. Integrating AI models into clinical practice holds promise for patient care, yet refining these models is crucial for enhanced accuracy in stroke management.

The Spider Silk Standardization Initiative (S3I): A powerful tool to harness biological variability and to systematize the characterization of major ampullate silk fibers spun by spiders from suburban Sydney, Australia.

The true stress-true strain curves of 11 Australian spider species from the Entelegynae lineage were tensile tested and classified based on the values of the alignment parameter, α*, in the framework of the Spider Silk Standardization Initiative (S3I). The application of the S3I methodology allowed the determination of the alignment parameter in all cases, and were found to range between α* = 0.03 and α* = 0.65. These data, in combination with previous results on other species included in the Initiative, were exploited to illustrate the potential of this approach by testing two simple hypotheses on the distribution of the alignment parameter throughout the lineage: (1) whether a uniform distribution may be compatible with the values obtained from the studied species, and (2) whether any trend may be established between the distribution of the α* parameter and phylogeny. In this regard, the lowest values of the α* parameter are found in some representatives of the Araneidae group, and larger values seem to be found as the evolutionary distance from this group increases. However, a significant number of outliers to this apparent general trend in terms of the values of the α* parameter are described.

Fish fauna of the São Francisco River Interbasin Water Transfer reservoirs / Ictiofauna dos reservatórios do Projeto de Integração do Rio São Francisco

Abstract Artificial impoundments are frequently built to mitigate the water scarcity in the drylands such as the Caatinga region in Brazil. The São Francisco Interbasin Water Transfer (SF-IWT) megaproject implemented many artificial reservoirs for that purpose. A checklist of fish species from the SF-IWT reservoirs is provided based on samples from eight years of monitoring. The collections were conducted semiannually at 28 reservoirs divided into three groups: the East Axis, North Axis, and Agreste Branch. The SF-IWT reservoirs presented a total of 47 species, 46 were recorded in the North Axis, 27 in the East Axis, and only seven in the Agreste Branch. Characids and cichlids represented most of the species. The three analyzed groups of reservoirs presented distinct communities and the reservoirs' age, richness and abundance were relevant variables responsible for fish composition. The SF-IWT reservoirs present a diverse and heterogeneous ichthyofauna, typical of lentic environments. The main colonizers of the SF-IWT reservoirs were fish from the São Francisco donor basin, invasive species anthropically released in those sites, and eventual species from the surrounding receiving basins. As the accumulation curves suggested, a continuous effort could reveal additional species, patterns in long-term colonization, and contribute to data on the reservoirs' future stabilization phase. Since invasive species were present in most reservoirs, along with donor-basin native species with potential to disperse to the receiving basins, a continuous and detailed monitoring is key for management planning and possible impacts assessment.

Resumo Barramentos artificiais são comumente construídos para mitigar a escassez hídrica em áreas semiáridas como a região da Caatinga brasileira. O Projeto de Integração do Rio São Francisco (PISF) com Bacias Hidrográficas do Nordeste Setentrional implementou muitos reservatórios artificiais com este propósito. Uma lista de espécies de peixes dos reservatórios do PISF foi obtida após amostragens realizadas em oito anos de monitoramento. As campanhas foram realizadas semestralmente em 28 reservatórios divididos em três grupos: Eixo Leste, Eixo Norte e Ramal do Agreste. Os reservatórios amostrados apresentaram um total de 47 espécies, 46 delas foram registradas no Eixo Norte, 27 no Eixo Leste e apenas sete no Ramal do Agreste. Characidae e Cichlidae foram as famílias mais representativas. Os três grupos de reservatórios analisados apresentaram comunidades distintas e a idade, a riqueza e a abundância de cada reservatório foram as variáveis que mais influenciaram a composição das espécies de peixes. Os reservatórios do PISF apresentaram uma ictiofauna diversa e heterogênea, característica de ambientes lênticos. Os principais colonizadores dos reservatórios do PISF foram peixes da bacia doadora do São Francisco, espécies invasoras antropicamente liberadas nesses locais e eventuais espécies das bacias receptoras do entorno. De acordo com o resultado das curvas de acúmulo, um esforço contínuo poderia revelar espécies adicionais, padrões na colonização em longo prazo e contribuir com dados para a fase futura de estabilização dos reservatórios. Visto que espécies invasoras estiveram presentes em quase todos os reservatórios, juntamente com espécies nativas da bacia doadora com potencial de dispersão para as bacias receptoras, um monitoramento continuo e detalhado é essencial para o planejamento de manejo e avaliação de impactos.

Strategies for the Biofunctionalization of Straining Flow Spinning Regenerated Bombyx mori Fibers.

High-performance regenerated silkworm (Bombyx mori) silk fibers can be produced efficiently through the straining flow spinning (SFS) technique. In addition to an enhanced biocompatibility that results from the removal of contaminants during the processing of the material, regenerated silk fibers may be functionalized conveniently by using a range of different strategies. In this work, the possibility of implementing various functionalization techniques is explored, including the production of fluorescent fibers that may be tracked when implanted, the combination of the fibers with enzymes to yield fibers with catalytic properties, and the functionalization of the fibers with cell-adhesion motifs to modulate the adherence of different cell lineages to the material. When considered globally, all these techniques are a strong indication not only of the high versatility offered by the functionalization of regenerated fibers in terms of the different chemistries that can be employed, but also on the wide range of applications that can be covered with these functionalized fibers.

Unexpected high toughness of Samia cynthia ricini silk gut.

Silk gut fibers were produced from the silkworm Samia cynthia ricini silk glands by the usual procedure of immersion in a mildly acidic solution and subsequent stretching. The morphology of the silk guts was assessed by scanning electron microscopy, and their microstructure was assessed by infrared spectroscopy and X-ray diffraction. It was found that both naturally spun and Samia silk guts share a common semicrystalline microstructure. The mechanical characterization of the silk guts revealed that these fibers show an elastomeric behavior when tested in water, and exhibit a genuine ground state to which the fiber may revert independently of its previous loading history. In spite of its large cross-sectional area compared with naturally spun silk fibers, Samia silk guts show values of work to fracture up to 160 MJ m-3, much larger than those of most of their natural counterparts, and establish a new record value for this parameter in silk guts.

Contaminated Incubators: Source of a Multispecies Enterobacter Outbreak of Neonatal Sepsis.

The genus Enterobacter includes species responsible for nosocomial outbreaks in fragile patients, especially in neonatal intensive care units (NICUs). Determining the primary source of infection is critical to outbreak management and patient outcomes. In this investigation, we report the management and control measures implemented during an Enterobacter outbreak of bloodstream infections in premature babies. The study was conducted in a French NICU over a 3-year period (2016 to 2018) and included 20 premature infants with bacteremia. The clinical and microbiological characteristics were identified, and whole-genome sequencing (WGS) was performed on bacteremia isolates. Initially, several outbreak containment strategies were carried out with no success. Next, outbreak investigation pinpointed the neonatal incubators as the primary reservoir and source of contamination in this outbreak. A new sampling methodology during "on" or "in use" conditions enabled its identification, which led to their replacement, thus resulting in the containment of the outbreak. WGS analysis showed a multiclonal outbreak. Some clones were identified in different isolation sources, including patients and neonatal incubators. In addition, microbiological results showed a multispecies outbreak with a high prevalence of Enterobacter bugandensis and Enterobacter xiangfangensis. We conclude that the NICU health care environment represents an important reservoir for Enterobacter transmission and infection. Finally, extracting samples from the neonatal incubator during active use conditions improves the recovery of bacteria from contaminated equipment. This method should be used more frequently to achieve better monitoring of the NICU for HAIs prevention. IMPORTANCE Neonatal incubators in the NICU can be an important reservoir of pathogens responsible for life-threatening outbreaks in neonatal patients. Traditional disinfection with antiseptics is not sufficient to eradicate the microorganisms that can persist for long periods in the different reservoirs. Identification and elimination of the reservoirs are crucial for outbreak prevention and control. In our investigation, using a new strategy of microbiological screening of neonatal incubators, we demonstrated that these were the primary source of contamination. After their replacement, the outbreak was controlled. This new methodology was effective in containing this outbreak and could be a viable alternative for infection prevention and control in outbreak situations involving incubators as a reservoir.

Delayed Bleeding in a Hemophilic Patient After Sinus Floor Elevation and Multiple Implant Placements: A Case Report.

Dental treatments in hemophilic patients are challenging, and the absence of adequate preparation for the procedures can be life-threatening. This letter describes a delayed postoperative bleeding after multiple dental implants with sinus floor elevation in a patient with mild hemophilia A.

dnaJ: a New Approach to Identify Species within the Genus Enterobacter.

The taxonomy of the genus Enterobacter can be confusing and has been considerably revised in recent years. We propose a PCR and amplicon sequencing technique based on a partial sequence of the dnaJ gene for species assignment consistent with DNA-DNA digital hybridization (dDDH) and pairwise average nucleotide identity (ANI). We performed a validation of the method by comparing the type strains of each species, sequences obtained from the GenBank database, and clinical specimens. Our results show that the polymorphism of the target sequence of dnaJ allows the identification of species. Using this gene, we assigned the species to 100 strains deposited in the GenBank database that were consistent with the species assignment by dDDH and ANI. The analysis showed that using the partial dnaJ sequence is congruent with WGS as far as correct identification of Enterobacter species is concerned. Finally, we applied our dnaJ method on a national collection of 68 strains identified as Enterobacter isolated from the blood cultures of premature babies using an algorithm based on a type-strain library and the SeqScape software. For the first time, we identified Enterobacter quasihormaechei in blood cultures from four neonatal sepsis cases. We also noticed a higher prevalence of E. bugandensis (36.3%; 32/88) and E. xiangfangensis (46.5%; 41/88). E. bugandensis is a novel species recently described specifically in instances of neonatal sepsis. In conclusion, sequencing a part of the dnaJ gene could be a quick, more economical, and highly discriminating method of identifying Enterobacter species in clinical practice and research. IMPORTANCE We propose a new approach for Enterobacter species identification based on the diversity of the gene encoding the heat shock protein DnaJ. This new tool can be easily implemented in clinical laboratories in addition to identification by MALDI-TOF.

Urban Intersection Classification: A Comparative Analysis.

Understanding the scene in front of a vehicle is crucial for self-driving vehicles and Advanced Driver Assistance Systems, and in urban scenarios, intersection areas are one of the most critical, concentrating between 20% to 25% of road fatalities. This research presents a thorough investigation on the detection and classification of urban intersections as seen from onboard front-facing cameras. Different methodologies aimed at classifying intersection geometries have been assessed to provide a comprehensive evaluation of state-of-the-art techniques based on Deep Neural Network (DNN) approaches, including single-frame approaches and temporal integration schemes. A detailed analysis of most popular datasets previously used for the application together with a comparison with ad hoc recorded sequences revealed that the performances strongly depend on the field of view of the camera rather than other characteristics or temporal-integrating techniques. Due to the scarcity of training data, a new dataset is created by performing data augmentation from real-world data through a Generative Adversarial Network (GAN) to increase generalizability as well as to test the influence of data quality. Despite being in the relatively early stages, mainly due to the lack of intersection datasets oriented to the problem, an extensive experimental activity has been performed to analyze the individual performance of each proposed systems.

CAPformer: Pedestrian Crossing Action Prediction Using Transformer.

Anticipating pedestrian crossing behavior in urban scenarios is a challenging task for autonomous vehicles. Early this year, a benchmark comprising JAAD and PIE datasets have been released. In the benchmark, several state-of-the-art methods have been ranked. However, most of the ranked temporal models rely on recurrent architectures. In our case, we propose, as far as we are concerned, the first self-attention alternative, based on transformer architecture, which has had enormous success in natural language processing (NLP) and recently in computer vision. Our architecture is composed of various branches which fuse video and kinematic data. The video branch is based on two possible architectures: RubiksNet and TimeSformer. The kinematic branch is based on different configurations of transformer encoder. Several experiments have been performed mainly focusing on pre-processing input data, highlighting problems with two kinematic data sources: pose keypoints and ego-vehicle speed. Our proposed model results are comparable to PCPA, the best performing model in the benchmark reaching an F1 Score of nearly 0.78 against 0.77. Furthermore, by using only bounding box coordinates and image data, our model surpasses PCPA by a larger margin (F1=0.75 vs. F1=0.72). Our model has proven to be a valid alternative to recurrent architectures, providing advantages such as parallelization and whole sequence processing, learning relationships between samples not possible with recurrent architectures.

Presence of 2-hydroxymyristate on endotoxins is associated with death in neonates with Enterobacter cloacae complex septic shock.

Enterobacter cloacae complex species are involved in infections among critically ill patients. After a recent E.cloacae outbreak of fulminant neonatal septic shock, we conducted a study to determine whether septic shock severity and its lethal consequence are related to structural features of the endotoxin (lipopolysaccharide [LPS]) of the strains isolated from hospitalized infants and more specifically its lipid A region. It appeared that the LPSs are very heterogeneous, carrying fifteen different molecular species of lipid A. The virulence was correlated with a structural feature identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and gas chromatography coupled with mass spectrometry: the presence of 2-hydroxymyristic acid as a secondary substituent in lipid A. This is the first published evidence linking LPS structural moiety to neonatal sepsis outcome and opens the possibility of using this fatty acid marker as a detection tool for high-risk patients, which could help reduce their mortality.

Vehicle Localization Using 3D Building Models and Point Cloud Matching.

Detecting buildings in the surroundings of an urban vehicle and matching them to building models available on map services is an emerging trend in robotics localization for urban vehicles. In this paper, we present a novel technique, which improves a previous work by detecting building façade, their positions, and finding the correspondences with their 3D models, available in OpenStreetMap. The proposed technique uses segmented point clouds produced using stereo images, processed by a convolutional neural network. The point clouds of the façades are then matched against a reference point cloud, produced extruding the buildings' outlines, which are available on OpenStreetMap (OSM). In order to produce a lane-level localization of the vehicle, the resulting information is then fed into our probabilistic framework, called Road Layout Estimation (RLE). We prove the effectiveness of this proposal, testing it on sequences from the well-known KITTI dataset and comparing the results concerning a basic RLE version without the proposed pipeline.

Novel bendable abutments as a solution to correct unfavorable implant inclination. A clinical report.

OBJECTIVE: This clinical case report describes a novel bendable abutment as a prosthetic solution for implants presenting with an unfavorable inclination. CLINICAL CONSIDERATIONS: A metal-ceramic screw-retained single crown was made on this novel bendable abutment in a patient presenting with a pronounced buccal inclination of an implant. A plastic reference guide is used to define the correct inclination and then this inclination is transferred to the abutment using a specific bending device at the same appointment. CONCLUSIONS: Bendable abutments can be used as a solution to correct unfavorable implant inclinations. This abutment can be customized at the same appointment considering a case-specific inclination rather than conventional pre-angled abutments. CLINICAL SIGNIFICANCE: Bendable abutments can be customized according to each case specificities while conventional pre-angled abutments may not be adequate for all patients. Also, the abutment customization could be easily done by dentists at their own practices using a specific bending device with hand pressure only, saving time, and the need to order pre-angled abutments or having it in stock.

Experimentações estéticas: o cuidado de si, do outro e do ambiente em que vivemos / Apropiaciones sociopoéticas: experimentaciones estéticas del cuidado sociopoetics / Aesthetic trials: taking care of oneself, of the other and of the environment in which we live

Objective: To present intervention research developed by the authors in the form of artistic and educational activities, called aesthetic experiments, analyzing them and their effects as a practical-theoretical set directed themselves, each other and the environment. Methods: It was built from the authors’ experience with research practices inspired by studies of The Three Ecologies and socialpoetics methodology, being used in the analysis face-to-face writing of the participants during the workshop and the answers to the questions sent by e-mail. Results: They point to the overcoming of inner fears and the discovery of personal potential to face challenges. The sensibility of the gaze and the involvement with the other as a fundamental element in the exercise of confidence in daily relationships. Conclusion: The experimentation process indicates that there is a power of the meeting, the exchange and sensibility when we privilege knowledge that is learned with the body in motion, relating to the other and the world.

Objetivo: apresentar a pesquisa-intervenção desenvolvida pelos autores em forma de atividades artísticopedagógicas, denominadas experimentações estéticas, analisando-as e seus efeitos enquanto conjunto práticoteórico voltado ao cuidado de si, do outro e do ambiente. Métodos: Construído a partir da experiência dos autores com práticas de pesquisa inspiradas nos estudos sobre as três ecologias e na metodologia sociopoética, sendo utilizada na análise a escrita presencial dos participantes durante as oficinas e as respostas deles às questões enviadas por e-mail. Resultados: Apontam para a superação dos medos internos e a descoberta das potencialidades pessoais para enfrentar desafios. A sensibilidade do olhar e o envolvimento com o outro como elemento fundamental no exercício de confiança das relações cotidianas. Conclusão: O processo de experimentação indica que existe uma potência do encontro, dos intercâmbios e da sensibilidade quando privilegiamos um conhecimento que se apreende com o corpo em movimento, relacionando-se com o outro e o mundo.

Objetivo: presentar la investigación-intervención desarrollada por los autores en forma de actividades artísticas y educativas, llamadas experimentos estéticos, analizandolos y a sus efectos enquanto um conjunto práctico-teórico dirigido al cuidado de sí, de los demás y de El medio ambiente. Métodos: Construido a partir de la experiencia de lós autores con las prácticas de investigación inspirados en los estudios sobre los tres ecologías y en metodología Sociopoética, siendo utilizados em el análisis los registros por escrito de los participantes durante el taller y las respuestas a las preguntas enviadas por e-mail. Resultados: indica la superación de los miedos internos y el descubrimiento del potencial personal para enfrentar los desafíos. La sensibilidad del ojo y la implicación con el otro como un elemento fundamental en el ejercicio de la confianza de las relaciones cotidianas. Conclusión: El proceso de experimentación indica que hay una potencia de lo encuentro, de lo intercambio y de La sensibilidad cuándo es privilegiado un conocimiento que se aprende com el cuerpo en movimiento, en relación con los demás y el mundo.

Pediatric Multiple Sclerosis in Portugal: A Multicentre Study.

INTRODUCTION: Multiple sclerosis is most often diagnosed among young adults but less frequently it may present during childhood or adolescence. In Portugal, there has been only one previous single-center, pediatric multiple sclerosis study. The main objective was the evaluation of the demographic, clinical, laboratorial and neuroradiological characteristics of patients with pediatric-onset multiple sclerosis in Portugal. The secondary objectives were to compare the characteristics of childhood-onset multiple sclerosis and adolescent-onset multiple sclerosis and to characterize the treatments prescribed. MATERIAL AND METHODS: We performed a retrospective observational, multicentric study. We reviewed data of all patients with multiple sclerosis younger than 18 years at the onset of their first multiple sclerosis symptoms. RESULTS: There were 46 patients (72% female) included with a mean age at diagnosis of 16.1 years. Six cases had childhood-onset and 40 cases had adolescence-onset. The median value of Expanded Disability Status Scale was two. Relapsing-remitting multiple sclerosis was most prevalent (98% of cases). In the cerebrospinal fluid study, 74% of patients had positive oligoclonal bands. Brain magnetic resonance imaging studies showed a predominant supratentorial involvement (98% of cases), whereas the cervical segment was the most frequently affected in the spinal cord. All the patients enrolled in the study underwent immunomodulatory therapy, 75% ofpatients with beta-interferon. Concerning differences between the childhood and the adolescent groups, we found a greater proportion of male patients and of individuals with cerebrospinal fluid pleocytosis among the childhood-onset group. DISCUSSION: This study provides new data on pediatric multiple sclerosis characteristics in Portugal and our results are similar to previously reported data in other parts of the worldConclusion: This is the first multicentric study characterizing pediatric multiple sclerosis in Portugal. The mechanisms underlying the particularities of pediatric multiple sclerosis remain largely unknown and further studies are required.

Introdução: A esclerose múltipla é habitualmente diagnosticada em adultos jovens mas, mais raramente, pode manifestar-se durante a infância ou adolescência. Os dados sobre a esclerose múltipla pediátrica em Portugal são escassos. O objectivo principal deste estudo é a avaliação das características demográficas, clínicas, laboratoriais e neurorradiológicas da esclerose múltipla de início em idade pediátrica em Portugal. Os objetivos secundários consistem na comparação entre a esclerose múltipla de início na infância e a esclerose múltipla de início na adolescência e na caracterização dos tratamentos prescritos. Material e Métodos: Realizou-se um estudo retrospectivo, observacional e multicêntrico, que consistiu na análise dos dados de todos os doentes com apresentação da EM antes dos 18 anos. Resultados: Incluíram-se 46 doentes (72% do sexo feminino), com uma idade média de diagnóstico de 16,1 anos. Seis casos tiveram início na infância, 40 na adolescência. A esclerose múltipla apresentou-se em 98% dos casos com a forma surto-remissão. O estudo do líquor revelou bandas oligoclonais em 74% dos doentes. A ressonância magnética encefálica mostrou predominantemente lesões supratentoriais (98% dos casos), enquanto que a ressonância medular revelou que o segmento cervical foi o mais frequentemente afectado. Todos os doentes iniciaram terapêutica imunomoduladora (75% com interferão ß). Relativamente às diferenças entre os dois grupos etários, encontrámos uma maior proporção de doentes do sexo masculino e com pleocitose no grupo com apresentação na infância. Discussão: Este trabalho fornece novos dados sobre as características da esclerose múltipla pediátrica em Portugal e os resultados são semelhantes aos reportados em outras partes do mundo. Conclusão: Este é o primeiro estudo multicêntrico português sobre a esclerose múltipla com apresentação na infância e adolescência. Mais estudos são necessários para clarificar os mecanismos subjacentes às particularidades da esclerose múltipla pediátrica.

Lost in dissociation: The main paradigms in unconscious cognition.

Contemporary studies in unconscious cognition are essentially founded on dissociation, i.e., on how it dissociates with respect to conscious mental processes and representations. This is claimed to be in so many and diverse ways that one is often lost in dissociation. In order to reduce this state of confusion we here carry out two major tasks: based on the central distinction between cognitive processes and representations, we identify and isolate the main dissociation paradigms; we then critically analyze their key tenets and reported findings.

Parachordal fistula--a case report and a short review.

Arteriovenous shunts of the neck and facial region rarely involve the external carotid artery and its branches. Most cases are considered to be iatrogenic or related to trauma but congenital shunts are rare. Parachordal arteriovenous fistulae are a group of embryologically derived arteriovenous shunts caused by defects involving the notochord, giving rise to cranial and paraspinal shunts. In the cranial regions, these shunts involve exclusively the metameric arteries--maxillary, ascending pharyngeal, occipital and vertebral. Signs and symptoms are variable, depending on the feeding vessel but also on the characteristics of the draining pathway. We report the case of a 17-year-old male patient with a shunt between the right internal maxillary artery and right external jugular vein detected at the age of 6, not associated with trauma, which we decided to treat because of an enlargement of the right cardiac atrium detected on routine examination. Digital subtraction angiography was performed to characterize the shunt followed by partial embolization with ballooning, coiling and Onyx injection. Echographic control 6 months after the procedure was compatible with complete occlusion of the shunt. We also perform a short review on this extremely rare entity.