Assessing the applicability and appropriateness of ChatGPT in answering clinical pharmacy questions.

OBJECTIVES: Clinical pharmacists rely on different scientific references to ensure appropriate, safe, and cost-effective drug use. Tools based on artificial intelligence (AI) such as ChatGPT (Generative Pre-trained Transformer) could offer valuable support. The objective of this study was to assess ChatGPT's capacity to correctly respond to clinical pharmacy questions asked by healthcare professionals in our university hospital. MATERIAL AND METHODS: ChatGPT's capacity to respond correctly to the last 100 consecutive questions recorded in our clinical pharmacy database was assessed. Questions were copied from our FileMaker Pro database and pasted into ChatGPT March 14 version online platform. The generated answers were then copied verbatim into an Excel file. Two blinded clinical pharmacists reviewed all the questions and the answers given by the software. In case of disagreements, a third blinded pharmacist intervened to decide. RESULTS: Documentation-related issues (n=36) and drug administration mode (n=30) were preponderantly recorded. Among 69 applicable questions, the rate of correct answers varied from 30 to 57.1% depending on questions type with a global rate of 44.9%. Regarding inappropriate answers (n=38), 20 were incorrect, 18 gave no answers and 8 were incomplete with 8 answers belonging to 2 different categories. No better answers than the pharmacists were observed. CONCLUSIONS: ChatGPT demonstrated a mitigated performance in answering clinical pharmacy questions. It should not replace human expertise as a high rate of inappropriate answers was highlighted. Future studies should focus on the optimization of ChatGPT for specific clinical pharmacy questions and explore the potential benefits and limitations of integrating this technology into clinical practice.

Sum decomposition of Mueller-matrix images and spectra of beetle cuticles.

Spectral Mueller matrices measured at multiple angles of incidence as well as Mueller matrix images are recorded on the exoskeletons (cuticles) of the scarab beetles Cetonia aurata and Chrysina argenteola. Cetonia aurata is green whereas Chrysina argenteola is gold-colored. When illuminated with natural (unpolarized) light, both species reflect left-handed and near-circularly polarized light originating from helicoidal structures in their cuticles. These structures are referred to as circular Bragg reflectors. For both species the Mueller matrices are found to be nondiagonal depolarizers. The matrices are Cloude decomposed to a sum of non-depolarizing matrices and it is found that the cuticle optical response, in a first approximation can be described as a sum of Mueller matrices from an ideal mirror and an ideal circular polarizer with relative weights determined by the eigenvalues of the covariance matrices of the measured Mueller matrices. The spectral and image decompositions are consistent with each other. A regression-based decomposition of the spectral and image Mueller matrices is also presented whereby the basic optical components are assumed to be a mirror and a circular polarizer as suggested by the Cloude decomposition. The advantage with a regression decomposition compared to a Cloude decomposition is its better stability as the matrices in the decomposition are determined a priori. The origin of the depolarizing features are discussed but from present data it is not possible to conclude whether the two major components, the mirror and the circular polarizer are laterally separated in domains in the cuticle or if the depolarization originates from the intrinsic properties of the helicoidal structure.

Genotype-phenotype correlations in fetuses and neonates with autosomal recessive polycystic kidney disease.

The prognosis of autosomal recessive polycystic kidney disease is known to correlate with genotype. The presence of two truncating mutations in the PKHD1 gene encoding the fibrocystin protein is associated with neonatal death while patients who survive have at least one missense mutation. To determine relationships between genotype and renal and hepatic abnormalities we correlated the severity of renal and hepatic histological lesions to the type of PKHD1 mutations in 54 fetuses (medical pregnancy termination) and 20 neonates who died shortly after birth. Within this cohort, 55.5% of the mutations truncated fibrocystin. The severity of cortical collecting duct dilatations, cortical tubule and glomerular lesions, and renal cortical and hepatic portal fibrosis increased with gestational age. Severe genotypes, defined by two truncating mutations, were more frequent in patients of less than 30 weeks gestation compared to older fetuses and neonates. When adjusted to gestational age, the extension of collecting duct dilatation into the cortex and cortical tubule lesions, but not portal fibrosis, was more prevalent in patients with severe than in those with a non-severe genotype. Our results show the presence of two truncating mutations of the PKHD1 gene is associated with the most severe renal forms of prenatally detected autosomal recessive polycystic kidney disease. Their absence, however, does not guarantee survival to the neonatal period.

Process optimization of the integrated synthesis and secretion of ectoine and hydroxyectoine under hyper/hypo-osmotic stress.

The synthesis and secretion of the industrial relevant compatible solutes ectoine and hydroxyectoine using the halophile bacterium Chromohalobacter salexigens were studied and optimized. For this purpose, a cascade of two continuously operated bioreactors was used. In the first bioreactor, cells were grown under constant hyperosmotic conditions and thermal stress driving the cells to accumulate large amounts of ectoines. To enhance the overall productivity, high cell densities up to 61 g L(-1) were achieved using a cross-flow ultrafiltration connected to the first bioreactor. In the coupled second bioreactor the concentrated cell broth was subjected to an osmotic and thermal down-shock by addition of fresh distilled water. Under these conditions, the cells are forced to secrete the accumulated intracellular ectoines into the medium to avoid bursting. The cultivation conditions in the first bioreactor were optimized with respect to growth temperature and medium salinity to reach the highest synthesis (productivity); the second bioreactor was optimized using a multi-objective approach to attain maximal ectoine secretion with simultaneous minimization of cell death and product dilution caused by the osmotic and thermal down-shock. Depending on the cultivation conditions, intracellular ectoine and hydroxyectoine contents up to 540 and 400 mg per g cell dry weight, respectively, were attained. With a maximum specific growth rate of 0.3 h(-1) in defined medium, productivities of approximately 2.1 g L(-1) h(-1) secreted ectoines in continuous operation were reached.

Supratentorial parenchyma in the developing fetal brain: in vitro MR study with histologic comparison.

PURPOSE: To assess the in vitro MR signal of the developing brain through histologic comparisons. METHODS: Five healthy fetal specimens aged 16, 19, 22, 27, and 34 gestational weeks were studied in vitro using T1- and T2-weighted sequences in frontal and axial planes. Neuropathologic studies included sections in the same frontal plane. Comparison of histologic sections with measurements of the relative widths of the layers of different signal intensities enabled us to assign cellular correspondence to each MR layer. RESULTS: In the cerebral mantle, a layered pattern was observed on both T1- and T2-weighted images. In the basal ganglia, signal from the pallidum and thalamus was isointense with white matter from 16 to 22 weeks' gestation; then, from 27 and 34 weeks' gestation, the signal was relatively high on T1-weighted images and low on T2-weighted images. The neostriatum had a relatively low signal on T1-weighted images and a high signal on T2-weighted images from 16 to 27 weeks' gestation: then, at 34 weeks' gestation, the signal was relatively high on T1-weighted images and low on T2-weighted images. CONCLUSION: MR imaging can clearly show specific patterns of growing fetal brain in vitro.

Pathologic and laboratory correlation in microcephaly associated with prenatal cocaine exposure.

The Authors report a case where cocaine abuse during pregnancy assessed by drug analysis at various site was associated with foetal microcephaly. Foetal pathologic findings revealed anomalies in neuronal migration and in the vascular architecture in the brain. Such anomalies might be the result of prolonged exposure to cocaine in utero, aggravated by the high concentration of cocaine metabolites in the amniotic fluid over a prolonged period.

[Prenatal MRI of corpus callosum agenesis. Study of 20 cases with neuropathological correlations]. / IRM anténatale des agénésies calleuses. Etude de 20 cas avec corrélations neuropathologiques.

Twenty prenatal MR studies of corpus callosum agenesis were retrospectively studied and compared with neuropathologic examinations (18) or postnatal imaging (2). Corpus callosum agenesis were either complete (14) or partial (6). Positive diagnosis was made in 19 cases/20. The diagnosis of "isolated" or "associated" corpus callosum agenesis was assessed in 11 cases/15. MR depicted 15 of the 33 associated neurologic abnormalities. Prenatal MR is a valuable complementary technique for the diagnosis of corpus callosum agenesis when sonography is doubtful. MR could improve prognosis evaluation, since it enables depiction of associated abnormalities, notably gyral abnormalities, posterior fossa malformations, and intra-cranial cysts. MR images prove to be useful before neuropathologic examinations.

[Genetics of first polar body]. / Génétique du premier globule polaire.

The development of FISH and ART identified aneuploidy in polar body. The presence of these oocyte abnormalities conducts to implantation failure. The aim of the new technique is to select the best oocyte by complete chromosome analysis, and study of second polar body.

[Gene expression profile of human cumulus cells: clinical applications for IVF]. / Etude génomique des cellules du cumulus: applications cliniques en FIV.

Genes expression profile of cumulus cells which surrounds oocyte correlated to different outcomes, allowing the identification of a specific expression signature of embryos developing towards pregnancy. Interestingly, genes in cumulus samples resulting in a successful pregnancy were predominantly up-regulated, including BCL2L11 and PCK1, respectively involved in apoptosis and gluconeogenesis. Some genes were nevertheless found down regulated in cumulus cells associated with a good pregnancy outcome, such as the transcription factor NFIB.

[Mitochondria and oocyte maturation]. / Mitochondrie et maturation ovocytaire.

Mitochondria play a central role in cellular energy metabolism. Mitochondrial genome (mtDNA) is specific with a maternal transmission. Defects of mtDNA, both quantitative (depletion) but also qualitative (mutation) were observed in patients with reproductive disorders, suggesting that a mitochondrial deficit could cause a failure of oocyte maturation. In our experience, some mtDNA point mutations would be subject to negative selection during female gametogenesis, with a threshold rate depending on the mutation. Below this threshold, the presence of mtDNA mutations would not impact oocyte maturation nor early embryonic development, as evidenced by the large number of oocytes and embryos carrying high mutation rates in our series.

[Cytogenetics of human spermatozoa: which interest?]. / Cytogénétique du spermatozoïde: quel intérêt?

Incidence of aneuploidy in human spermatozoa could be detected by various methods for precise indications. Taking in consideration this aneuploidy rate could optimize the ICSI prognosis and genetic counselling.

[IMSI: indications, results and reflexions]. / IMSI: indication, résultats et réflexions.

The presence of nuclear vacuoles in human sperm decreases pregnancy rates. Intracytoplasmic morphologically selected sperm injection (ISMI) increases pregnancy rate rather than ICSI after real time fine morphology of motile human sperm (MSOME). However, the exact indications of IMSI are on debate.

[Embryonnary metabolomics]. / Métabolomique embryonnaire.

Non invasive methods to assess embryo quality become essential in ART. Non invasive proteomic and metabolomic analysis of protein expression (secretome) try to identify novel biomarkers of development and viability of human embryo.

[Role of toxic factors in the fecundity of the couple]. / Le rôle des facteurs toxiques dans la fertilité du couple.

There are numerous toxic factors in environment that can influence fecundity, without forgetting behaviour toxins as medicaments, tobacco, alcohol, cannabis. These mailmen will have an influence in the course of the Medical care in Procreation, some of them diminish the chances of success; it is necessary to spot risk factors and to act as a precautionary measure to ameliorate the fecundity of the couple and results in AMP.

[Last morphological selection]. / Implantation et choix de l'embryon. Sélection morphologique ultime.

Selection criteria for embryo transfer is an essential step in ART. Evaluation of pronuclear morphology, evaluation of zygote, embryo cleavage, quality of blastomeres predict the viability of embryos. Multinucleation in cleavage stage embryos is associated with a lower implantation and pregnancy rate.

[Quality of transfer. Biologist and clinician's point of view]. / Qualité du transfert. Point de vue du biologiste et du clinicien.

Embryonic transfer is one of the briefest procedures in the long-lasting chain of events occurring during an infertility treatment. Embryo transfer is, however, one of the most crucial steps in assisted reproductive technologies. The realization of this ultimate gesture involves the control of numerous parameters that exert an impact on its success. These various influential factors engage the multidisciplinary team: biologist, clinician... to permanently search for ways to optimize embryo transfer outcome.

[Secrets of proportions in follicular liquid]. / Les secrets des dosages dans le liquide folliculaire.

Only 5% of oocytes lead to life birth after IVF. Currently, it is difficult to evaluate oocyte quality on the sole basis of morphology criteria. Embryo morphology is considered as a good marker of potential implantation of embryo after ET, however it is not enough. Therefore, we need to develop non invasive assessment of oocyte quality. Research performed on follicular fluid may represent a new tool of increasing interest. The presence of G-CSF in follicular fluid could predict ongoing pregnancy. Cytokines, IL-7 and IL-17 could be also a predictor of success.

[Fragmentation and/or decondensation of spermatic DNA: which consequences?]. / Fragmentation et/ou décondensation de l'ADN spermatique: quelles conséquences?

Absence of DNA fragmentation and/or decondensation is a marker of sperm quality and is related to outcome of assisted reproductive techniques: new tests have been set up to determine fragmentation rate.

[Influence of paternal age]. / Influence de l'âge paternel.

Father's age increase miscarriage, malformation, risk of autism, schizophrenia, and bipolar troubles in children.