Humans Continue to Outperform Large Language Models in Complex Clinical Decision-Making: A Study with Medical Calculators.

Although large language models (LLMs) have been assessed for general medical knowledge using medical licensing exams, their ability to effectively support clinical decision-making tasks, such as selecting and using medical calculators, remains uncertain. Here, we evaluate the capability of both medical trainees and LLMs to recommend medical calculators in response to various multiple-choice clinical scenarios such as risk stratification, prognosis, and disease diagnosis. We assessed eight LLMs, including open-source, proprietary, and domain-specific models, with 1,009 question-answer pairs across 35 clinical calculators and measured human performance on a subset of 100 questions.

Demystifying Large Language Models for Medicine: A Primer.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices.

A Novel Dynamic Growth Rod Inducing Spinal Growth Modulation for the Correction of Spinal Deformities.

Background: Growth rods are the gold standard for treating early-onset scoliosis (EOS). However, current treatments with growth rods do not optimize spinal growth in EOS patients, and frequent distraction surgeries significantly increase complications, imposing considerable economic and psychological burdens on patients. An improved growth rod is urgently required to address the need for dynamic growth and external regulation.

The Role of Ultrasonography in Diagnosing and Managing Sialolithiasis: A Case Report and Literature Review.

Sialolith-induced obstructive sialadenitis is a commonly encountered clinical scenario, yet the variations in the size and location of the stone can complicate immediate clinical assessment. Utilizing dynamic ultrasound imaging along with specific structural markers can provide valuable, immediate objective evidence in diagnosing submandibular sialolithiasis. This initial ultrasound evaluation streamlines the decision-making process by facilitating the timely scheduling of confirmatory computed tomography scans and guiding subsequent surgical interventions.

A new species of Zonstein, 1987 (Araneae, Nemesiidae) from Fujian, China.

Background: The genus Zonstein, 1987 comprises 66 species, distributed across regions from East Asia to the Caucasus, with about 20 species recorded from China. According to Zonstein et al. (2018) and Zonstein (2024), members of can be identified by the presence of two to three retroventral megaspines arranged sequentially on tibia I in males and paired spermathecae in females, each bearing two-branched heads or a lateral diverticulum.

Optimal Timing and Approaches for First Tangential Excision in Patients with ≥70% TBSA Burns: Insights from a Retrospective Cohort of a Mass Casualty Incident.

Objective: We aim to determine the optimal timing and approaches for first tangential excision of severely burned patients ≥70% total body surface area (TBSA).

Background: Early tangential excision is the gold-standard surgical therapy for full-thickness burns. However, there are debates about its optimal timing and approaches for severely burned patients ≥70%TBSA.

Selective Crystallization Separation of Uranium(VI) Complexes from Lanthanides.

The limited availability of uranium (U) resources poses significant challenges to the advancement of nuclear energy. Recycling uranium from spent fuel is critical, but the coexistence of lanthanides (Ln) complicates the extraction process significantly. Here, we present an N/O ligand, ()-'-(pyridin-2-ylmethylene) picolinohydrazide (), designed for the selective recovery of U(VI) over Ln(III/IV) in acidic environments.

A novel small-molecule fluorescent probe caused by minimal structural modifications for specific staining of the cell nuclear membrane.

The nuclear membrane is a double-layered structure that physically protects the cell's DNA from the chemical reactions occurring in other parts of the cell. In this study, we present the first brand-new small-molecule fluorescent probe that selectively stains the nuclear membrane, allowing for the visualization of nuclear morphology without interfering with the DNA's activity.

Correction: Silver(I)-iodine cluster with efficient thermally activated delayed fluorescence and suppressed concentration quenching.

Correction for 'Silver(I)-iodine cluster with efficient thermally activated delayed fluorescence and suppressed concentration quenching' by Xiao Li , , 2025, https://doi.org/10.1039/d4dt02855d.

Nonvolatile Magnonics in Bilayer Magnetic Insulators.

Nonvolatile control of spin order or spin excitations offers a promising avenue for advancing spintronics; however, practical implementation remains challenging. In this Letter, we propose a general framework to realize electrical control of magnons in 2D magnetic insulators. We demonstrate that in bilayer ferromagnetic insulators with strong spin-layer coupling, the electric field can effectively manipulate the spin exchange interactions between the layers, enabling nonvolatile control of the corresponding magnons.

Properties of the major Zn-binding site of human alpha-fetoprotein, a potential foetal plasma zinc carrier.

The foetal plasma protein α-fetoprotein (AFP) harbours a high-affinity zinc binding site that is likely involved in transport and delivery of essential zinc during foetal development. Based on a recent electron microscopy structure of AFP and aided by biophysical studies on an AFP-derived peptide, we present a refined 5-coordinate model for this site.

Steady state and transient absorption spectroscopy in metal halide perovskites.

Metal halide perovskites (MHPs) have emerged as the most promising materials due to superior optoelectronic properties and great applications spanning from photovoltaics to photonics. Absorption spectroscopy provides a broad and deep insight into the carrier dynamics of MHPs, and is a critical complement to fluorescence and scattering spectroscopy. However, absorption spectroscopy is often misunderstood or underestimated, being seen as UV-vis spectroscopy only, which can lead to various misinterpretations.

Monomeric or Homodimer Conjugates of Fibroblast Activation Protein Inhibitor and Cyanine 7 Bearing a Meso-Chloride as Near-Infrared Fluorescence Probes: Design, Synthesis, and Comparative Imaging of Distinct Breast Cancer Subtypes.

Intraoperative fluorescence navigation can illuminate the tumor, directing surgeons to accurately achieve negative margins, which not only reduces recurrence but also minimizes the incidence of complications. Herein, we developed two near-infrared fluorescent probes (Em = 820 nm) and (Em = 823 nm) with prolonged tumor retention (>72 h) and high target-to-background ratios (up to 4.5) based on the conjugation of pan-cancer targeted fibroblast activation protein inhibitor (FAPI) and the "tumor-seeking" Cyanine 7 bearing a meso-chloride and a cyclohexenyl skeleton (Cy7-Cl).

Anti-atherosclerotic effects of LncRNA NEXN-AS1 by regulation of the canonical inflammasome pathway of pyroptosis via NEXN.

Introduction: . Pyroptosis is closely related to many chronic diseases including atherosclerosis, but the potential pathomechanisms are still unclear. This research aimed to explore how lncRNAs may contribute to pyroptosis and the potential mechanisms.

Multiple Electron Transfers Enable High-Capacity Cathode Through Stable Anionic Redox.

Single-electron transfer, low alkali metal contents, and large-molecular masses limit the capacity of cathodes. This study uses a cost-effective and light-molecular-mass orthosilicate material, KFeSiO, with a high initial potassium content, as a cathode for potassium-ion batteries to enable the transfer of more than one electron. Despite the limited valence change of Fe ions during cycling, KFeSiO can undergo multiple electron transfers via successive oxygen anionic redox reactions to generate a high reversible capacity.

Pretargeted Multimodal Tumor Imaging by Enzymatic Self-Immobilization Labeling and Bioorthogonal Reaction.

Covalent modification of cell membranes has shown promise for tumor imaging and therapy. However, existing membrane labeling techniques face challenges such as slow kinetics and poor selectivity for cancer cells, leading to off-target effects and suboptimal efficacy. Here, we present an enzyme-triggered self-immobilization labeling strategy, termed E-SIM, which enables rapid and selective labeling of tumor cell membranes with bioorthogonal trans-cycloctene (TCO) handles .

Permeable, Stretchable, and Recyclable Cellulose Aerogel On-Skin Electronics for Dual-Modal Sensing and Personal Healthcare.

Flexible on-skin electronics present tremendous popularity in intelligent electronic skins (e-skins), healthcare monitoring, and human-machine interfaces. However, the reported e-skins can hardly provide high permeability, good stretchability, and large sensitivity and are limited in long-term stability and efficient recyclability when worn on the human body. Herein, inspired from the human skin, a permeable, stretchable, and recyclable cellulose aerogel-based electronic system is developed by sandwiching a screen-printed silver sensing layer between a biocompatible CNF/HPC/PVA (cellulose nanofiber/hydroxypropyl cellulose/poly(vinyl alcohol)) aerogel hypodermis layer and a permeable polyurethane layer as the epidermis layer.

Hybrid Repair of Ascending Aortic Intramural Hematoma and Arch Ulcer in a 74-Year-Old Woman - A Case Report.

BACKGROUND Acute intramural hematoma (IMH) of the ascending thoracic aorta and aortic arch is a life-threatening condition, particularly in elderly patients with comorbidities, due to its risk of progression and rupture. Unlike aortic dissection, IMH lacks an intimal tear, influencing both clinical presentation and treatment strategy. This report describes a 74-year-old hypertensive woman with type A IMH and a penetrating atherosclerotic ulcer (PAU), managed with a hybrid surgical approach that combines external Dacron wrapping of the ascending aorta and endovascular stenting of the aortic arch with in-situ fenestration of the supra-aortic arteries.

Mechanism, Performance, and Application of g-CN-Coupled TiO as an S-Scheme Heterojunction Photocatalyst for the Abatement of Gaseous Benzene.

In this research, S-scheme heterojunction photocatalysts are prepared through the hybridization of nitrogen-rich g-CN with TiO (coded as TCN-(): as the weight ratio of TiO:g-CN). The photocatalytic potential of TCN-() is evaluated against benzene (1-5 ppm) across varying humidity levels using a dynamic flow packed-bed photocatalytic reactor. Among the prepared composites, TCN-(10) exhibits the highest synergy between g-CN and TiO at "" ratio of 10%, showing superior best benzene degradation performance (e.

Infections Due to Corynebacterium kroppenstedtii With Focus on Granulomatous Lobular Mastitis for Tissue Specificity, Pathogenesis, Bacteriologic Workup, and Treatment.

Objective.—: To report the isolation and significance of C kroppenstedtii, features of patients with GLM, pathologic findings and mechanism, bacteriologic workup, and optimal treatment.

Design.

Deep learning in integrating spatial transcriptomics with other modalities.

Spatial transcriptomics technologies have been extensively applied in biological research, enabling the study of transcriptome while preserving the spatial context of tissues. Paired with spatial transcriptomics data, platforms often provide histology and (or) chromatin images, which capture cellular morphology and chromatin organization. Additionally, single-cell RNA sequencing (scRNA-seq) data from matching tissues often accompany spatial data, offering a transcriptome-wide gene expression profile of individual cells.

Correlation between paraspinal muscle fat infiltration and thoracic vertebral degeneration based on phantom-less QCT: a novel insight into thoracic vertebral degeneration.

Purpose: This study aimed to elucidate the correlation between the degree of fat infiltration (FI) in thoracic paraspinal muscles and thoracic vertebral degeneration (TVD).

Methods: This cross-sectional study comprised 474 patients who underwent standard thoracic computed tomography (CT) scans. The FI was quantified as the percentage of adipose tissues within the cross-sectional area of thoracic paraspinal muscles.

Characteristics and recovery trends of severe TBI patients with a favorable functional outcome at 6-month follow-up.

Traumatic Brain Injury (TBI) is a devastating cause of death and disability. Outcomes following TBI have been extensively studied; however, less attention has been given to identifying characteristics of individuals who have a favorable outcome following severe TBI. We conducted a retrospective analysis of a database containing information on TBI patients admitted to a level 1 trauma center between 2015 and 2021.

Application of double-needle bi-direction barbed sutures in laparoscopic common bile duct suture: a propensity score matching analysis.

Laparoscopic exploration of the common bile duct (CBD) has emerged as a predominant method in hepatobiliary surgery owing to its minimally invasive nature and favorable outcomes compared to traditional open surgery. Suturing the CBD during laparoscopic procedures is critical for ensuring proper bile drainage and reducing postoperative complications. This retrospective study enrolled patients who underwent laparoscopic exploration of the CBD for choledocholithiasis at the Wujin Hospital Affiliated with Jiangsu University between January 2016 and December 2023.

Resurgence of common respiratory viruses and mycoplasma pneumoniae after ending the zero-COVID policy in Shanghai.

China has adhered to policies of zero-COVID for almost three years since the outbreak of COVID-19, which has remarkably affected the circulation of respiratory pathogens. However, China has begun to end the zero-COVID policies in late 2022. Here, we reported a resurgence of common respiratory viruses and Mycoplasma pneumoniae with unique epidemiological characteristics among children after ending the zero-COVID policy in Shanghai, China, 2023.