Virtual patients using large language models: Scalable, contextualized simulation of clinician-patient dialog with feedback.

Background: Virtual patients (VPs) are computer screen-based simulations of patient-clinician encounters. VP use is limited by cost and low scalability.

Objective: Show proof-of-concept that VPs powered by large language models (LLMs) generate authentic dialogs, accurate representations of patient preferences, and personalized feedback on clinical performance; and explore LLMs for rating dialog and feedback quality.

Migratory birds benefit from urban environments in a highly anthropized Neotropical region.

Land use change from wildlands to urban and productive environments can dramatically transform ecosystem structure and processes. Despite their structural and functional differences from wildlands, human-modified environments offer unique habitat elements for wildlife. In this study, we examined how migratory birds use urban, productive, and wildland environments of a highly anthropized region of Western Mexico known as "El Bajío".

The type of diet consumed during prepuberty modulates plasma cholesterol, hepatic LXRα expression, and DNA methylation and hydroxymethylation during adulthood in male rats.

Childhood obesity increases the risk of developing metabolic diseases in adulthood, since environmental stimuli during critical windows of development can impact on adult metabolic health. Studies demonstrating the effect of prepubertal diet on adult metabolic disease risk are still limited. We hypothesized that a prepubertal control diet (CD) protects the adult metabolic phenotype from diet-induced obesity (DIO), while a high-fat diet (HFD) would predispose to adult metabolic alterations.

Diverse and highly differentiated lava suite in Jezero crater, Mars: Constraints on intracrustal magmatism revealed by Mars 2020 PIXL.

The Jezero crater floor features a suite of related, iron-rich lavas that were examined and sampled by the Mars 2020 rover Perseverance, and whose textures, minerals, and compositions were characterized by the Planetary Instrument for X-ray Lithochemistry (PIXL). This suite, known as the Máaz formation (fm), includes dark-toned basaltic/trachy-basaltic rocks with intergrown pyroxene, plagioclase feldspar, and altered olivine and overlying trachy-andesitic lava with reversely zoned plagioclase phenocrysts in a K-rich groundmass. Feldspar thermal disequilibrium textures indicate that they were carried from their crustal staging area.

Evaluating the performance of a new ergonomic laparoscopic needle holder for intracorporeal suturing.

In laparoscopy, the absence of ergonomics in the instruments affects the performance and efficiency of the surgeon, increasing the likelihood of developing musculoskeletal injuries. This article presents the development of a laparoscopic needle holder with an ergonomic handle and the experience in its use with surgeons in the intracorporeal suturing task. The handle of the laparoscopic needle holder consists of a semi-spherical piece that easily adapts to the palm of the surgeon's hand and improves the posture and ergonomics of the wrist, allowing the direct transmission of rotational movements around the longitudinal axis of the instrument towards the tip.

A pangenome analysis reveals the center of origin and evolutionary history of Phytophthora infestans and 1c clade species.

We examined the evolutionary history of Phytophthora infestans and its close relatives in the 1c clade. We used whole genome sequence data from 69 isolates of Phytophthora species in the 1c clade and conducted a range of genomic analyses including nucleotide diversity evaluation, maximum likelihood trees, network assessment, time to most recent common ancestor and migration analysis. We consistently identified distinct and later divergence of the two Mexican Phytophthora species, P.

Machine learning-driven discovery of structurally related natural products as activators of the cardiac calcium pump SERCA2a.

A key molecular dysfunction in heart failure is the reduced activity of the cardiac sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) in cardiac muscle cells. Reactivating SERCA2a improves cardiac function in heart failure models, making it a validated target and an attractive therapeutic approach for heart failure therapy. However, finding small-molecule SERCA2a activators is challenging.

The Potential Role of Sanguinarine as an Inhibitor of Leishmania PP2C in the Induction of Apoptosis.

Leishmania spp. cause a wide range of human diseases, localized skin lesions, mucocutaneous and visceral infections. In the present study, the aim was to investigate the potential role of sanguinarine as a specific inhibitor of Leishmania PP2C that can induce apoptosis in the parasite.

Immunomodulatory activity of Trypanosoma cruzi recombinant antigen combination TSA-1-C4 and Tc24-C4 induce activation of macrophages and CD8 T cells.

Chagas disease is a chronic infection caused by the protozoan parasite, Trypanosoma cruzi, with limited benefits of the currently available anti-parasitic chemotherapeutic approaches to halt the progression of heart disease. Recombinant TSA-1-C4 and Tc24-C4 proteins have been developed as promising antigen candidates for therapeutic vaccines, leading to propose them in combination as a bivalent recombinant protein strategy. In this study, we evaluated the immunomodulatory effect of the combined TSA-1-C4 and Tc24-C4 recombinant proteins by in vitro assays using murine macrophages.

Morphological and Molecular Characterization of Two Species of Ligophorus (Monogenea: Ancyrocephalidae) in Mullets from the Yucatán Peninsula, with Comments on the Geographical Distribution of L. mediterraneus.

Background: Ligophorus Euzet and Suriano, 1977 is a specious genus of ancyrocephalid monogeneans parasitizing mullets around the world, with most species distributed in the western Pacific and the Mediterranean Sea. Only nine out of the 62 species in the genus have been reported from the Americas, and from them, only two have been sequenced.

Methods: We analyzed two species of Mugil (L.

Human health risk assessment by exposure to contaminants from an urban reservoir: a pilot study in the Madin Dam (México).

Water contamination greatly impacts human health. The Metropolitan Area of the Valley of Mexico (MAVM) is one of the most densely inhabited and polluted places globally, with a significant problem being the rising water demand. The research aims to assess the impact of metals such as iron, aluminum, lead, cadmium, and total chromium, among others, in the water of the Madin Dam, a key reservoir in the area's water supply.

Radiological and anatomical evaluation of the internal venous system in the context of access to the third ventricle - proposal of a new classification.

Background: The internal venous system of the brain is a crucial anatomical landmark during accesses to the third ventricle through the foramen of Monro. Many classifications based on radiological assessment of the system have been developed, but they tend to be descriptive and do not highlight favorable anatomical variants. The aim of our study was to create a system based on morphometric measurements to facilitate preoperative decision-making regarding access to third ventricle tumors.

Relationship assessment of microbial community and cometabolic consumption of 2-chlorophenol.

The relationship of microbial community and cometabolic consumption of 2-chlorophenol (2-CP) in a nitrifying sequencing batch reactor (SBR) was studied. The assessment of the population dynamics of the nitrifying sludge during the cometabolic 2-CP consumption with increasing ammonium (NH) concentrations in the SBR showed the presence of 39 different species of which 10 were always present in all cycles. Fifty-five percent of the species found were grouped as Proteobacteria (45% as β-proteobacteria and 10% as γ-proteobacteria class), 30% as Acidobacteria, and 15% as Deinococcus-Thermus phyla.

Regional challenges to optimize the management of patients with severe asthma type 2 inflammation: a Delphi consensus in seven countries.

Severe asthma burdens patients and presents clinical management challenges for healthcare professionals. Biologics are crucial interventions for severe type two (T2) patients with high eosinophil counts. We conducted a Delphi consensus in seven developing or typically underrepresented countries to understand expert agreement on managing severe asthma with type two (T2) inflammation.

Insights into the Planarization of Benzo-Thianthrene Rings: Relevance of Electronic and Steric Effects with Resulting Aromatic Properties.

Covalent-organic frameworks (COFs) are useful architectures for two- (2D) and three-dimensional (3D) active materials. Recently, the characterization of the nonplanar benzo[5,6][1,4]dithiino[2,3-]thianthrene-6,13-dicarbonitrile (bTEpCN), as a prototypical section of 2D COFs, enables further understanding of the properties on such extended networks. Upon adsorption on the Au(111) surface, planarization of bTEpCN is achieved.

Economic and Clinical Benefits of Bivalent Respiratory Syncytial Virus Prefusion F (RSVpreF) Maternal Vaccine for Prevention of RSV in Infants: A Cost-Effectiveness Analysis for Mexico.

Background/objectives: Respiratory syncytial virus (RSV) is a leading cause of respiratory infections in children. A novel RSVpreF vaccine for use among pregnant women for the prevention of RSV in infants is expected to be licensed in Mexico. Hence, the clinical and economic burden of RSV among infants in Mexico, with and without a year-round RSVpreF maternal vaccination program, was estimated.

Comprehensive Structural, Chemical, and Optical Characterization of CuZnSnS Films on Kapton Using the Automated Successive Ionic Layer Adsorption and Reaction Method.

This study provides a comprehensive structural, chemical, and optical characterization of CZTS thin films deposited on flexible Kapton substrates via the Successive Ionic Layer Adsorption and Reaction (SILAR) method. The investigation explored the effects of varying deposition cycles (40, 60, 70, and 80) and annealing treatments on the films. An X-ray diffraction (XRD) analysis demonstrated enhanced crystallinity and phase purity, particularly in films deposited with 70 cycles.

A Comparison of the Clinical and Epidemiological Profile of Rocky Mountain Spotted Fever with Dengue and COVID-19 in Hospitalized Children, Sonora, México, 2015-2022.

Background: Rocky Mountain spotted fever (RMSF) is a challenge for physicians because the disease can mimic other endemic febrile illnesses, such as dengue and COVID-19. The comparison of their main clinical and epidemiological manifestations in hospitalized children can help identify characteristics that improve empirical suspicion and timely therapeutic interventions.

Methods: A cross-sectional study was conducted on a series of patients aged 0 to 18 years, hospitalized between 2015 and 2022, with a diagnosis of RMSF, dengue, or COVID-19.

Non-Linear Biomechanical Evaluation and Comparison in the Assessment of Three Different Piece Dental Implant Systems for the Molar Region: A Finite Element Study.

The widely available options of different manufacturers in dental implant systems have complicated the selection criteria process for periodontists, necessitating careful consideration of various factors when selecting suitable solutions for individual patient needs. Optimal implant selection requires careful consideration of the patient-specific factors, implant design, and surgical technique. Understanding the biomechanical behavior of implant-tissue interactions is crucial for achieving successful and long-lasting implant therapy.

Preclinical Efficacy and Proteomic Prediction of Molecular Targets for s-cal14.1b and s-cal14.2b Conotoxins with Antitumor Capacity in Xenografts of Malignant Pleural Mesothelioma.

Malignant pleural mesothelioma (MPM) is a rare neoplasm with increasing incidence and mortality rates. Although recent advances have improved the overall prognosis, they have not had an important impact on survival of patients with MPM, such that more effective treatments are needed. Some species of marine snails have been demonstrated to be potential sources of novel anticancer molecules.

Dehydrothyrsiferol Against Cutaneous Leishmaniasis: Treatment Outcome in a Murine Model.

One of the most important steps in preclinical drug discovery is to demonstrate the in vivo efficacy of potential leishmanicidal compounds and good characteristics at the level of parasite killing prior to initiating human clinical trials. This paper describes the use of dehydrothyrsiferol (DT), isolated from the red alga , in a pharmaceutical form supported on Sepigel, and the in vivo efficacy against a mouse model of cutaneous leishmaniasis. Studying the ultrastructural effect of DT was also carried out to verify the suspected damage at the cellular level and determine the severity of damages produced in the homeostasis of promastigotes.

PMT4 Is Involved in -Glycosylation, Cell Wall Organization, Membrane Integrity, and Virulence.

Proteins found within the fungal cell wall usually contain both - and -oligosaccharides. -glycosylation is the process where these oligosaccharides (hereinafter: glycans) are attached to asparagine residues, while in -glycosylation the glycans are covalently bound to serine or threonine residues. The family is grouped into , , and subfamilies.

The Effect of Temperature over the Growth and Biofilm Formation of the Thermotolerant .

is a medically relevant fungus, particularly in tropical regions. Although its aflatoxin production and thermotolerance are well documented, its biofilm-forming ability has received less attention, despite being a key factor in the virulence of as an opportunistic pathogen, which can significantly impact therapeutic outcomes. To investigate the influence of temperature on the growth and biofilm formation of an isolate, we compared it on solid media with the reference strain ATCC 22546 and documented morphological changes during conidial germination.