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In this study, we present a novel swarm-based approach for generating optimized stress-aligned trajectories for 3D printing applications. The method utilizes swarming dynamics to simulate the motion of virtual agents along the stress field of a part under loading conditions. The resulting agent trajectories are then used as print trajectories. With this approach, the complex global trajectory generation problem is subdivided into a set of sequential and computationally efficient quadratic programs. Through comprehensive evaluations in both simulation and experiments, we compare our method to state-of-the-art approaches. Our results demonstrate a remarkable improvement in computational efficiency, achieving a $115\times $ faster computation speed than existing methods. This efficiency, combined with the possibility to tune the trajectory spacing to match the deposition process constraints, makes the potential integration of our approach into existing 3D printing processes seamless. Additionally, the open-hole tensile specimen produced on a conventional fused filament fabrication setup with our algorithm achieves a notable $\approx 10\%$ improvement in specific modulus compared to existing trajectory optimization methods.

Abstract Background Large language models (LLMs) have shown promise in various medical applications, including clinical decision-making and education. In oncology, the increasing complexity of patient care and the vast volume of medical literature require efficient tools to assist practitioners. However, the use of LLMs in oncology education and knowledge assessment remains underexplored. This study aims to evaluate and compare the oncological knowledge of four LLMs using standardized board examination questions. Methods We assessed the performance of four LLMs—Claude 3.5 Sonnet (Anthropic), ChatGPT 4o (OpenAI), Llama-3 (Meta), and Gemini 1.5 (Google)—using the Turkish Society of Medical Oncology’s annual board examination questions from 2016 to 2024. A total of 790 valid multiple-choice questions covering various oncology topics were included. Each model was tested on its ability to answer these questions in Turkish. Performance was analyzed based on the number of correct answers, with statistical comparisons made using chi-square tests and one-way ANOVA. Results Claude 3.5 Sonnet outperformed the other models, passing all eight exams with an average score of 77.6%. ChatGPT 4o passed seven out of eight exams, with an average score of 67.8%. Llama-3 and Gemini 1.5 showed lower performance, passing four and three exams respectively, with average scores below 50%. Significant differences were observed among the models’ performances (F = 17.39, p

Background/aims: Endoscopic retrograde cholangiopancreatography (ERCP) is an essential diagnostic and therapeutic method for pancreato-biliary disorders in adults, but its use in pediatric populations remains limited. This study aims to evaluate the indications, technical success, and safety of ERCP in pediatric patients., Materials and Methods: A retrospective analysis of all ERCP procedures performed on patients under 18 years of age was conducted at 2 tertiary centers in Türkiye (Harran University and Gaziantep University Hospital) during the period between January 2013 and May 2024. The data used for the study were obtained from patients' medical records., Results: A total of 153 ERCP procedures were performed on 83 pediatric patients (64%, female) with a mean age of 12.9 years (range 3-17) at the time of ERCP. Common bile duct stones were the most frequent indication (n = 39, 47%) for ERCP, followed by biliary hydatid cyst-related complications (n = 24, 29%). The overall cannulation success rate was 98.7% (82/83). Endoscopic sphincterotomy was performed in 79 (95%) patients. More than one ERCP procedure was performed in 41 (49%) patients. Stones were extracted in 32 patients (30 were biliary and 2 pancreatic). Stent placement was performed in 33 patients (25 biliary and 8 pancreatic). Post-ERCP pancreatitis developed in 4.8% (n = 4) of patients, and all classified as mild. Ten (12%) patients developed mild/moderate cholangitis following ERCP. One patient (1.2%) experienced minor bleeding. About half of the patients (48%) were discharged within 1 day postprocedure. No patient experienced procedure-related mortality., Conclusion: Our study results indicate that ERCP is both effective and safe in the pediatric population.

Vaccines are the most effective tool against COVID-19 and are generally safe. Very rare and heterogeneous cases of acute liver injury associated to all types of SARS-CoV-2 vaccines have been reported, mostly with autoimmune features. Epidemiological studies used heterogeneous diagnostic criteria and included different populations. Immunological studies in selected cases of acute liver injury linked to mRNA SARS-CoV-2 vaccines suggest that it has a unique pathophysiology, the vaccine-encoded spike protein playing a central role in triggering the aberrant immune response. In most series, liver injury was observed more often following the second vaccine dose. Latency from vaccination to the diagnosis of hepatitis was 1-147 days after the last vaccine dose. Raised immunoglobulin G levels and positive anti-nuclear and/or anti-smooth muscle antibodies are frequent. The vast majority of reported cases have been treated with corticosteroids, mostly associated with azathioprine. Outcome is generally favourable, but cases requiring liver transplantation or causing death have been reported. The heterogeneous clinical entity of acute liver injury linked to SARS-CoV-2 vaccines includes patients requiring long-term immunosuppression, similarly to autoimmune hepatitis, and patients with self-limiting liver damage, possibly representing a unique form of autoimmune-like hepatitis, which we suggest being referred to as SARS-CoV-2 vaccine-associated liver injury (SVALI). Further studies are needed to investigate the pathogenic mechanisms related to the immune response to the spike viral protein in the liver., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)