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Introduction There are no established methods to identify children with atypical diabetes for further study. We aimed to develop strategies to systematically ascertain cases of atypical pediatric diabetes using electronic medical records (EMR).Research design and methods We tested two strategies in a large pediatric hospital in the USA. Strategy 1: we designed a questionnaire to rule out typical diabetes and applied it to the EMR of 100 youth with diabetes. Strategy 2: we built three electronic queries to generate reports of three atypical pediatric diabetes phenotypes: unknown type, type 2 diabetes (T2D) diagnosed

Abstract Background Despite treatment with highly effective antimalarial drugs, malaria annually claims the lives of over half a million children under 5-years of age in sub-Saharan Africa. Cerebral malaria (CM), defined as Plasmodium falciparum infection with coma, is the severe malaria syndrome with the highest mortality. Studies in the CM mouse model suggest that a T cell-mediated response underlies CM pathology, opening a new target for therapy in humans. This trial aims to establish the preliminary safety of one such novel therapy, the glutamine antagonist 6-diazo-5-oxo-L-norleucine (DON). Methods In this phase I/IIa dose-escalation clinical trial, a single dose of intravenous (IV) DON is administered to three participants groups—healthy adults and adults with uncomplicated malaria, then pediatric participants with CM—to primarily assess safety. The secondary objective of this trial is to assess pharmacokinetics of DON over a range of doses. The open-label adult portion of the trial enrolls 40 healthy adults concurrently with 40 adults with uncomplicated malaria. Cohorts of 10 participants receive a single IV dose of DON with doses escalating between cohorts from 0.1 mg/kg, 1.0 mg/kg, 5.0 mg/kg, to 10 mg/kg. Following subsequent safety review, a randomized, double-blind, and placebo-controlled pediatric study enrolls 72 participants aged 6 months to 14 years with CM. The pediatric portion of the study minimally spans three malaria seasons including a planned interim analysis after 50% of pediatric enrollments. The first half of pediatric participants receive DON 0.1 mg/kg, 1.0 mg/kg, or placebo. Dosing for the second half of pediatric participants is informed by the safety and preliminary efficacy results of those previously enrolled. The pediatric portion of the study has an exploratory outcome evaluating the preliminary efficacy of DON. Efficacy is assessed by diagnostics predictive of CM outcome: electroencephalography (EEG), magnetic resonance imaging (MRI), and transcranial doppler (TCD), measured before and after DON administration. All participants with malaria receive standard of care antimalarials in accordance with local guidelines, regardless of study drug dose group. Discussion This preliminary safety and efficacy study evaluates DON, a candidate adjunctive therapy for pediatric CM. If results support DON preliminary safety and efficacy, follow-up phase II and III clinical trials will be indicated. Trial registration This trial was registered on ClinicalTrials.gov on 28 July 2022 (NCT05478720).

The in situ growth dynamics of colloidal silver–gold core–shell (Ag@Au CS) nanoparticles (NPs) are studied using time-dependent second harmonic generation (SHG) and extinction spectroscopy. Four sequential additions of chloroauric acid, sodium citrate, and hydroquinone are added to a silver nanoparticle solution to form a gold shell around a 45 nm silver core under different reaction conditions, resulting in final sizes ranging from 80 to 125 nm in diameter. In the first addition, a bumpy, urchin-like surface morphology is produced, while the second, third, and fourth additions provide additional nanoparticle growth with the surface morphology becoming more smooth and uniform, as shown using transmission electron microscopy measurements. The in situ extinction spectra increase in intensity for each addition, where blue-shifting and spectral narrowing are observed as the Ag@Au CS NPs grow in size. The extinction spectra are compared to Mie theory simulations, showing general agreement at later stages of the reactions for smooth CS surfaces. The in situ SHG signal is dominated by surface-enhanced plasmonic hotspots at the early stages of the shell growth, followed by gradual decreases in signal as the surface becomes more smooth. Two-photon fluorescence is also monitored during the CS growth, showing complementary information for comparisons to the extinction and SHG results. The holistic study of the synthesis and characterization of Ag@Au CS nanoparticles using in situ SHG spectroscopy, extinction spectroscopy, and Mie theory simulations allows for a comprehensive analysis of the complex growth dynamics occurring at the nanoscale for developing optimized plasmonic nanomaterial properties. [ABSTRACT FROM AUTHOR]

With the global impetus for the elimination of canine-mediated human rabies, the need for robust rabies surveillance systems has become ever more important. Many countries are working to improve their rabies surveillance programs and, as a result, the reported use of lateral flow devices (LFDs) is increasing. Despite their known diagnostic limitations, previous studies have hypothesised that the benefits associated with LFDs could make them potentially quite useful towards improving the overall robustness of surveillance programs. To test this, a best practice standard operating procedure was developed which was used to guide the implementation of the ADTEC LFD as a diagnostic screening tool in Zanzibar. Over the course of the first 22 months of this investigation, 83 samples were subjected to in-field diagnostic screening, coupled with subsequent laboratory confirmation, and only one false-negative result was detected. Furthermore, the findings of our investigation indicated that the routine use of LFDs as a diagnostic screening tool resulted in a four-fold increase in the number of samples subjected to rabies diagnosis per month and a three-fold increase in the number of wards where samples were collected per year. Our findings suggest that LFDs could play a noteworthy role in improving the robustness of surveillance systems by increasing the number of samples tested and promoting diagnostic screening in areas distant from laboratories. Their implementation would, however, need to be carefully controlled through standardised protocols that align with the international best practices to ensure their judicious use.

Understanding past and present relationships of traditional cultures with biodiversity through biocultural research can help inform inclusive conservation policy and planning in a country seeking to undo past injustices such as South Africa. This review of 326 articles published between 1990 and 2019 maps the methodology employed in biocultural research, the focus of this research niche, ethical conduct and research recommendations to understand the state of biocultural research and make recommendations for biocultural research that is representative of South Africa’s diverse cultural landscape. This systematic review of original research articles indexed on the Scopus database found South African biocultural research to exclude Swati and Ndebele cultures while having an unevenly strong focus on plants, human health sciences, rural areas, and three of the country’s nine provinces. Some of this unevenness is likely because of utility of plants in human health and association of traditional practices with rural areas. Using a systematic review approach for this study not only ensured replicability but it also introduced a limitation of the results only being applicable to peer-reviewed articles indexed on the Scopus database. Conservation implications: Biocultural research’s strong focus on utilitarian use could encourage conservation policy that favours utilitarian use of wildlife. An even focus in biocultural research is recommended to avoid the knowledge pool for conservation policy being mostly focussed on utilitarian value.

The aquatic and terrestrial clades of species of Trypanosoma could provide insight into the evolutionary history of the genus, as well as complementary information for biomedical studies of medically and economically important species of Trypanosoma. The ecological interactions and phylogeny of aquatic trypanosomes are currently not well-understood, mostly due to their complex life cycles and a deficiency of data. The species of Trypanosoma from African anuran hosts are of the least understood taxa in the genus. Trypanosomes were collected from South African frogs and subjected to morphological and phylogenetic analyses. This study redescribes Trypanosoma (Trypanosoma) nelspruitense Laveran, 1904 and Trypanosoma (Haematomonas) grandicolor Pienaar, 1962, with morphological and molecular data. The present study aims to create a platform for further future research on African anuran trypanosomes.

Despite the implementation of various control strategies aimed at eliminating canine-mediated rabies, the disease is still endemic in up to 150 countries across the world. Rabies remains endemic to South Africa, with various reservoir species (both wildlife species and domestic dogs) capable of maintaining rabies infection, and the epidemiology of the disease is yet to be adequately defined. As such, this study used surveillance data collected between 1998 and 2019 from the two diagnostic laboratories in the country for a statistical space–time analysis to determine regions where significant disease clusters could occur. In addition, the robustness of surveillance activities across the country was evaluated through the mathematical evaluation and visualization of testing rates based on the average number of samples tested per species group. In our study, various significant disease clusters were detected for domestic animals, wildlife and livestock. The significant disease clusters for domestic animals and livestock were primarily restricted to eastern South Africa, while the significant disease clusters in wildlife species were detected across northern and western South Africa. Furthermore, the testing rates identified districts from various provinces where surveillance activities could be considered inadequate, consequently influencing the geographical range of the observed clusters. These results could be used to direct intervention campaigns towards high-risk areas, while also allocating the required resources to improve surveillance in the surrounding areas where surveillance was deemed inadequate.

We generalize Koopman–von Neumann classical mechanics to poly symplectic fields and recover De Donder–Weyl’s theory. Compared with Dirac’s Hamiltonian density, it inspires a new Hamiltonian formulation with a canonical momentum field that is Lorentz-covariant with symplectic geometry. We provide commutation relations for the classical and quantum fields that generalize the Koopman–von Neumann and Heisenberg algebras. The classical algebra requires four fields that generalize spacetime, energy–momentum, frequency–wavenumber, and the Fourier conjugate of energy–momentum. We clarify how first and second quantization can be found by simply mapping between operators in classical and quantum commutator algebras.

This study uses Bureau of Economic Analysis data on state-level productivity levels and growth rates over the period 1977–2019. We find that states with relatively high productivity tend to experience somewhat lower productivity growth over time, whereas states with relatively lower productivity experience somewhat higher productivity growth over time. We find compelling evidence for significant contributions from education (in the form of a college degree) as well as the role played by higher growth rates in the state-level Hispanic population as factors contributing to increased productivity. Worker/labour productivity constitutes a good indicator of changes to wages and living standards. Empirically examining interstate differences in state-level worker productivity growth across different time intervals helps to identify factors that influence geographical differentials in productivity as well as aids in the identification of the specific factors that determine rates of productivity growth and decline.

Abstract Maturity‐onset of diabetes of the young (MODY) are monogenic forms of diabetes characterized by early onset diabetes with autosomal dominant inheritance. Since its first description about six decades ago, there have been significant advancements in our understanding of MODY from clinical presentations to molecular diagnostics and therapeutic responses. The prevalence of MODY is estimated as at least 1.1–6.5% of the pediatric diabetes population with a high degree of geographic variability that might arise from several factors in the criteria used to ascertain cases. GCK‐MODY, HNF1A‐MODY, and HNF4A‐MODY account for >90% of MODY cases. While some MODY forms do not require treatment (i.e., GCK‐MODY), some others are highly responsive to oral agents (i.e., HNF1A‐MODY). The risk of micro‐ and macro‐vascular complications of diabetes also differ significantly between MODY forms. Despite its high clinical impact, 50–90% of MODY cases are estimated to be misdiagnosed as type 1 or type 2 diabetes. Although there are many clinical features suggestive of MODY diagnosis, there is no single clinical criterion. An online MODY Risk Calculator can be a useful tool for clinicians in the decision‐making process for MODY genetic testing in some situations. Molecular genetic tests with a commercial gene panel should be performed in cases with a suspicion of MODY. Unresolved atypical cases can be further studied by exome or genome sequencing in a clinical or research setting, as available.

The host response against infection with Plasmodium commonly raises self-reactivity as a side effect, and antibody deposition in kidney has been cited as a possible cause of kidney injury during severe malaria. In contrast, animal models show that infection with the parasite confers long-term protection from lethal lupus nephritis initiated by autoantibody deposition in kidney. We have limited knowledge of the factors that make parasite infection more likely to induce kidney damage in humans, or the mechanisms underlying protection from autoimmune nephritis in animal models. Our experiments with the autoimmune-prone FcγR2B[KO] mice have shown that a prior infection with P. yoelii 17XNL protects from end-stage nephritis for a year, even when overall autoreactivity and systemic inflammation are maintained at high levels. In this report we evaluate post-infection alterations, such as hemozoin accumulation and compensatory changes in immune cells, and their potential role in the kidney-specific protective effect by Plasmodium. We ruled out the role of pigment accumulation with the use of a hemozoin-restricted P. berghei ANKA parasite, which induced a self-resolved infection that protected from autoimmune nephritis with the same mechanism as parasitic infections that accumulated normal levels of hemozoin. In contrast, adoptive transfer experiments revealed that bone marrow cells were altered by the infection and could transmit the kidney protective effect to a new host. While changes in the frequency of bone marrow cell populations after infection were variable and unique to a particular parasite strain, we detected a sustained bias in cytokine/chemokine expression that suggested lower fibrotic potential and higher Th1 bias likely affecting multiple cell populations. Sustained changes in bone marrow cell activation profile could have repercussions in immune responses long after the infection was cleared.

This paper explores a formal model of autopoiesis as presented by Maturana, Uribe and Varela, and analyzes this model and its implications through the lens of the notions of eigenforms (fixed points) and the intricacies of Goedelian coding. The paper discusses the connection between autopoiesis and eigenforms and a variety of different perspectives and examples. The paper puts forward original philosophical reflections and generalizations about its various conclusions concerning specific examples, with the aim of contributing to a unified way of understanding (formal models of) living systems within the context of natural sciences, and to see the role of such systems and the formation of information from the point of view of analogs of biological construction. To this end, we pay attention to models for fixed points, self-reference and self-replication in formal systems and in the description of biological systems.

This study reports the development of a novel amphiphobic coating. The coating is a bilayer arrangement, where carbon nanotubes (CNTs) form the underlayer and fluorinated alkyl-silane (FAS) forms the overlayer, resulting in the development of highly amphiphobic coatings suitable for a wide range of substrates. The effectiveness of these coatings is demonstrated through enhanced contact angles for water and artificial blood plasma fluid on glass, stainless steel, and porous PTFE. The coatings were characterized using Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA), atomic force microscopy (AFM), and contact angle (CA) measurements. The water contact angles achieved with the bilayer coating were 106 ± 2°, 116 ± 2°, and 141 ± 2° for glass, stainless steel, and PTFE, respectively, confirming the hydrophobic nature of the coating. Additionally, the coating displayed high repellency for blood plasma, exhibiting contact angles of 102 ± 2°, 112 ± 2°, and 134 ± 2° on coated glass, stainless steel, and PTFE surfaces, respectively. The presence of the CNT underlayer improved plasma contact angles by 29%, 21.7%, and 16.5% for the respective surfaces. The presence of the CNT layer improved surface roughness significantly, and the average roughness of the bilayer coating on glass, stainless steel, and PTFE was measured to be 488 nm, 301 nm, and 274 nm, respectively. Mechanistically, the CNT underlayer contributed to the surface roughness, while the FAS layer provided high amphiphobicity. The maximum effect was observed on modified glass, followed by stainless steel and PTFE surfaces. These findings highlight the promising potential of this coating method across diverse applications, particularly in the biomedical industry, where it can help mitigate complications associated with device–fluid interactions.

A correction was made to the e-First version of this paper on 2 March 2022 prior to the final issue publication. The current online and print versions are identical and both contain the correction. Taxonomic bias, resulting in some taxa receiving more attention than others, has been shown to persist throughout history. Such bias in primary biodiversity data needs to be addressed because the data are vital to environmental management. This study reviews taxonomic bias in South African primary biodiversity data obtained from the Global Biodiversity Information Facility (GBIF). The focus was specifically on animal classes, and regression analysis was used to assess the influence of scientific interest and cultural salience on taxonomic bias. A higher resolution analysis of the two explanatory variables' influence on taxonomic bias is conducted using a generalised linear model on a subset of herpetofaunal families from the focal classes. Furthermore, the potential effects of cultural salience and scientific interest on a taxon's extinction risk are investigated. The findings show that taxonomic bias in South Africa's primary biodiversity data has similarities with global scale taxonomic bias. Among animal classes, there is strong bias towards birds while classes such as Polychaeta and Maxillopoda are under-represented. Cultural salience has a stronger influence on taxonomic bias than scientific interest. It is, however, unclear how these explanatory variables may influence the extinction risk of taxa. We recommend that taxonomic bias can be reduced if primary biodiversity data collection has a range of targets that guide (but do not limit) accumulation of species occurrence records per habitat. Within this range, a lower target of species occurrence records accommodates species that are difficult to detect. The upper target means occurrence records for any species are less urgent but nonetheless useful and thus data collection efforts can focus on species with fewer occurrence records. Key words: biodiversity hotspot, biomonitoring, conservation, surrogate species, taxonomic chauvinism. Il a ete demontre que le biais taxonomique, qui fait que certains taxons recoivent plus d'attention que d'autres, persiste a travers l'histoire. Ce type de biais dans les donnees primaires de biodiversite doit etre aborde, car ces donnees sont vitales pour la gestion de l'environnement. Cette etude examine le biais taxonomique dans les donnees primaires de biodiversite d'Afrique du Sud obtenues aupres du Global Biodiversity Information Facility (GBIF). L'accent est mis sur les classes d'animaux, et une analyse de regression est utilisee pour evaluer l'influence de l'interet scientifique et de la pregnance culturelle sur le biais taxonomique. Une analyse a plus haute resolution de l'influence des deux variables explicatives sur le biais taxonomique est menee a l'aide d'un modele lineaire generalise sur un sous-ensemble de familles herpetofauniques de classes focales. En outre, les effets potentiels de la pregnance culturelle et de l'interet scientifique sur le risque d'extinction d'un taxon sont etudies. Les resultats montrent que le biais taxonomique des donnees primaires sur la biodiversite en Afrique du Sud presente des similarites avec le biais taxonomique a l'echelle mondiale. Parmi les classes d'animaux, il existe un fort biais en faveur des oiseaux, tandis que des classes telles que les Polychaeta et les Maxillopoda sont sous-representees. La pregnance culturelle a une plus grande influence sur le biais taxonomique que l'interet scientifique. Cependant, la maniere dont ces variables explicatives peuvent influencer le risque d'extinction des taxons n'est pas claire. Les auteurs recommandent que le biais taxonomique puisse etre reduit si la collecte de donnees primaires sur la biodiversite est assortie d'une serie de cibles qui guident (sans la limiter) l'accumulation d'enregistrements d'occurrence d'especes par habitat. a l'interieur de cette fourchette, une cible inferieure de releves d'occurrence d'especes permet de prendre en compte les especes difficiles a detecter. La cible superieure signifie que les releves d'occurrence d'une espece sont moins urgents, mais neanmoins utiles et que les efforts de collecte de donnees peuvent donc se concentrer sur les especes ayant moins de releves d'occurrence. [Traduit par la Redaction] Mots-cles : point nevralgique de la biodiversite, biosurveillance, conservation, especes substitutives, chauvinisme taxonomique., Background Primary biodiversity data reflects the knowledge and practices in the study of biodiversity (Troudet et al. 2017) and consists of species occurrence records (Soberon and Peterson 2004). These occurrence [...]

Introduction: Recent evidence has emerged suggesting that a non-contact anterior cruciate ligament (ACL) tear can result from repetitive submaximal loading of the ligament. In other words, when the intensity of ACL-straining athletic activities is increased too rapidly, microdamage can accumulate in the ligament beyond the rate at which it can be repaired, thereby leading to material fatigue in the ligament and its eventual failure. The objective of this survey-based exploratory study was to retrospectively determine whether the levels of various athletic activities performed by ACL-injured patients significantly changed during the 6 months before injury.Methods: Forty-eight ACL-injured patients completed a survey to characterize their participation in various activities (weightlifting, sport-specific drills, running, jumping, cutting, pivoting/twisting, and decelerating) at three timepoints (1 week, 3 months, 6 months) prior to ACL injury. Activity scores, which summarized the frequency and intensity of each activity, were calculated for each patient at each time interval. A series of linear mixed-effects regression models was used to test whether there was a significant change in levels of the various activities in the 6-month period leading up to ACL injury.Results: Patients who sustained a non-contact ACL injury markedly increased their sport-specific drills activity levels in the time leading up to injury (p = 0.098), while those patients who sustained a contact ACL injury exhibited no change in this activity during the same time period (p = 0.829). Levels of running, jumping, cutting, pivoting/twisting, and decelerating increased for non-contact ACL-injured patients but decreased for contact ACL-injured patients, though not significantly (p values > 0.10). Weightlifting activity significantly decreased leading up to injury among contact ACL-injured patients (p = 0.002).Discussion: We conclude that levels of ACL-straining athletic activities or maneuvers in non-contact ACL-injured patients markedly increased in the 6 months leading up to their injury, providing evidence that changing levels of certain activities or maneuvers may play a role in ACL injury risk. This warrants further investigation of the hypothesis that too rapid an increase in activities or maneuvers known to place large loads on the ACL can cause microdamage to accumulate in the ligament, thereby leading to failure.

ABSTRACT Cerebral malaria (CM), the deadliest complication of Plasmodium infection, is a complex and unpredictable disease. However, our understanding of the host and parasite factors that cause CM is limited. Using a mouse model of CM, experimental CM (ECM), we performed a three-way comparison between ECM-susceptible C57BL/6 mice infected with ECM-causing Plasmodium ANKA parasites [ANKA(C57BL/6)], ECM-resistant BALB/c mice infected with Plasmodium ANKA [ANKA(BALB/c)], and C57BL/6 mice infected with Plasmodium NK65 that does not cause ECM [NK65(C57BL/6)]. All ANKA(C57BL/6) mice developed CM. In contrast, in ANKA(BALB/c) and NK65(C57BL/6), infections do not result in CM and proceed similarly in terms of parasite growth, disease course, and host immune response. However, parasite gene expression in ANKA(BALB/c) was remarkably different than that in ANKA(C57BL/6) but similar to the gene expression in NK65(C57BL/6). Thus, Plasmodium ANKA has an ECM-specific gene expression profile that is activated only in susceptible hosts, providing evidence that the host has a critical influence on the outcome of infection. IMPORTANCE Hundreds of thousands of lives are lost each year due to the brain damage caused by malaria disease. The overwhelming majority of these deaths occur in young children living in sub-Saharan Africa. Thus far, there are no vaccines against this deadly disease, and we still do not know why fatal brain damage occurs in some children while others have milder, self-limiting disease progression. Our research provides an important clue to this problem. Here, we showed that the genetic background of the host has an important role in determining the course and the outcome of the disease. Our research also identified parasite molecules that can potentially be targeted in vaccination and therapy approaches.

We herein describe Paraharmotrema karinganiense n. gen., n. sp. Dutton & Bullard (Liolopidae Dollfus, 1934) from specimens infecting the intestine of the serrated hinged terrapin (Pelusios sinuatus), east African black mud turtle (Pelusios subniger) (both Nwanedzi River, Mozambique), and South African helmeted terrapin (Pelomedusa galeata) (North-western Zululand, KwaZulu-Natal Province, South Africa). The new genus can be easily differentiated from the other accepted liolopid genera (Liolope Cohn, 1902; Helicotrema Odhner, 1912; Harmotrema Nicoll, 1914; Dracovermis Brooks & Overstreet, 1978) by the combination of having a linguliform body approximately 6–9 × longer than wide, tegumental spines/scales, a minute ventral sucker located in the anterior 1/7−1/8 of the body, deeply lobed testes that are transverse and abut the caeca (spanning the intercaecal space), a uterus that is lateral to the anterior testis (not ventral to the anterior testis), a lobed ovary that is dextral and nearest the posterior testis, and a vitellarium that does not extend anteriad to the level of the ventral sucker and that does not fill the intercaecal space. Nucleotide sequences of large subunit ribosomal DNA (28S) and internal transcribed space region (ITS2) from all analyzed specimens of the new species were identical, respectively; the 28S sequences differed from that of Liolope copulans Cohn, 1902 and from that of Harmotrema laticaudae Yamaguti, 1933 by 103 (8%) and 105 (8%) nucleotides, respectively. The 28S phylogenetic analysis recovered the new genus sister to a clade comprising L. copulans and H. laticaudae. A key to liolopid genera is provided herein. The present study comprises the first nucleotide-based phylogenetic placement of Harmotrema and first record of a liolopid from South Africa or Mozambique. It is the first proposal of a new liolopid genus in 43 yrs, and it documents a second liolopid genus from P. subniger while tripling the number of liolopid turtle hosts reported from the continent of Africa.

Simple Summary: Large language models (LLMs) are revolutionizing the field of medicine, particularly in Gastroenterology, by improving access to information, diagnostics, treatment customization, and medical education. They analyze extensive medical data to enhance decision-making, patient outcomes, and educational tasks. While LLMs face challenges such as incomplete data, varying response accuracy, and reliance on specific input wording, they have shown promising results. However, their full integration into medical practice requires further research and regulation. Moreover, the successful integration of LLMs into medical practice necessitates customization to specific medical contexts and adherence to guidelines. This review focuses on the current evidence supporting the use of LLMs in Gastroenterology, emphasizing their potential and limitations. Large language models (LLMs) are transforming the medical landscape by enhancing access to information, diagnostics, treatment customization, and medical education, especially in areas like Gastroenterology. LLMs utilize extensive medical data to improve decision-making, leading to better patient outcomes and personalized medicine. These models are instrumental in interpreting medical literature and synthesizing patient data, facilitating real-time knowledge for physicians and supporting educational pursuits in medicine. Despite their potential, the complete integration of LLMs in real-life remains ongoing, particularly requiring further study and regulation. This review highlights the existing evidence supporting LLMs' use in Gastroenterology, addressing both their potential and limitations. Recent studies demonstrate LLMs' ability to answer questions from physicians and patients accurately. Specific applications in this field, such as colonoscopy, screening for colorectal cancer, and hepatobiliary and inflammatory bowel diseases, underscore LLMs' promise in improving the communication and understanding of complex medical scenarios. Moreover, the review discusses LLMs' efficacy in clinical contexts, providing guideline-based recommendations and supporting decision-making processes. Despite these advancements, challenges such as data completeness, reference suitability, variability in response accuracy, dependency on input phrasing, and a lack of patient-generated questions underscore limitations in reproducibility and generalizability. The effective integration of LLMs into medical practice demands refinement tailored to specific medical contexts and guidelines. Overall, while LLMs hold significant potential in transforming medical practice, ongoing development and contextual training are essential to fully realize their benefits. [ABSTRACT FROM AUTHOR]