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Abstract Abstract reasoning is a key ability for an intelligent system. Large language models (LMs) achieve above-chance performance on abstract reasoning tasks but exhibit many imperfections. However, human abstract reasoning is also imperfect. Human reasoning is affected by our real-world knowledge and beliefs, and shows notable “content effects”; humans reason more reliably when the semantic content of a problem supports the correct logical inferences. These content-entangled reasoning patterns are central to debates about the fundamental nature of human intelligence. Here, we investigate whether language models—whose prior expectations capture some aspects of human knowledge—similarly mix content into their answers to logic problems. We explored this question across three logical reasoning tasks: natural language inference, judging the logical validity of syllogisms, and the Wason selection task. We evaluate state of the art LMs, as well as humans, and find that the LMs reflect many of the same qualitative human patterns on these tasks—like humans, models answer more accurately when the semantic content of a task supports the logical inferences. These parallels are reflected in accuracy patterns, and in some lower-level features like the relationship between LM confidence over possible answers and human response times. However, in some cases the humans and models behave differently—particularly on the Wason task, where humans perform much worse than large models, and exhibit a distinct error pattern. Our findings have implications for understanding possible contributors to these human cognitive effects, as well as the factors that influence language model performance.

Autophagy is a catabolic process that is important for maintaining cellular homeostasis. This pathway in hepatocytes is stimulated and controlled by the hepatitis C virus (HCV)—upon infection—to promote its own replication. HCV induces autophagy indirectly and directly through different mechanisms and temporally controls the autophagic flux. This enables the virus to maximize its replication and attenuate the innate immune responses that it activates. In this review, we discuss the relationship between HCV and autophagy, and the crosstalk between HCV-induced autophagy and host innate immune responses.

Purpose The development of a strong professional identity in medicine has important consequences for patient care, as proper identity formation impacts a physician’s confidence, wellbeing, and performance. In non-medical professions, exposure to discrimination and stigma impacts how individuals construct their professional identity. Our study aims to explore how microaggressions from peers impact the professional identity formation of resident physicians. This work was guided by conceptual frameworks on professional identity formation that included socialization, role modelling, and hierarchical structures. Methods We conducted semi-structured interviews with [blinded] residents between July 2021 and November 2022. Participants were recruited utilizing both convenience and snowball sampling of residents who self-identified as having experienced microaggressions. During the iterative data collection, we adopted thematic analysis using open coding to identify overarching themes. Results We interviewed 17 residents from five specialties. Overall, participants perceived that experiencing microaggressions impacted their sense of belonging in medicine, and had a negative impact on participants’ progression in residency due to feelings of perceived incompetence, exhaustion at work, and missed opportunities. Participants also felt like they had to guard the diverse aspects of their identities to mitigate the experience of microaggressions. Barriers in addressing microaggressions included fear of personal and professional repercussions, and a sense of futility that reporting would lead to tangible change. More education about microaggressions, increasing transparency on reporting microaggressions, access to open-minded mentors, and creating a safe space to debrief may help mitigate the negative impacts of microaggressions on professional identity formation. Conclusions Our study suggests that microaggressions between peers are a barrier to trainees’ socialization into the medical profession, as they lead to feelings of exclusion and exhaustion that impact clinical performance. Education on how to identify, report and respond to microaggressions will help to improve the learning environment for vulnerable trainees.

This study examined the test-retest reliability and predictive validity of the East Asia-Pacific Early Child Development Scales (EAP-ECDS) Short Form. In China, preschools typically provide children with educational activities in age-segregated classrooms – Kindergarten Level 1 (K1) (3 to 4 years), Kindergarten Level 2 (K2) (4 to 5 years), and Kindergarten Level 3 (K3) (5 to 6 years). A total of 709 children in K2 (Mage = 57.85 months, SD = 4.77) were randomly selected from 29 kindergartens in Shanghai municipality and Guizhou province of China. Children were assessed using the EAP-ECDS in K2 and K3. School readiness was assessed in K3, and literacy and mathematics achievement were assessed in Grade 2. Pearson’s correlation coefficient and intraclass correlation coefficient (ICC = 0.73) indicated that the tool had good test-retest reliability across K2 and K3. Regarding predictive validity, K2 EAP-ECDS predicted K3 school readiness (β = 0.26), Grade 2 language and literacy (β = 0.18) and mathematics (β = 0.22) after adjusting for age, gender, socioeconomic status, and region. Findings support using the tool to measure the holistic development of preschool-aged children in China and the region.

The traditional setting of health research is academic centres. However, Canadian health care could benefit from research conducted and started in centres where most of the population receives care with substantial potential to conduct research: community hospitals. Increased involvement of community hospitals in research could offer more capacity for research, more broadly generalizable study results and expedited knowledge translation. It could also lead to increased staff engagement, opportunities for continuing education and enhanced clinician career satisfaction. We discuss the challenges community hospitals face in pursuing clinical research, potential strategies to address these barriers, and the benefits of fostering a research culture in the community hospital setting. Enrolling patients from community hospitals into multicentre trials can also directly benefit studies. Patients in community hospitals may represent a different cross-section of society, thereby improving generalizability of study results. Moreover, increasing the number of eligible patients can reduce time required to complete studies, reduce study implementation costs and identify helpful or harmful interventions more quickly.

Nearly half of people with HIV in the United States are 50 years or older, and this proportion is growing. Between 2012 and 2016, the largest percent increase in the prevalence rate of HIV was among people aged 65 and older, the eligibility age for Medicare coverage for individuals without a disability or other qualifying condition. Previous work suggests that older people with HIV may have higher rates of chronic conditions and develop them more rapidly than older people who do not have HIV. This study compared the health status of older people with HIV with the older US population not living with HIV by comparing: (1) mortality; (2) prevalence of certain conditions, and (3) incidence of these conditions with increasing age. We used a sample of Medicare beneficiaries aged 65 and older from the Medicare Master Beneficiary Summary File for the years 2011 to 2016, including 100% of individuals with HIV (N = 43,708), as well as a random 1% sample of individuals without diagnosed HIV (N = 1,029,518). We conducted a survival analysis using a Cox proportional hazards model to assess mortality and to determine the need to adjust for differential mortality in our analyses of the incidence of certain chronic conditions. These results showed that Medicare beneficiaries living with HIV have a significantly higher hazard of mortality compared to older people without diagnosed HIV (3.6 times the hazard). We examined the prevalence of these conditions using logistic regression analysis and found that people with HIV have a statistically significant higher odds of depression, chronic kidney disease, chronic obstructive pulmonary disease (COPD), osteoporosis, hypertension, ischemic heart disease, diabetes, chronic hepatitis, end-stage liver disease, lung cancer, and colorectal cancer. To look at the rate at which older people are diagnosed with conditions as they age, we used a Fine-Gray competing risk model and showed that for individuals without diagnosis of a given condition at age 65, the future incidence of that condition over the remaining study period was higher for people with HIV even after adjusting for differential hazard of mortality and for other demographic characteristics. Many of these results also varied by personal characteristics including Medicaid dual enrollment, sex, and race and ethnicity, as well as by condition. Increasing access to care and improving health outcomes for people with HIV is a critical goal of the National HIV/AIDS Strategy 2020. It is important for clinicians and policymakers to be aware that despite significant advances in the treatment and care of people with HIV, older people with HIV have a higher odds of having multiple chronic conditions at any point in time, a higher incidence of new diagnoses of these conditions over time, and a higher hazard of mortality than Medicare beneficiaries without HIV.

Machine learning (ML) has the potential to improve the dermatologist’s practice from diagnosis to personalized treatment. Recent advancements in access to large datasets (e.g., electronic medical records, image databases, omics), faster computing, and cheaper data storage have encouraged the development of ML algorithms with human-like intelligence in dermatology. This article is an overview of the basics of ML, current applications of ML, and potential limitations and considerations for further development of ML. We have identified five current areas of applications for ML in dermatology: (1) disease classification using clinical images; (2) disease classification using dermatopathology images; (3) assessment of skin diseases using mobile applications and personal monitoring devices; (4) facilitating large-scale epidemiology research; and (5) precision medicine. The purpose of this review is to provide a guide for dermatologists to help demystify the fundamentals of ML and its wide range of applications in order to better evaluate its potential opportunities and challenges.

Wilson disease affects 1 in 30,000 live births and patients can present with symptoms at any age, although most cases are diagnosed before age 55 years. Most pediatric patients present with hepatic manifestations, while adults have hepatic manifestations with or without psychiatric or neurologic manifestations. In Wilson disease, the spectrum of liver disease at presentation can range from mild biochemical abnormalities to acute liver failure or cirrhosis. Common neurologic symptoms include dystonia, tremor or ataxia, while psychiatric symptoms can resemble paranoia, depression or schizophrenia. Kayser-Fleischer rings, which represent copper deposits in the Descemet membrane of the cornea, are a pathognomonic finding of Wilson disease. However, they can be absent in around 50% of patients with Wilson disease. Here, Chan and Tran examine the case of a 19-year-old with Wilson disease.

Positive associations have been found between executive function (EF) and language skills in young children. However, the relations between specific components of EF and language are unclear. This study examined these relations among young children in three Asian countries. A series of EF and language tasks was administered to 700 children (350 girls) aged from 3 to 6 years from urban and rural areas in Bangladesh (n = 232), China (n = 233), and India (n = 235). Overall EF was positively associated with oral language and literacy after controlling for age, socio-demographic variables, and country. Hierarchical linear regression analyses examined the associations of three EF components (working memory, shifting, and inhibitory control) with oral language and literacy. In all three contexts, inhibitory control was significantly associated with oral language; and working memory was significantly associated with literacy. Specific patterns of relations between EF components and language were observed across contexts. Future research may consider whether these findings can be generalized to different language systems.