BACKGROUND: Although uncertainties exist regarding implementation, artificial intelligence-driven generative language models (GLMs) have enormous potential in medicine. Deployment of GLMs could improve patient comprehension of clinical texts and improve low health literacy.
OBJECTIVE: The goal of this study is to evaluate the potential of ChatGPT-3.5 and GPT-4 to tailor the complexity of medical information to patient-specific input education level, which is crucial if it is to serve as a tool in addressing low health literacy.
METHODS: Input templates related to 2 prevalent chronic diseases-type II diabetes and hypertension-were designed. Each clinical vignette was adjusted for hypothetical patient education levels to evaluate output personalization. To assess the success of a GLM (GPT-3.5 and GPT-4) in tailoring output writing, the readability of pre- and posttransformation outputs were quantified using the Flesch reading ease score (FKRE) and the Flesch-Kincaid grade level (FKGL).
RESULTS: Responses (n=80) were generated using GPT-3.5 and GPT-4 across 2 clinical vignettes. For GPT-3.5, FKRE means were 57.75 (SD 4.75), 51.28 (SD 5.14), 32.28 (SD 4.52), and 28.31 (SD 5.22) for 6th grade, 8th grade, high school, and bachelor\'s, respectively; FKGL mean scores were 9.08 (SD 0.90), 10.27 (SD 1.06), 13.4 (SD 0.80), and 13.74 (SD 1.18). GPT-3.5 only aligned with the prespecified education levels at the bachelor\'s degree. Conversely, GPT-4\'s FKRE mean scores were 74.54 (SD 2.6), 71.25 (SD 4.96), 47.61 (SD 6.13), and 13.71 (SD 5.77), with FKGL mean scores of 6.3 (SD 0.73), 6.7 (SD 1.11), 11.09 (SD 1.26), and 17.03 (SD 1.11) for the same respective education levels. GPT-4 met the target readability for all groups except the 6th-grade FKRE average. Both GLMs produced outputs with statistically significant differences (P<.001; 8th grade P<.001; high school P<.001; bachelors P=.003; FKGL: 6th grade P=.001; 8th grade P<.001; high school P<.001; bachelors P<.001) between mean FKRE and FKGL across input education levels.
CONCLUSIONS: GLMs can change the structure and readability of medical text outputs according to input-specified education. However, GLMs categorize input education designation into 3 broad tiers of output readability: easy (6th and 8th grade), medium (high school), and difficult (bachelor\'s degree). This is the first result to suggest that there are broader boundaries in the success of GLMs in output text simplification. Future research must establish how GLMs can reliably personalize medical texts to prespecified education levels to enable a broader impact on health care literacy.

BACKGROUND: The rapid evolution of ChatGPT has generated substantial interest and led to extensive discussions in both public and academic domains, particularly in the context of medical education.
OBJECTIVE: This study aimed to evaluate ChatGPT\'s performance in a pulmonology examination through a comparative analysis with that of third-year medical students.
METHODS: In this cross-sectional study, we conducted a comparative analysis with 2 distinct groups. The first group comprised 244 third-year medical students who had previously taken our institution\'s 2020 pulmonology examination, which was conducted in French. The second group involved ChatGPT-3.5 in 2 separate sets of conversations: without contextualization (V1) and with contextualization (V2). In both V1 and V2, ChatGPT received the same set of questions administered to the students.
RESULTS: V1 demonstrated exceptional proficiency in radiology, microbiology, and thoracic surgery, surpassing the majority of medical students in these domains. However, it faced challenges in pathology, pharmacology, and clinical pneumology. In contrast, V2 consistently delivered more accurate responses across various question categories, regardless of the specialization. ChatGPT exhibited suboptimal performance in multiple choice questions compared to medical students. V2 excelled in responding to structured open-ended questions. Both ChatGPT conversations, particularly V2, outperformed students in addressing questions of low and intermediate difficulty. Interestingly, students showcased enhanced proficiency when confronted with highly challenging questions. V1 fell short of passing the examination. Conversely, V2 successfully achieved examination success, outperforming 139 (62.1%) medical students.
CONCLUSIONS: While ChatGPT has access to a comprehensive web-based data set, its performance closely mirrors that of an average medical student. Outcomes are influenced by question format, item complexity, and contextual nuances. The model faces challenges in medical contexts requiring information synthesis, advanced analytical aptitude, and clinical judgment, as well as in non-English language assessments and when confronted with data outside mainstream internet sources.

UNASSIGNED: The introduction of ChatGPT by OpenAI has garnered significant attention. Among its capabilities, paraphrasing stands out.
UNASSIGNED: This study aims to investigate the satisfactory levels of plagiarism in the paraphrased text produced by this chatbot.
UNASSIGNED: Three texts of varying lengths were presented to ChatGPT. ChatGPT was then instructed to paraphrase the provided texts using five different prompts. In the subsequent stage of the study, the texts were divided into separate paragraphs, and ChatGPT was requested to paraphrase each paragraph individually. Lastly, in the third stage, ChatGPT was asked to paraphrase the texts it had previously generated.
UNASSIGNED: The average plagiarism rate in the texts generated by ChatGPT was 45% (SD 10%). ChatGPT exhibited a substantial reduction in plagiarism for the provided texts (mean difference -0.51, 95% CI -0.54 to -0.48; P<.001). Furthermore, when comparing the second attempt with the initial attempt, a significant decrease in the plagiarism rate was observed (mean difference -0.06, 95% CI -0.08 to -0.03; P<.001). The number of paragraphs in the texts demonstrated a noteworthy association with the percentage of plagiarism, with texts consisting of a single paragraph exhibiting the lowest plagiarism rate (P<.001).
UNASSIGNED: Although ChatGPT demonstrates a notable reduction of plagiarism within texts, the existing levels of plagiarism remain relatively high. This underscores a crucial caution for researchers when incorporating this chatbot into their work.

Mesoscopic photoacoustic imaging (PAI) enables label-free visualization of vascular networks in tissues with high contrast and resolution. Segmenting these networks from 3D PAI data and interpreting their physiological and pathological significance is crucial yet challenging due to the time-consuming and error-prone nature of current methods. Deep learning offers a potential solution; however, supervised analysis frameworks typically require human-annotated ground-truth labels. To address this, an unsupervised image-to-image translation deep learning model is introduced, the Vessel Segmentation Generative Adversarial Network (VAN-GAN). VAN-GAN integrates synthetic blood vessel networks that closely resemble real-life anatomy into its training process and learns to replicate the underlying physics of the PAI system in order to learn how to segment vasculature from 3D photoacoustic images. Applied to a diverse range of in silico, in vitro, and in vivo data, including patient-derived breast cancer xenograft models and 3D clinical angiograms, VAN-GAN demonstrates its capability to facilitate accurate and unbiased segmentation of 3D vascular networks. By leveraging synthetic data, VAN-GAN reduces the reliance on manual labeling, thus lowering the barrier to entry for high-quality blood vessel segmentation (F1 score: VAN-GAN vs. U-Net = 0.84 vs. 0.87) and enhancing preclinical and clinical research into vascular structure and function.

Symbolic task planning is a widely used approach to enforce robot autonomy due to its ease of understanding and deployment in engineered robot architectures. However, techniques for symbolic task planning are difficult to scale in real-world, highly dynamic, human-robot collaboration scenarios because of the poor performance in planning domains where action effects may not be immediate, or when frequent re-planning is needed due to changed circumstances in the robot workspace. The validity of plans in the long term, plan length, and planning time could hinder the robot\'s efficiency and negatively affect the overall human-robot interaction\'s fluency. We present a framework, which we refer to as Teriyaki, specifically aimed at bridging the gap between symbolic task planning and machine learning approaches. The rationale is training Large Language Models (LLMs), namely GPT-3, into a neurosymbolic task planner compatible with the Planning Domain Definition Language (PDDL), and then leveraging its generative capabilities to overcome a number of limitations inherent to symbolic task planners. Potential benefits include (i) a better scalability in so far as the planning domain complexity increases, since LLMs\' response time linearly scales with the combined length of the input and the output, instead of super-linearly as in the case of symbolic task planners, and (ii) the ability to synthesize a plan action-by-action instead of end-to-end, and to make each action available for execution as soon as it is generated instead of waiting for the whole plan to be available, which in turn enables concurrent planning and execution. In the past year, significant efforts have been devoted by the research community to evaluate the overall cognitive capabilities of LLMs, with alternate successes. Instead, with Teriyaki we aim to providing an overall planning performance comparable to traditional planners in specific planning domains, while leveraging LLMs capabilities in other metrics, specifically those related to their short- and mid-term generative capabilities, which are used to build a look-ahead predictive planning model. Preliminary results in selected domains show that our method can: (i) solve 95.5% of problems in a test data set of 1,000 samples; (ii) produce plans up to 13.5% shorter than a traditional symbolic planner; (iii) reduce average overall waiting times for a plan availability by up to 61.4%.

The integration of artificial intelligence (AI), particularly deep learning models, has transformed the landscape of medical technology, especially in the field of diagnosis using imaging and physiological data. In otolaryngology, AI has shown promise in image classification for middle ear diseases. However, existing models often lack patient-specific data and clinical context, limiting their universal applicability. The emergence of GPT-4 Vision (GPT-4V) has enabled a multimodal diagnostic approach, integrating language processing with image analysis.
In this study, we investigated the effectiveness of GPT-4V in diagnosing middle ear diseases by integrating patient-specific data with otoscopic images of the tympanic membrane.
The design of this study was divided into two phases: (1) establishing a model with appropriate prompts and (2) validating the ability of the optimal prompt model to classify images. In total, 305 otoscopic images of 4 middle ear diseases (acute otitis media, middle ear cholesteatoma, chronic otitis media, and otitis media with effusion) were obtained from patients who visited Shinshu University or Jichi Medical University between April 2010 and December 2023. The optimized GPT-4V settings were established using prompts and patients\' data, and the model created with the optimal prompt was used to verify the diagnostic accuracy of GPT-4V on 190 images. To compare the diagnostic accuracy of GPT-4V with that of physicians, 30 clinicians completed a web-based questionnaire consisting of 190 images.
The multimodal AI approach achieved an accuracy of 82.1%, which is superior to that of certified pediatricians at 70.6%, but trailing behind that of otolaryngologists at more than 95%. The model\'s disease-specific accuracy rates were 89.2% for acute otitis media, 76.5% for chronic otitis media, 79.3% for middle ear cholesteatoma, and 85.7% for otitis media with effusion, which highlights the need for disease-specific optimization. Comparisons with physicians revealed promising results, suggesting the potential of GPT-4V to augment clinical decision-making.
Despite its advantages, challenges such as data privacy and ethical considerations must be addressed. Overall, this study underscores the potential of multimodal AI for enhancing diagnostic accuracy and improving patient care in otolaryngology. Further research is warranted to optimize and validate this approach in diverse clinical settings.

UNASSIGNED: This paper explores a significant shift in the field of mental health in general and psychotherapy in particular following generative artificial intelligence\'s new capabilities in processing and generating humanlike language. Following Freud, this lingo-technological development is conceptualized as the \"fourth narcissistic blow\" that science inflicts on humanity. We argue that this narcissistic blow has a potentially dramatic influence on perceptions of human society, interrelationships, and the self. We should, accordingly, expect dramatic changes in perceptions of the therapeutic act following the emergence of what we term the artificial third in the field of psychotherapy. The introduction of an artificial third marks a critical juncture, prompting us to ask the following important core questions that address two basic elements of critical thinking, namely, transparency and autonomy: (1) What is this new artificial presence in therapy relationships? (2) How does it reshape our perception of ourselves and our interpersonal dynamics? and (3) What remains of the irreplaceable human elements at the core of therapy? Given the ethical implications that arise from these questions, this paper proposes that the artificial third can be a valuable asset when applied with insight and ethical consideration, enhancing but not replacing the human touch in therapy.

New insights into intractable industrial challenges can be revealed by framing them in terms of natural science. One intractable industrial challenge is that creative production can be much more financially expensive and time consuming than standardized production. Creative products include a wide range of goods that have one or more original characteristics. The scaling up of creative production is hindered by high financial production costs and long production durations. In this paper, creative production is framed in terms of interactions between entropy and complexity during progressions from emergent pragmatics to action semantics. An analysis of interactions between entropy and complexity is provided that relates established practice in creative production to organizational survival in changing environments. The analysis in this paper is related to assembly theory, which is a recent theoretical development in natural science that addresses how open-ended generation of complex physical objects can emerge from selection in biology. Parallels between assembly practice in industrial production and assembly theory in natural science are explained through constructs that are common to both, such as assembly index. Overall, analyses reported in the paper reveal that interactions between entropy and complexity underlie intractable challenges in creative production, from the production of individual products to the survival of companies.

In this cross-sectional study, we evaluated the completeness, readability, and syntactic complexity of cardiovascular disease prevention information produced by GPT-4 in response to 4 kinds of prompts.

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