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Cognitive scientists attribute representations to complex systems in order to explain their behavior. The shocking facility with which Large Language Models (LLMs) perform difficult linguistic and non-linguistic tasks has generated an increasing amount of speculation concerning what sorts of internal representations might underlie this behavior (whether personal, sub-personal, and of which kinds) and what properties such representations might have (for instance, whether they are grounded). This paper aims to elaborate and defend a conservative explanatory methodology, based on analyses of particular LLM behaviors, according to which attribution of sub-personal representations is key to explaining model performance which is robust, systematic, and flexible, especially in zero-shot settings, and that behavioral benchmarking alone is insufficient to resolve questions about representation due to the mutual underdetermination of performance and competence. The resulting view should help frame future explanations of LLM behavior, and provide an empirically grounded alternative to mere a priori speculation.

Objective. To compare the adequacy, agreement, and acceptability of Papanicolaou testing (cytology) for cervical cancer screening using self-collected samples compared to physician-collected samples in Grenada in the Caribbean. Furthermore, the study identifies the human papillomavirus (HPV) genotypes present among asymptomatic women testing positive for HPV, the etiologic cause of cervical cancer. Methods. Participants were divided into two groups and two cervical samples were collected from the women in each group: a self-collected sample and a physician-collected sample. Cervical specimens were tested for cytology and HPV. HPV genotyping was performed on positive specimens. Results. Self-collected samples were adequate and in agreement with physician-collected samples, showing no difference between the two sampling methods. Oncogenic high-risk HPV genotypes were identified in cervical samples which were positive for atypical squamous cells and low-grade squamous intraepithelial lesions. The high-risk HPV genotypes found, notably HPV 45 and 53, differed from those most commonly reported. Although the commonly reported high-risk genotypes HPV 16 and 18 were found, so were 31, 33, 35, 52, 66, 68, and 82. Conclusions. Using self-collection facilitated the discovery of unexpected HPV genotypes among asymptomatic women in Grenada. These findings add new information to the literature regarding cervical cancer and neoplasia screening and HPV genotypes in the Caribbean. This genotype information may impact surveillance of women with low-grade lesions, HPV vaccine selection, and possibly further vaccine research. Research regarding HPV in Caribbean pathology samples of cervical neoplasia and cancer is needed.

Bicuspid aortic valve (BAV) is the most common congenital heart malformation in adults, but it can also cause childhood-onset complications. The presentation and clinical course of young adults who present due to BAV complications are relatively uncharacterized. In a multicenter study, we found that young people who experience significant complications related to BAV disease before age 30 are distinguished from the majority of BAV cases that manifest after age 50 by a relatively severe clinical course, with higher rates of surgical interventions, more frequent second interventions, and a greater burden of congenital heart malformations. These observations highlight the need for prompt recognition, regular lifelong surveillance, and targeted interventions to address the significant health burdens of patients with early-onset BAV complications.

Abstract The urgency of interconnected social-ecological dilemmas such as rapid biodiversity loss, habitat loss and fragmentation, and the escalating climate crisis have led to increased calls for the protection of ecologically important areas of the planet. Protected areas (PA) are considered critical to address these dilemmas although growing divides in wellbeing can exacerbate conflict around PAs and undermine effectiveness. We investigate the influence of proximity to PAs on wellbeing outcomes. We develop a novel multi-dimensional index of wellbeing for households and across Africa and use Random Forest Machine Learning techniques to assess the importance score of households’ proximity to protected areas on their wellbeing outcomes compared with the importance scores of an array of other social, environmental, and local and national governance factors. This study makes important contributions to the conservation literature, first by expanding the ways in which wellbeing is measured and operationalized, and second, by providing additional empirical support for recent evidence that proximity to PAs is an influential factor affecting observed wellbeing outcomes, albeit likely through different pathways than the current literature suggests.

Even the most conscientious nonprofit organizations can fall victim to fraud. We examine how a nonprofit organization’s Form 990 disclosures and media coverage about an asset diversion influence subsequent donor support. Consistent with a loss in trust, we observe a decrease in donations following a diversion. This decrease is amplified when the diversion is reported in the news. We also find that donations decline more when organizations do not provide transparent disclosures and when losses are higher but only if the diversion receives media coverage. Finally, our results indicate that donors punish organizations less when they report higher recoveries and governance improvements. This study describes mechanisms though which news coverage enhances donor oversight. The media can: (a) directly inform some donors, (b) prompt some donors to obtain further information, and (c) motivate organizations to provide higher-quality disclosure.

Abstract Earth observation (EO) technologies, such as very high-resolution optical satellite data available from Maxar, can enhance economic consequence modeling of disasters by capturing the fine-grained and real-time behavioral responses of businesses and the public. We investigated this unique approach to economic consequence modeling to determine whether crowd-sourced interpretations of EO data can be used to illuminate key economic behavioral responses that could be used for computable general equilibrium modeling of supply chain repercussions and resilience effects. We applied our methodology to the COVID-19 pandemic experience in Los Angeles County, California as a case study. We also proposed a dynamic adjustment approach to account for the changing character of EO through longer-term disasters in the economic modeling context. We found that despite limitations, EO data can increase sectoral and temporal resolution, which leads to significant differences from other data sources in terms of direct and total impact results. The findings from this analytical approach have important implications for economic consequence modeling of disasters, as well as providing useful information to policymakers and emergency managers, whose goal is to reduce disaster costs and to improve economic resilience.

Abstract We present a spatial testbed of simulated boundary data based on a set of very high-resolution census-based areal units surrounding Guadalajara, Mexico. From these input areal units, we simulated 10 levels of spatial resolutions, ranging from levels with 5,515–52,388 units and 100 simulated zonal configurations for each level – totalling 1,000 simulated sets of areal units. These data facilitate interrogating various realizations of the data and the effects of the spatial coarseness and zonal configurations, the Modifiable Areal Unit Problem (MAUP), on applications such as model training, model prediction, disaggregation, and aggregation processes. Further, these data can facilitate the production of spatially explicit, non-parametric estimates of confidence intervals via bootstrapping. We provide a pre-processed version of these 1,000 simulated sets of areal units, meta- and summary data to assist in their use, and a code notebook with the means to alter and/or reproduce these data.

BACKGROUND: The impact of adjunctive anti-inflammatory treatment on outcomes for patients with Kawasaki disease (KD) and coronary artery aneurysms (CAAs) is unknown. METHODS: Using data from the International KD Registry in patients with ≥ medium CAA we evaluate associations of treatment with outcomes and major adverse cardiac events (MACE). RESULTS: Medium or large CAA was present in 527 (32%) patients. All were treated with intravenous immunoglobulin (IVIG), 70% were male, and the median age was 1.3 years (interquartile range: 0.4-4.0 years). The most common acute therapies included single IVIG alone in 243 (46%), multiple IVIG in 100 (19%), multiple IVIG + corticosteroids in 75 (14%), and multiple IVIG + infliximab + corticosteroids in 44 (8%) patients. Patients who received therapy beyond single IVIG had a larger CA z-score at baseline (P < 0.001) and a higher rate of bilateral CAA (P < 0.001). Compared with IVIG alone, early adjunctive treatments (within 3 days of initial IVIG) were not associated with time to CAA regression or MACE, whereas later adjunctive therapy was associated with MACE and longer time to CAA regression. Patients receiving IVIG plus steroids vs IVIG alone had a trend towards shorter time to CAA regression and lower risk of MACE (P = 0.07). A larger CAA z-score at baseline was the strongest predictor of an increase in the CAA z-score over follow-up, lower likelihood of CAA regression, and higher risk of MACE. CONCLUSIONS: Persistence of CAA and MACE are more strongly associated with baseline severity CAA than with acute adjuvant anti-inflammatory therapy. Patients who received late adjunctive therapy are at higher risk for worse outcomes.

IntroductionPhysical exercise and cognitive training have the potential to enhance cognitive function and mobility in older adults at risk of Alzheimer's disease and related dementia (ADRD), but little is known about the feasibility of delivering multidomain interventions in home settings of older adults at risk of ADRD. This study aims to assess the feasibility of home-based delivery of exercise and cognitive interventions, and to evaluate the relationship between participants' intervention preferences and their subsequent adherence. Secondary objectives include the effect of the interventions on ADRD risk factors, including frailty, mobility, sleep, diet and psychological health.Methods and analysisThe SYNchronising Exercises, Remedies in GaIt and Cognition at Home (SYNERGIC@Home) feasibility trial is a randomised control trial that follows a 2×2 factorial design, with a 16-week home-based intervention programme (3 sessions per week) of physical exercises and cognitive training. Participants will be randomised in blocks of four to one of the following four arms: (1) combined exercise (aerobic and resistance)+cognitive training (NEUROPEAK); (2) combined exercise+control cognitive training (web searching); (3) control exercise (balance and toning)+cognitive training; and (4) control exercise+control cognitive training. SYNERGIC@Home will be implemented through video conferencing. Baseline and post-intervention assessments at 4-month and 10-month follow-up will include measures of cognition, frailty, mobility, sleep, diet and psychological health. Primary feasibility outcome is adherence to the interventions. Primary analytic outcome is the relationship between pre-allocation preference for a given intervention and subsequent adherence to the allocated intervention. A series of secondary analytic outcomes examining the potential effect of the individual and combined interventions on cognitive, mobility and general well-being will be measured at baseline and follow-up.Ethics and disseminationEthics approval was granted by the relevant research ethics boards. Findings of the study will be presented to stakeholders and published in peer-reviewed journals and at provincial, national and international conferences.Trial registration numberNCT04997681, Pre-results.

Bicuspid aortic valve (BAV), the most common congenital heart defect, is a major cause of aortic valve disease requiring valve interventions and thoracic aortic aneurysms predisposing to acute aortic dissections. The spectrum of BAV ranges from early onset valve and aortic complications (EBAV) to sporadic late onset disease. Rare genomic copy number variants (CNVs) have previously been implicated in the development of BAV and thoracic aortic aneurysms. We determined the frequency and gene content of rare CNVs in EBAV probands (n = 272) using genome-wide SNP microarray analysis and three complementary CNV detection algorithms (cnvPartition, PennCNV, and QuantiSNP). Unselected control genotypes from the Database of Genotypes and Phenotypes were analyzed using identical methods. We filtered the data to select large genic CNVs that were detected by multiple algorithms. Findings were replicated in a BAV cohort with late onset sporadic disease (n = 5040). We identified 3 large and rare (< 1,1000 in controls) CNVs in EBAV probands. The burden of CNVs intersecting with genes known to cause BAV when mutated was increased in case-control analysis. CNVs intersecting with GATA4 and DSCAM were enriched in cases, recurrent in other datasets, and segregated with disease in families. In total, we identified potentially pathogenic CNVs in 9% of EBAV cases, implicating alterations of candidate genes at these loci in the pathogenesis of BAV.

There is much conventional management parking nowadays. One of them is on campus 1 of Muhammadiyah University of Bengkulu. Many vehicles that do not belong to students or staff from the Muhammadiyah University of Bengkulu are parked in the inner area of campus. In addition, it causes vulnerable to direct physical contact with other people, while the government recommends not to have direct physical contact with other people in the era of the Covid-19 virus pandemic. So this study designs a smart parking system with Node MCU and IoT-based RFID. Parking systems that use RFID are able to filter incoming vehicles, increase security and efficiency in parking areas, and able to reduce the impact of the spread of the Covid-19 virus. The technology used is RFID as a user Id reader Sensor, Node MCU as a microcontroller, E-KTP as access to the parking area, servo as a parking portal driver, LCD as a sign whether access is accepted or not, and infrared as a distance sensor that will signal to a servo to close the portal. This system can be hoped to overcome the current problems.

A placebo effect is a positive clinical response to non-specific elements of treatment with a sham or inert replica of a drug, device, or surgical intervention. There is considerable evidence that placebo effects are driven by expectation of benefit from the intervention. Expectation is shaped by a patient's past experience, observations of the experience of others, and written, verbal, or non-verbal information communicated during treatment. Not surprisingly, expectation in the clinical setting is strongly influenced by the attitude, affect, and communication style of the healthcare provider. While positive expectations can produce beneficial effects, negative information and experiences can lead to negative expectations, and consequently negative or nocebo effects. Key components identified and studied in the placebo and nocebo literature intersect with factors identified as barriers to quality care in the clinical setting for Black patients and other patients of color, including poor patient-clinician communication, medical mistrust, and perceived discrimination. Thus, in the context of discrimination and bias, the absence of placebo and presence of nocebo-generating influences in clinical settings could potentially reinforce racial and ethnic inequities in clinical outcomes and care. Healthcare inequities have consequences that ripple through the medical system, strengthening adverse short- and long-term outcomes. Here, we examine the potential for the presence of nocebo effects and absence of placebo effects to play a role in contributing to negative outcomes related to unequal treatment in the clinical encounter.

Objectives To adapt the content and functionalities of Brain Health PRO, a web-based multidomain program designed to increase dementia literacy, to the context and needs of users, providers and community organisations across Québec, Canada.Design Five consecutive qualitative co-creation focus group sessions 30–90 min in duration each, exploring potential barriers and facilitators to usability, accessibility, comprehensibility, participant recruitment and retention.Setting Virtual meetings.Participants A 15-member team based in Québec and Ontario, Canada, consisting of 9 researchers (including a graduate student and the project coordinator), representing occupational therapy, sensory rehabilitation, neuropsychology, psychology, health science and research methods, 3 informal caregivers of older adults living with cognitive decline and 3 members of the Federation of Quebec Alzheimer Societies.Data analysis Session recordings were summarised through both qualitative description and thematic analysis.Results The synthesised recommendations included adjustments around diversity, the complexity and presentation styles of the materials, suggestions on refining the web interface and the measurement approaches; it influenced aspects of participant recruitment, retention efforts and engagement with the content of Brain Health PRO.Conclusions Co-creation in dementia prevention research is important because it involves collaboration between researchers, community support and service providers, and persons with lived experience as care providers, in the design and implementation of clinical studies. This approach helps to ensure that the content and presentation of educational material is relevant and meaningful to the target population and those involved in its delivery, and it leads to a greater understanding of their needs and perspectives.