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In a randomized controlled study involving 1,298 participants from a general sample, performance of humans when assisted by a large language model (LLM) was sensibly inferior to that of the LLM alone when assessing ten medical scenarios leading to disease identification and recommendations for treatment.

Large Language Models demonstrate expert-level accuracy in medical exams, supporting their potential inclusion in healthcare settings. Here, authors reveal that their metacognitive abilities are underexplored, showing significant gaps in recognizing knowledge limitations, difficulties in modulating their confidence, and challenges in identifying when a problem cannot be answered due to insufficient information.

Cibula et al. present survival results of the SENTIX trial and demonstrate that SLN biopsy alone does not increase the risk of disease recurrence in patients with early-stage cervical cancer.

Li et al. introduced tract-geometry coupling (TGC) to quantify the coupling between white matter tracts and cortical geometry in the human brain, shedding light on how the brain’s wiring and shape evolve together and its support for behavior and growth.

Resistance to anti-EGFR therapy is a clinical issue for patients with advanced head and neck cancers. Here, the authors show that therapy-resistant cancer cells enhance fatty acid metabolism, which can be therapeutically targeted by inhibiting peroxisome proliferator-activated receptor alpha (PPARα).

In the first results from an ongoing global cancer screening data repository, screening program organization was better overall in Europe compared to other continents; however, there were substantial gaps in implementation across both high- and low-resource settings.

Alcoholic hepatitis, a common cause of liver failure, lacks effective treatment. Here, the authors show altered hepatic HNF4a isoform expression and hypermethylation of its target genes in patients. HNF4a dysregulation is improved in vitro by TGFb or PPARg modulation suggesting potential therapeutic avenues.

Co-production includes diverse aims, terminologies and practices. This study explores such diversity by mapping differences in how 32 initiatives from 6 continents co-produce diverse outcomes for the sustainable development of ecosystems at local to global scales.

This study presents a predictive equation for total energy expenditure derived from doubly labelled water measurements. Applying this equation to two large datasets (the National Diet and Nutrition Survey and National Health and Nutrition Examination Survey) shows that the misreporting of total energy intake is greater than 50%, with important implications for macronutrient availability.

Although the first dissection of the human ovary dates back to the 17th century, its characterization is still limited. Here, the authors have unraveled a unique biophysical and topological phenotype of reproductive-age tissue, bridging biophysics and female fertility and providing a blueprint for the artificial ovary.

How biodiversity is linked to multiple ecosystem functions is not fully understood. Here, the authors show that a new mechanism, which they term the 'jack-of-all-trades' effect, best explains patterns of tree diversity and ecosystem multifunctionality in European forests.

A small-molecule inhibitor of TMPRSS2 is effective against SARS-CoV-2 variants of concern in human lung cells and in donor-derived colonoids, and also shows prophylactic and therapeutic benefits in a mouse model of COVID-19.

Immune checkpoint blockade has become standard care for patients with recurrent metastatic head and neck squamous cell carcinoma (HNSCC). Here the authors present the results of a non-randomized phase Ib/IIa trial, reporting safety and efficacy of neoadjuvant nivolumab monotherapy and nivolumab plus ipilimumab prior to standard-of-care surgery in patients with HNSCC. .

Hydroxychloroquine and chloroquine have been investigated as a potential treatment for Covid-19 in several clinical trials. Here the authors report a meta-analysis of published and unpublished trials, and show that treatment with hydroxychloroquine for patients with Covid-19 was associated with increased mortality, and there was no benefit from chloroquine.

Therapeutic options to treat the common cancer hepatocellular carcinoma are limited and new treatments are therefore required. Radioembolization with iodine-131 or rhenium-188 labeled lipiodol, or with yttrium-90 labeled microspheres is a promising approach. Jean-Luc Raoul and coauthors discuss the different radionuclides and delivery vehicles used, the clinical trial data and the future perspectives for radioembolization.

Examination of archaeological pottery residues and modern genes suggest that environmental conditions, subsistence economics and pathogen exposure may explain selection for lactase persistence better than prehistoric consumption of milk.

Contrary to the view that urbanization is a major driver of the global rise in obesity, the global increase in body-mass index is shown to be mostly due to increases in the body-mass indexes of rural populations.

Genome-wide association meta-analyses identify 26 risk loci for epilepsy, including 19 loci specific to genetic generalized epilepsy. Prioritized candidate genes implicate synaptic processes and overlap with targets of antiseizure medications.

Using computational modeling and EEG, the study suggests several metacognitive states correlate with rational adjustments in behavior; this might benefit steering behavior towards optimality

Impulsivity is a multi-dimensional construct, and it is plausible that distinct brain networks contribute to its different aspects. Here the authors identify distinct cortical and subcortical networks underlying cognitive, clinical and genetic dimensions of impulsivity in a large sample of adolescents.

The media can shape the collective memory of a nation. A new study reports that the organization of memory traces for World War II events in the brain follows the same structure as the collective memory schema derived from television coverage.

At Piton de la Fournaise volcano, satellite deformation allows to constrain the geometry of 57 magmatic intrusions. Versatile modeling reveals that a major spoon-shaped destabilization structure accommodates intrusions and seaward flank displacement.

MHC class I presentation of viral peptides aids CD8⁺ T cell recognition of infected cells. Desjardins and colleagues describe an MHC class I viral peptide presentation pathway that integrates autophagosomes and proteasome-dependent processes.

Replacing the β-cell mass in individuals with diabetes mellitus could restore normal metabolic control, and might become a therapy choice for these patients. This Review summarizes the options for regenerative therapy in pancreatic disease with focus on diabetes mellitus.

Here, Ferren et al. isolate Syrian hamster brainstem and lung tissue to establish ex vivo culture systems to study SARS-CoV-2 local viral tropism, immune response and tissue pathology. Further, they provide evidence that these systems can be used for screening of anti-viral compounds.

The military actions in the conflict between Ukraine and Russia have far-reaching environmental consequences, especially with regard to water management. A study presents data showing the severe impacts on water resources, sanitation and infrastructure during the first three months of the war.

Renal transplantation is the preferred treatment option for patients with autosomal dominant polycystic kidney disease (ADPKD) and end-stage renal disease. Here, the authors discuss special considerations for pretransplant screening and living-related kidney donation in patients with ADPKD, as well as post-transplant outcomes and complications in these patients.

These authors contributed equally.

People learn to exert more control after conflict detection, when stimuli associated with conflict are selectively reinforced, providing evidence for reinforcement learning of abstract cognitive control adaptations.