Real-world study of the multimorbidity and health service utilisation among individuals with non-diabetic hyperglycemia and type 2 diabetes mellitus in North West London.

INTRODUCTION: The prevalence of non-diabetic hyperglycemia (NDH) and type 2 diabetes mellitus (T2DM) is increasing. While T2DM is recognised to be associated with multimorbidity and early mortality, people with NDH are frequently thought to be devoid of such complications, potentially exposing individuals with NDH to suboptimal care. We therefore used the Discover London Secure Data Environment (SDE) dataset to appreciate the relationship of NDH/T2DM with multimorbidity, healthcare usage, and clinical outcomes. RESEARCH DESIGN AND METHODS: The dataset was retrospectively analysed between January 1, 2015 and December 31, 2020 to understand the relationship between NDH/T2DM and multimorbidity primary/secondary healthcare usage and clinical outcomes. This was compared with a cohort of individuals with thyroid disease but no NDH/T2DM. RESULTS: The dataset identified 152,384 and 124,190 adults with NDH and T2DM compared with 11,626 individuals with thyroid disease (control group). Individuals with NDH and individuals with T2DM had a high burden of disease, with only 13.1% of individuals with either NDH or T2DM not found to be suffering from at least one of the disease states of interest. The three most common comorbidities experienced by individuals with NDH were hypertension (41.4%), hypercholesterolemia (37.5%), and obesity (29.8%) compared with retinopathy (68.7%), hypertension (59.4%), and obesity (45.8%) in individuals with T2DM. Comparatively, the most common comorbidities in the control group were depression (30.8%), hypercholesterolemia (24.4%), and hypertension (17.1%). 28 (control group), 12 (NDH), and 16 (T2DM) primary care contacts per individual per year were identified, with 27,881, 282,371, and 314,880 inpatient admissions for the control, NDH, and T2DM cohorts, respectively. Prescription of drugs used to treat T2DM in individuals with NDH and T2DM was 27,772 (18.2%) and 109,361 (88.1%), respectively, accounting for approximately one in five individuals with NDH developing T2DM. CONCLUSION: Both NDH and T2DM were associated with significant multimorbidity alongside primary and secondary care utilisation. Given the morbidity highlighted with NDH, we highlight the need for earlier detection of NDH, recognition of multimorbidity associated with both NDH and T2DM, as well as the need for the further implementation of interventions to prevent progression to T2DM/multimorbidity.

Shared functional specialization in transformer-based language models and the human brain.

When processing language, the brain is thought to deploy specialized computations to construct meaning from complex linguistic structures. Recently, artificial neural networks based on the Transformer architecture have revolutionized the field of natural language processing. Transformers integrate contextual information across words via structured circuit computations. Prior work has focused on the internal representations ("embeddings") generated by these circuits. In this paper, we instead analyze the circuit computations directly: we deconstruct these computations into the functionally-specialized "transformations" that integrate contextual information across words. Using functional MRI data acquired while participants listened to naturalistic stories, we first verify that the transformations account for considerable variance in brain activity across the cortical language network. We then demonstrate that the emergent computations performed by individual, functionally-specialized "attention heads" differentially predict brain activity in specific cortical regions. These heads fall along gradients corresponding to different layers and context lengths in a low-dimensional cortical space.

Word Forms Reflect Trade-Offs Between Speaker Effort and Robust Listener Recognition.

How do cognitive pressures shape the lexicons of natural languages? Here, we reframe George Kingsley Zipf's proposed "law of abbreviation" within a more general framework that relates it to cognitive pressures that affect speakers and listeners. In this new framework, speakers' drive to reduce effort (Zipf's proposal) is counteracted by the need for low-frequency words to have word forms that are sufficiently distinctive to allow for accurate recognition by listeners. To support this framework, we replicate and extend recent work using the prevalence of subword phonemic sequences (phonotactic probability) to measure speakers' production effort in place of Zipf's measure of length. Across languages and corpora, phonotactic probability is more strongly correlated with word frequency than word length. We also show this measure of ease of speech production (phonotactic probability) is strongly correlated with a measure of perceptual difficulty that indexes the degree of competition from alternative interpretations in word recognition. This is consistent with the claim that there must be trade-offs between these two factors, and is inconsistent with a recent proposal that phonotactic probability facilitates both perception and production. To our knowledge, this is the first work to offer an explanation why long, phonotactically improbable word forms remain in the lexicons of natural languages.

Learning From Aggregated Opinion.

The capacity to leverage information from others' opinions is a hallmark of human cognition. Consequently, past research has investigated how we learn from others' testimony. Yet a distinct form of social information-aggregated opinion-increasingly guides our judgments and decisions. We investigated how people learn from such information by conducting three experiments with participants recruited online within the United States (N = 886) comparing the predictions of three computational models: a Bayesian solution to this problem that can be implemented by a simple strategy for combining proportions with prior beliefs, and two alternatives from epistemology and economics. Across all studies, we found the strongest concordance between participants' judgments and the predictions of the Bayesian model, though some participants' judgments were better captured by alternative strategies. These findings lay the groundwork for future research and show that people draw systematic inferences from aggregated opinion, often in line with a Bayesian solution.

Reconciling shared versus context-specific information in a neural network model of latent causes.

It has been proposed that, when processing a stream of events, humans divide their experiences in terms of inferred latent causes (LCs) to support context-dependent learning. However, when shared structure is present across contexts, it is still unclear how the "splitting" of LCs and learning of shared structure can be simultaneously achieved. Here, we present the Latent Cause Network (LCNet), a neural network model of LC inference. Through learning, it naturally stores structure that is shared across tasks in the network weights. Additionally, it represents context-specific structure using a context module, controlled by a Bayesian nonparametric inference algorithm, which assigns a unique context vector for each inferred LC. Across three simulations, we found that LCNet could (1) extract shared structure across LCs in a function learning task while avoiding catastrophic interference, (2) capture human data on curriculum effects in schema learning, and (3) infer the underlying event structure when processing naturalistic videos of daily events. Overall, these results demonstrate a computationally feasible approach to reconciling shared structure and context-specific structure in a model of LCs that is scalable from laboratory experiment settings to naturalistic settings.

Variations in orientation relationships between rutile inclusions and garnet host relate to magmatic growth zoning.

Rutile inclusions in almandine-spessartine garnet from a peraluminous pegmatoid from the Moldanubian zone (Bohemian Massif, AT) show distinct changes in aspect ratio, shape preferred orientations (SPO) and crystallographic orientation relationships (COR) along the transition between microstructurally different growth zones in the garnet core and rim. For identification of the COR characteristics we pool specific CORs based on their common axial relationship into three COR groups: Group 103R/111G, Group 001R/111G and Group 001R/100G. The rutile inclusions in the garnet core domains are elongated along the four Grt ⟨ 111 ⟩ directions and are dominated by COR Group 103R/111G. The garnet rim zone additionally contains rutile needles elongated along Grt ⟨ 100 ⟩ . Here, Group 001R/111G and 001R/100G are more abundant than in the garnet core. Needle-shaped rutile in the rim shows a systematic correlation between SPOs and CORs as needles elongated parallel to Grt ⟨ 111 ⟩ are dominated by Group 103R/111G and 001R/111G, whereas those needles elongated parallel to Grt ⟨ 100 ⟩ exclusively pertain to CORs of 001R/100G. Furthermore, the frequency of each particular SPO in the garnet rim clearly depends on the local growth direction of the particular Grt{112} sector. Facet-specific variations in rutile SPO frequencies in different sectors and growth zones of garnet were observed even between equivalent directions, indicating that the microstructures and textures of rutile inclusions reflect varying parameters of garnet growth. The characteristic differences in COR groups of different garnet growth zones are referred to compositional changes in the bulk melt or compositional boundary layer, associated with magmatic fractional crystallisation. Supplementary Information: The online version contains supplementary material available at 10.1007/s00410-024-02146-9.

Using games to understand the mind.

Board, card or video games have been played by virtually every individual in the world. Games are popular because they are intuitive and fun. These distinctive qualities of games also make them ideal for studying the mind. By being intuitive, games provide a unique vantage point for understanding the inductive biases that support behaviour in more complex, ecological settings than traditional laboratory experiments. By being fun, games allow researchers to study new questions in cognition such as the meaning of 'play' and intrinsic motivation, while also supporting more extensive and diverse data collection by attracting many more participants. We describe the advantages and drawbacks of using games relative to standard laboratory-based experiments and lay out a set of recommendations on how to gain the most from using games to study cognition. We hope this Perspective will lead to a wider use of games as experimental paradigms, elevating the ecological validity, scale and robustness of research on the mind.

Identifying resource-rational heuristics for risky choice.

Perfectly rational decision making is almost always out of reach for people because their computational resources are limited. Instead, people may rely on computationally frugal heuristics that usually yield good outcomes. Although previous research has identified many such heuristics, discovering good heuristics and predicting when they will be used remains challenging. Here, we present a theoretical framework that allows us to use methods from machine learning to automatically derive the best heuristic to use in any given situation by considering how to make the best use of limited cognitive resources. To demonstrate the generalizability and accuracy of our method, we compare the heuristics it discovers against those used by people across a wide range of multi-attribute risky choice environments in a behavioral experiment that is an order of magnitude larger than any previous experiments of its type. Our method rediscovered known heuristics, identifying them as rational strategies for specific environments, and discovered novel heuristics that had been previously overlooked. Our results show that people adapt their decision strategies to the structure of the environment and generally make good use of their limited cognitive resources, although their strategy choices do not always fully exploit the structure of the environment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reconciling categorization and memory via environmental statistics.

How people represent categories and how those representations change over time is a basic question about human cognition. Previous research has demonstrated that people categorize objects by comparing them to category prototypes in early stages of learning but consider the individual exemplars within each category in later stages. However, these results do not seem consistent with findings in the memory literature showing that it becomes increasingly easier to access representations of general knowledge than representations of specific items over time. Why would one rely more on exemplar-based representations in later stages of categorization when it is more difficult to access these exemplars in memory? To reconcile these incongruities, our study proposed that previous findings on categorization are a result of human participants adapting to a specific experimental environment, in which the probability of encountering an object stays uniform over time. In a more realistic environment, however, one would be less likely to encounter the same object if a long time has passed. Confirming our hypothesis, we demonstrated that under environmental statistics identical to typical categorization experiments the advantage of exemplar-based categorization over prototype-based categorization increases over time, replicating previous research in categorization. In contrast, under realistic environmental statistics simulated by our experiments the advantage of exemplar-based categorization over prototype-based categorization decreases over time. A second set of experiments replicated our results, while additionally demonstrating that human categorization is sensitive to the category structure presented to the participants. These results provide converging evidence that human categorization adapts appropriately to environmental statistics.

The universal law of generalization holds for naturalistic stimuli.

Shepard's universal law of generalization is a remarkable hypothesis about how intelligent organisms should perceive similarity. In its broadest form, the universal law states that the level of perceived similarity between a pair of stimuli should decay as a concave function of their distance when embedded in an appropriate psychological space. While extensively studied, evidence in support of the universal law has relied on low-dimensional stimuli and small stimulus sets that are very different from their real-world counterparts. This is largely because pairwise comparisons-as required for similarity judgments-scale quadratically in the number of stimuli. We provide strong evidence for the universal law in a naturalistic high-dimensional regime by analyzing an existing data set of 214,200 human similarity judgments and a newly collected data set of 390,819 human generalization judgments (N = 2,406 U.S. participants) across three sets of natural images. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Replies to commentaries on beyond playing 20 questions with nature.

Commentaries on the target article offer diverse perspectives on integrative experiment design. Our responses engage three themes: (1) Disputes of our characterization of the problem, (2) skepticism toward our proposed solution, and (3) endorsement of the solution, with accompanying discussions of its implementation in existing work and its potential for other domains. Collectively, the commentaries enhance our confidence in the promise and viability of integrative experiment design, while highlighting important considerations about how it is used.

Improving Memory Search Through Model-Based Cue Selection.

We often use cues from our environment when we get stuck searching our memories, but prior research has failed to show benefits of cuing with other, randomly selected list items during memory search. What accounts for this discrepancy? We proposed that cues' content critically determines their effectiveness and sought to select the right cues by building a computational model of how cues affect memory search. Participants (N = 195 young adults from the United States) recalled significantly more items when receiving our model's best (vs. worst) cue. Our model provides an account of why some cues better aid recall: Effective cues activate contexts most similar to the remaining items' contexts, facilitating recall in an unsearched area of memory. We discuss our contributions in relation to prominent theories about the effect of external cues.

Optimal metacognitive control of memory recall.

Most of us have experienced moments when we could not recall some piece of information but felt that it was just out of reach. Research in metamemory has established that such judgments are often accurate; but what adaptive purpose do they serve? Here, we present an optimal model of how metacognitive monitoring (feeling of knowing) could dynamically inform metacognitive control of memory (the direction of retrieval efforts). In two experiments, we find that, consistent with the optimal model, people report having a stronger memory for targets they are likely to recall and direct their search efforts accordingly, cutting off the search when it is unlikely to succeed and prioritizing the search for stronger memories. Our results suggest that metamemory is indeed adaptive and motivate the development of process-level theories that account for the dynamic interplay between monitoring and control. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reconciling truthfulness and relevance as epistemic and decision-theoretic utility.

People use language to influence others' beliefs and actions. Yet models of communication have diverged along these lines, formalizing the speaker's objective in terms of either the listener's beliefs or actions. We argue that this divergence lies at the root of a longstanding controversy over the Gricean maxims of truthfulness and relevance. We first bridge the divide by introducing a speaker model which considers both the listener's beliefs (epistemic utility) and their actions (decision-theoretic utility). We show that formalizing truthfulness as an epistemic utility and relevance as a decision-theoretic utility reconciles the tension between them, readily explaining puzzles such as context-dependent standards of truthfulness. We then test a set of novel predictions generated by our model. We introduce a new signaling game which decouples utterances' truthfulness and relevance, then use it to conduct a pair of experiments. Our first experiment demonstrates that participants jointly maximize epistemic and decision-theoretic utility, rather than either alone. Our second experiment shows that when the two conflict, participants make a graded tradeoff rather than prioritizing one over the other. These results demonstrate that human communication cannot be reduced to influencing beliefs or actions alone. Taken together, our work provides a new foundation for grounding rational communication not only in what we believe, but in what those beliefs lead us to do. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

UVB-emitting LEDs for reptile lighting: Identifying the risks of nonsolar UV spectra.

UVB lamps are used to provide reptiles housed indoors with the UV radiation necessary to synthesize vitamin D3 in their skin. Since 2019, UVB-LED lamps have been on sale for use in reptile husbandry. We performed spectral analysis and mapped the UV irradiance for 18 of these lamps. The positive benefits of UVB-LED lamps over traditional products include greater energy efficiency, freedom from mercury and easy installation without external ballasts. However, the spectra of all the UVB-LED lamps tested had little similarity to the solar UV spectrum. Some lamps emitted short-wavelength, non-terrestrial, radiation known to cause acute photo-kerato-conjunctivitis; we report one case. All lamps were lacking significant output in the range 315-335 nm, essential for natural self-regulation of cutaneous vitamin D3 synthesis, preventing overproduction. We describe a possible risk of serious hypervitaminosis D based on our spectral analysis. We call for long-term animal studies to assess this risk, in which the reptiles under these lamps are exposed to species-appropriate UV index levels according to their Ferguson Zone allocation and serum levels of vitamin D3 and 25(OH)D3 monitored. Spectral modifications of the lamps to make the spectrum more like sunlight may be an essential way of mitigating this risk.

Optimal nudging for cognitively bounded agents: A framework for modeling, predicting, and controlling the effects of choice architectures.

People's decisions often deviate from classical notions of rationality, incurring costs to themselves and society. One way to reduce the costs of poor decisions is to redesign the decision problems people face to encourage better choices. While often subtle, these nudges can have dramatic effects on behavior and are increasingly popular in public policy, health care, and marketing. Although nudges are often designed with psychological theories in mind, they are typically not formalized in computational terms and their effects can be hard to predict. As a result, designing nudges can be difficult and time-consuming. To address this challenge, we propose a computational framework for understanding and predicting the effects of nudges. Our approach builds on recent work modeling human decision making as adaptive use of limited cognitive resources, an approach called resource-rational analysis. In our framework, nudges change the metalevel problem the agent faces-that is, the problem of how to make a decision. This changes the optimal sequence of cognitive operations an agent should execute, which in turn influences their behavior. We show that models based on this framework can account for known effects of nudges based on default options, suggested alternatives, and information highlighting. In each case, we validate the model's predictions in an experimental process-tracing paradigm. We then show how the framework can be used to automatically construct optimal nudges, and demonstrate that these nudges improve people's decisions more than intuitive heuristic approaches. Overall, our results show that resource-rational analysis is a promising framework for formally characterizing and constructing nudges. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Machine culture.

The ability of humans to create and disseminate culture is often credited as the single most important factor of our success as a species. In this Perspective, we explore the notion of 'machine culture', culture mediated or generated by machines. We argue that intelligent machines simultaneously transform the cultural evolutionary processes of variation, transmission and selection. Recommender algorithms are altering social learning dynamics. Chatbots are forming a new mode of cultural transmission, serving as cultural models. Furthermore, intelligent machines are evolving as contributors in generating cultural traits-from game strategies and visual art to scientific results. We provide a conceptual framework for studying the present and anticipated future impact of machines on cultural evolution, and present a research agenda for the study of machine culture.

Rational Simplification and Rigidity in Human Planning.

Planning underpins the impressive flexibility of goal-directed behavior. However, even when planning, people can display surprising rigidity in how they think about problems (e.g., "functional fixedness") that lead them astray. How can our capacity for behavioral flexibility be reconciled with our susceptibility to conceptual inflexibility? We propose that these tendencies reflect avoidance of two cognitive costs: the cost of representing task details and the cost of switching between representations. To test this hypothesis, we developed a novel paradigm that affords participants opportunities to choose different families of simplified representations to plan. In two preregistered, online studies (Ns = 377 and 294 adults), we found that participants' optimal behavior, suboptimal behavior, and reaction time were explained by a computational model that formalized people's avoidance of representational complexity and switching. These results demonstrate how the selection of simplified, rigid representations leads to the otherwise puzzling combination of flexibility and inflexibility observed in problem solving.

Resampling reduces bias amplification in experimental social networks.

Large-scale social networks are thought to contribute to polarization by amplifying people's biases. However, the complexity of these technologies makes it difficult to identify the mechanisms responsible and evaluate mitigation strategies. Here we show under controlled laboratory conditions that transmission through social networks amplifies motivational biases on a simple artificial decision-making task. Participants in a large behavioural experiment showed increased rates of biased decision-making when part of a social network relative to asocial participants in 40 independently evolving populations. Drawing on ideas from Bayesian statistics, we identify a simple adjustment to content-selection algorithms that is predicted to mitigate bias amplification by generating samples of perspectives from within an individual's network that are more representative of the wider population. In two large experiments, this strategy was effective at reducing bias amplification while maintaining the benefits of information sharing. Simulations show that this algorithm can also be effective in more complex networks.

On the hazards of relating representations and inductive biases.

The success of models of human behavior based on Bayesian inference over logical formulas or programs is taken as evidence that people employ a "language-of-thought" that has similarly discrete and compositional structure. We argue that this conclusion problematically crosses levels of analysis, identifying representations at the algorithmic level based on inductive biases at the computational level.