Large Language Models lack essential metacognition for reliable medical reasoning.

Large Language Models have demonstrated expert-level accuracy on medical board examinations, suggesting potential for clinical decision support systems. However, their metacognitive abilities, crucial for medical decision-making, remain largely unexplored. To address this gap, we developed MetaMedQA, a benchmark incorporating confidence scores and metacognitive tasks into multiple-choice medical questions.

Impact of high-quality, mixed-domain data on the performance of medical language models.

Objective: To optimize the training strategy of large language models for medical applications, focusing on creating clinically relevant systems that efficiently integrate into healthcare settings, while ensuring high standards of accuracy and reliability.

Materials And Methods: We curated a comprehensive collection of high-quality, domain-specific data and used it to train several models, each with different subsets of this data. These models were rigorously evaluated against standard medical benchmarks, such as the USMLE, to measure their performance.

Nonsurgical Consecutive Exotropia Following Childhood Esotropia: A Multicentered Study.

Purpose: Nonsurgical consecutive exotropia (NCX) occurs when an esotropia (ET) spontaneously converts to exotropia (XT) without surgical intervention. Although NCX is considered to occur in early-onset accommodative ET with high hyperopia, consensus on causation is lacking. We report the clinical characteristics of NCX and assess the response to conservative management.

Spatial Resolution Evaluation Based on Experienced Visual Categories With Sweep Evoked Periodic EEG Activity.

Purpose: Visual function is typically evaluated in clinical settings with visual acuity (VA), a test requiring to behaviorally match or name optotypes such as tumbling E or Snellen letters. The ability to recognize these symbols has little in common with the automatic and rapid visual recognition of socially important stimuli in real life. Here we use sweep visual evoked potentials to assess spatial resolution objectively based on the recognition of human faces and written words.

Frontotemporal dementia patients exhibit deficits in predictive saccades.

Prediction and time estimation are all but required for motor function in everyday life. In the context of eye movements, for instance, they allow predictive saccades and eye re-acceleration in anticipation of a target re-appearance. While the neural pathways involved are not fully understood, it is known that the frontal lobe plays an important role.

Vision Screening in Belgian Children: Too Much or Not Enough?

Purpose: To describe the vision screening procedures in the three Belgian linguistic communities and present Belgian screening results.

Methods: Analyses were carried out on 636 260 Belgian children between 2009 and 2016. Pre-school children were tested once or twice, while schoolchildren were tested seven or eight times.

Motor skills in children with strabismus.

Purpose: To assess the extent to which strabismus in children was associated with motor difficulties and to examine which parameters of strabismus were most closely associated with motor development.

Methods: The motor skills of children who were suffering from strabismus, were tested binocularly using the Movement Assessment Battery for Children, Second Edition (MABC-2) and compared with the motor performance of monocularly tested healthy controls without any ophthalmologic disease.

Results: A total of 40 children with strabismus (mean, 7.

Integration of past and current visual information during eye movements in amblyopia.

Combination of signals based on their reliability is an increasingly popular model for sensorimotor processing. However, how reliability is estimated, or how such estimation is affected by prolonged exposure to noisy inputs, is still unknown. In this study, we compare patients with unilateral functional amblyopia with control subjects tracking either a reliable target, or a blurry, unreliable target, in a task of repeated, sustained smooth pursuit.

Rapid Objective Assessment of Contrast Sensitivity and Visual Acuity With Sweep Visual Evoked Potentials and an Extended Electrode Array.

Purpose: Sweep visual evoked potentials (sVEPs) provide an implicit, objective, and sensitive evaluation of low-level visual functions such as visual acuity and contrast sensitivity. For practical and traditional reasons, sVEPs in ophthalmologic examinations have usually been recorded over a single or a limited number of electrodes over the medial occipital region. Here we examined whether a higher density of recording electrodes improves the estimation of individual low-level visual thresholds with sVEPS, and to which extent such testing could be streamlined for clinical application.

Case Report: Red Urine After Day Care Strabismus Surgery.

In the absence of surgery on the urinary tract, the emission of red urine after anesthesia should be considered as a diagnostic emergency because it can be a sign of hematuria, hemoglobinuria, blood transfusion reaction, significant myoglobinuria, or porphyria.This case describes the management of a 12-year-old boy who presented red urine at the day care unit after strabismus surgery.

Development of internal models and predictive abilities for visual tracking during childhood.

The prediction of the consequences of our own actions through internal models is an essential component of motor control. Previous studies showed improvement of anticipatory behaviors with age for grasping, drawing, and postural control. Since these actions require visual and proprioceptive feedback, these improvements might reflect both the development of internal models and the feedback control.

Spontaneous improvement in oculomotor function of children with cerebral palsy.

Eye movements are essential to get a clear vision of moving objects. In the present study, we assessed quantitatively the oculomotor deficits of children with cerebral palsy (CP). We recorded eye movements of 51 children with cerebral palsy (aged 5-16 years) with relatively mild motor impairment and compared their performance with age-matched control and premature children.

The saccadic system does not compensate for the immaturity of the smooth pursuit system during visual tracking in children.

Motor skills improve with age from childhood into adulthood, and this improvement is reflected in the performance of smooth pursuit eye movements. In contrast, the saccadic system becomes mature earlier than the smooth pursuit system. Therefore, the present study investigates whether the early mature saccadic system compensates for the lower pursuit performance during childhood.

Dramatic impairment of prediction due to frontal lobe degeneration.

Prediction is essential for motor function in everyday life. For instance, predictive mechanisms improve the perception of a moving target by increasing eye speed anticipatively, thus reducing motion blur on the retina. Subregions of the frontal lobes play a key role in eye movements in general and in smooth pursuit in particular, but their precise function is not firmly established.

Review of the major findings about Duane retraction syndrome (DRS) leading to an updated form of classification.

In view of all the reported evidence by electromyography in the 1970s, by histology in the 1980s, and by cerebral imagery since the 2000s, Duane retraction syndrome (DRS) has been described as the consequence of a congenital anomaly of the 6th cranial nerve nuclei with aberrant innervations by supply from the 3rd cranial nerve. Both genetic and environmental factors are likely to play a role when the cranial nerves and ocular muscles are developing between the 4th and the 8th week of gestation. New data from eye movement recordings contributed to better understanding the binocular control of saccades.

Binocular coordination of saccades in Duane Retraction Syndrome.

Disconjugate oculomotor adaptation is driven by the need to maintain binocular vision. Since binocular vision in Duane Retraction Syndrome (DRS) patients is normal in half of their horizontal field of gaze (i.e.

Properties of saccades in Duane retraction syndrome.

Purpose: To improve understanding of the binocular control of saccades by making high-resolution eye movement recordings in patients with unilateral Duane retraction syndrome (DRS) type I (marked by congenital absence of the sixth cranial nerve).

Methods: Binocular eye movements were recorded in four patients in binocular viewing conditions during a saccade task.

Results: Affected-side gaze showed normal saccades of the sound eye and undershooting saccades of the affected eye-evidence of intact interneurons, but deficient motoneurons, in the sixth-nerve nucleus on the affected side.

What triggers catch-up saccades during visual tracking?

When tracking moving visual stimuli, primates orient their visual axis by combining two kinds of eye movements, smooth pursuit and saccades, that have very different dynamics. Yet, the mechanisms that govern the decision to switch from one type of eye movement to the other are still poorly understood, even though they could bring a significant contribution to the understanding of how the CNS combines different kinds of control strategies to achieve a common motor and sensory goal. In this study, we investigated the oculomotor responses to a large range of different combinations of position error and velocity error during visual tracking of moving stimuli in humans.