Jingxian He

Junjie Wang, Xianyang Gan, Dan Liu et al.

The widespread adoption of generative artificial intelligence conversational agents (AICAs) among university students constitutes a novel cognitive social environment whose impact on the maturing brain remains elusive. Combining surveys with high resolution structural MRI, we examined patterns of general, functional, and socio emotional AICA use, academic performance, mental health, and brain structural signatures in a comparatively large sample of 222 young individuals. Across computational anatomy, meta analytic network level, and behavioral decoding analyses, we observed use specific associations. Higher general and functional AICA use frequencies were linked to better academic outcomes (GPA), larger dorsolateral prefrontal and calcarine gray matter volume, and enhanced hippocampal network clustering and local efficiency. In contrast, more frequent socio emotional AICA use was associated with poorer mental health (depression, social anxiety) and lower volume of superior temporal and amygdalar regions central to social and affective processing. These findings indicate that the same class of AI tools exerts distinct effects depending on usage patterns and motivations, engaging prefrontal hippocampal systems that support cognition versus socio emotional systems that may track distress linked usage. These heterogeneities are crucial for designing environments that harness the educational benefits of AI while mitigating mental health risks.

Jiahui Niu, Huizi Yu, Wenkong Wang et al.

Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care. Here, we propose AIPatient Arena, an EHRs-grounded evaluation framework for assessing the clinical utility of LLMs across eight dimensions of clinical competence. The framework integrates EHR data into patient-specific knowledge graphs, enabling multi-turn physician-patient interactions. We applied AIPatient Arena on a primary cohort of 437 patients and two out-of-distribution validation cohorts of 119 and 67 patients. We observe that LLMs performed well in medical interview questioning skills (QS; mean scores, 4.43-4.99/5), ethical and professional conduct (ET; 4.38-4.93/5), and clarity and transparency of clinical explanations (EX; 3.80-4.72/5). Performance was moderate in information integration (II; 3.19-4.21/5) and medication safety and justification (MS; 3.13-3.78/5), but persistent weaknesses were observed in handling of ambiguous patient responses (HR; 2.57-3.32/5), information coverage (IC; 2.08-3.02/5), and diagnostic accuracy and reasoning (Dx; 2.63-3.55/5). Process-based evaluation revealed recurrent interaction failures, including repetitive questioning, omission of past medical history, and inadequate handling of uncertainty. Richer conversational context improved diagnostic reasoning but yielded limited gains in treatment planning. These findings indicate that final-answer accuracy alone is insufficient for evaluating clinical readiness and highlight the importance of assessing how models gather, interpret, and communicate information throughout a consultation. AIPatient Arena provides an EHR-grounded framework for workflow-oriented pre-deployment evaluation of medical LLMs.