Alfredo Vannacci

This Correspondence questions the symmetry assumed by Chen et al. (Nature 650, 36–40; 2026), who treat human minds and large language models as comparable black boxes evaluated through their outputs. The asymmetry is structural. Human intelligence is a natural phenomenon whose generative mechanisms remain incompletely understood, whereas LLMs are designed systems whose operating principle (statistical optimization of token prediction) is known. For LLMs, the known mechanism already suffices to explain behaviour, without invoking understanding. Establishing artificial general intelligence would require evidence that a system's behaviour cannot be fully accounted for by its generative mechanism alone.

This study examines the use of Beatrice Alemagna's picture book 'What is a Child?' as a tool for understanding and implementing nurturing care principles in perinatal healthcare settings. Through mixed-methods analysis of forum discussions among 42 perinatal professionals, including psychologists, midwives, physicians, nurses, pharmacists and early childhood educators, we explored how engagement with the book's metaphorical and visual elements facilitated professional reflection and development. Qualitative analysis revealed four primary themes: the power of metaphors in conveying complex caregiving concepts, the importance of collective care and community support, understanding the temporality of care and fostering transformative dialogue. Quantitative analysis showed significant differences in thematic engagement across professional groups, with medical professionals emphasising physical health (20.8%) and nutrition (32.1%), while psychologists focused more on early learning opportunities (28.3%) and responsive caregiving (21.0%). However, the picture book's narrative framework encouraged professionals to transcend their domain-specific perspectives, fostering a more holistic appreciation of nurturing care principles. These findings suggest that carefully selected picture books can serve as sophisticated tools for professional development in perinatal care, particularly in translating abstract theoretical concepts into actionable insights while honouring different professional perspectives and expertise.

Background: When infertility is diagnosed, physicians have the difficult task to break bad news. Their communication skills play a central role in improving patients' coping abilities and adherence to infertility treatments. However, specific guidelines and training courses on this topic are still lacking. The aim of the present study is to provide some practical advice for improving breaking bad news in infertility diagnosis through a systematic literature review of qualitative and quantitative studies. Methods: Electronic searches were performed in the MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Psychology and Behavioral Sciences Collection databases. All articles focusing on the communication of the diagnosis of infertility were included. The main findings of each included article were then summarized. Results: Literature search identified 11,838 references that were screened for eligibility. Full texts of 81 articles were retrieved, and their analysis led to the inclusion of 4 articles, which treated the theme of communication of infertility only partially. The main addressed aspects concerning the communication of the infertility diagnosis were the following: the value that patients give to healthcare professionals' communication skills; the importance of giving clear information on diagnostic procedures and treatments in order to decrease patients' anxiety; and the importance of involving both partners. Conclusions: This review pointed out that the communication of the infertility diagnosis is still underinvestigated. Specific guidelines are currently not available, but other protocols could be used. Taking into account the principal aspects of communication highlighted with this review, in this study, we suggested an adaptation of the original SPIKES protocol that could be used by healthcare professionals for the communication of the infertility status.