Explore the vast range of titles available.

Background Owing to the rapid growth in the popularity of Large Language Models (LLMs), various performance evaluation studies have been conducted to confirm their applicability in the medical field. However, there is still no clear framework for evaluating LLMs. Objective This study reviews studies on LLM evaluations in the medical field and analyzes the research methods used in these studies. It aims to provide a reference for future researchers designing LLM studies. Methods & materials We conducted a scoping review of three databases (PubMed, Embase, and MEDLINE) to identify LLM-related articles published between January 1, 2023, and September 30, 2023. We analyzed the types of methods, number of questions (queries), evaluators, repeat measurements, additional analysis methods, use of prompt engineering, and metrics other than accuracy. Results A total of 142 articles met the inclusion criteria. LLM evaluation was primarily categorized as either providing test examinations ( n  = 53, 37.3%) or being evaluated by a medical professional ( n  = 80, 56.3%), with some hybrid cases ( n  = 5, 3.5%) or a combination of the two ( n  = 4, 2.8%). Most studies had 100 or fewer questions ( n  = 18, 29.0%), 15 (24.2%) performed repeated measurements, 18 (29.0%) performed additional analyses, and 8 (12.9%) used prompt engineering. For medical assessment, most studies used 50 or fewer queries ( n  = 54, 64.3%), had two evaluators ( n  = 43, 48.3%), and 14 (14.7%) used prompt engineering. Conclusions More research is required regarding the application of LLMs in healthcare. Although previous studies have evaluated performance, future studies will likely focus on improving performance. A well-structured methodology is required for these studies to be conducted systematically.

Microproteins are small polypeptides translated from short open reading frames (sORFs) that typically encode < 100 amino acids. Advances in ribosome profiling, mass spectrometry, and computational prediction have revealed a growing number of microproteins that play important roles in cellular metabolism, organelle function, and stress adaptation; however, these were considered non-coding or functionally insignificant. At the mitochondrial level, microproteins, such as MTLN (also known as mitoregulin/MOXI) and BRAWNIN, contribute to lipid oxidation, oxidative phosphorylation efficiency, and respiratory chain assembly. Other microproteins at the endoplasmic reticulum-mitochondria interface, including PIGBOS and several muscle-resident regulators of calcium cycling, show diverse biological contexts in which these microproteins act. A subset of microproteins responds to nutrient availability. For example, SMIM26 modulates mitochondrial complex I translation under serine limitation, and non-coding RNA expressed in mesoderm-inducing cells encoded with peptides facilitates glucose uptake during differentiation, indicating that some microproteins can affect metabolic adaptation through localized translational- or organelle-level mechanisms. Rather than functioning as primary nutrient sensors, these microproteins complement classical nutrient-responsive pathways such as AMP-activated protein kinase-, peroxisome proliferator-activated receptor-, and carbohydrate response element binding protein-mediated signaling. As the catalog of microproteins continues to expand, integrating proteogenomics, nutrient biology, and functional studies will be central to defining their physiological relevance; these integrative approaches will also help reveal their potential applications in metabolic health.

In studies evaluating the association between body mass index (BMI) and risk of tuberculosis (TB), the data for the underweight population has been limited and results were conflicting. Our study aimed to evaluate whether being underweight increases the risk of TB using a nationwide representative sample from the Republic of Korea. A large population-based cohort study of over ten million subjects who participated in the health screening in 2010 was performed using the Korean National Health Insurance database 2010–2017. We evaluated the incidence and risk of TB by BMI category (kg/m 2 ) for Asians using a multivariable Cox regression model, adjusting for age, sex, smoking, alcohol consumption, regular exercise, low-income state, and underlying hypertension, diabetes mellitus, and dyslipidemia. To evaluate the association between BMI and TB risk, the underweight population was further subdivided according to the degree of thinness. During 70,063,154.3 person-years of follow-up, 52,615 of 11,135,332 individuals developed active TB with an incidence of 0.75 per 1000 person-years. Overall, there was a log-linear inverse relationship between TB incidence and BMI, within the BMI range of 15–30 kg/m 2 (R 2  = 0.95). The estimated adjusted hazard ratio (HR) for incident TB in the underweight population (BMI < 18.5) was 2.08 (95% confidence intervals, CI 2.02–2.15), overweight (23 ≤ BMI < 25) was 0.56 (0.55–0.58) and obese (BMI ≥ 25) was 0.40 (0.39–0.41) relative to the normal weight population. Among the underweight population, TB risk increased as the degree of thinness increased (adjusted HR = 1.98, 1.91–2.05; 2.50, 2.33–2.68; and 2.83, 2.55–3.15, for mild, moderate and severe thinness, respectively) ( p for trend < 0.001). We found a significant inverse relationship between BMI and TB incidence, which was especially profound in the underweight population. Public health strategies to screen TB more actively in the underweight population and improve their weight status may help reduce the burden of TB.

Most persons with confirmed coronavirus disease (COVID-19) have no or mild symptoms. During the COVID-19 pandemic, communities need efficient methods to monitor asymptomatic patients to reduce transmission. We describe the structure and operating protocols of a community treatment center (CTC) run by Seoul National University Hospital (SNUH) in South Korea. SNUH converted an existing facility into a CTC to isolate patients who had confirmed COVID-19 but mild or no symptoms. Patients reported self-measured vital signs and symptoms twice a day by using a smartphone application. Medical staff in a remote monitoring center at SNUH reviewed patient vital signs and provided video consultation to patients twice daily. The CTC required few medical staff to perform medical tests, monitor patients, and respond to emergencies. During March 5-26, 2020, we admitted and treated 113 patients at this center. CTCs could be an alternative to hospital admission for isolating patients and preventing community transmission.

[This corrects the article DOI: 10.1371/journal.pone.0270808.].

Background Stomach cancer is one the most common neoplasms with high mortality. However, fear of cancer recurrence (FCR) in stomach cancer survivors has been scarcely evaluated. Thus, the aim of this study was to evaluate FCR and factors related to FCR in Korean stomach cancer survivors. Methods A total of 363 stomach cancer survivors who had completed primary treatment and had no metastasis or recurrence were recruited between September 2014 and March 2017 regardless of time lapse after the initial diagnosis. FCR was assessed using the Korean version of the FCR Inventory (FCRI). Participants were divided into two groups; clinical FCRI group (score of severity subscale of FCRI ≥ 13) and non-clinical FCRI group (the scores < 13). Socio-demographic factors, cancer stage, treatment, psychological factors, health-related quality of life (HRQoL), and health promotion and disease prevention behaviors were obtained using a self–administered questionnaire supplemented with face-to-face interview to fill out incomplete information. Factors associated with FCR were evaluated using linear regression analysis and multiple logistic regression analysis after adjusting for age, sex, cancer stage, time since cancer diagnosis, family cancer diagnosis, and comorbidities. Results Average (standard deviation) time interval between cancer diagnosis and study participation was 7.3 (3.2) years. The distribution of socio-demographic and cancer–related factors did not differ according to the level of FCR. The higher FCRI level was associated with lower levels of social support (β: -0.190, p  < 0.001), lower emotional function (β: -0.356, p  < 0.001), more severe fatigue (β: 0.333, p  < 0.001), more sleep problems (β: 0.299, p  = 0.002), higher anxiety (β: 0.443, p  < 0.001), and higher depression (β: 0.207, p  < 0.001). However, clinical level of FCR was not associated with health promotion and disease prevention behaviors. Conclusions FCR in stomach cancer survivors was associated with social, psychological, and HRQoL factors rather than demographic, socioeconomic, or cancer–related factors. This finding suggests that careful attention to FCR is necessary to provide more comprehensive survivorship care for stomach cancer survivors.

We aimed to investigate the demographic characteristics, common chief complaints, and diagnosis of geriatric cancer-related emergency department (ED) visits and trends of ED outcomes. This retrospective observational study included all ED visits in South Korea between 2016 and 2020. The study population was older people ≥ 65 years living with cancer who visited ED with cancer-related problems. The demographics, common diagnoses, and ED outcomes were investigated. A multivariate logistic regression analysis was conducted to investigate factors associated with mortality. Geriatric cancer-related ED (GCED) visits were 746,416 cases over 5 years. The proportion of older adults among cancer-related ED visits increased from 50.1% in 2016 to 55.3% in 2020. The proportion of the “oldest old” (≥ 85 years) increased from 9.6 to 12.1%. For GCED, the ward admission rate after ED treatment was 60.2% and in-hospital mortality rate was 11.8%. Both of these increased with age group (“young old” (65–74), “middle old” (75–84), and “oldest old” (≥ 85 years) groups admission rates: 56.1%, 62.8%, and 68.0%; and mortality rates: 10.0%, 12.7%, and 15.7%, respectively). The most common diagnosis was pneumonia (4.9%). Old age and ambulance use were also associated with mortality. Older adults account for more than half of cancer-related ED visits, and their number is increasing every year. GCED visits are associated with high hospitalization and mortality, especially among the oldest old. It is important to prepare for a rise in GCED visits is necessary.

PurposeThe purpose of the Korean Frailty and Aging Cohort Study (KFACS) is to initiate a nationwide, population-based prospective cohort study of older adults living in the community to assess their frailty status and explore transitions between frailty states over time in Korea.ParticipantsThe KFACS is a multicentre longitudinal study with the baseline survey conducted from May 2016 to November 2017. Each centre recruited participants using quota sampling stratified by age and sex. The number of participants recruited through 2 years of baseline study from 10 centres was 3014, with each site accounting for approximately 300 participants. The inclusion criteria were: having an age of 70–84 years, currently living in the community, having no plans to move out in the next 2 years, having no problems with communication and no prior dementia diagnosis.Findings to dateTo define physical frailty, the KFACS used a modified version of the Fried Frailty Phenotype (FFP) consisting of five components of frailty: unintended weight loss, weakness, self-reported exhaustion, slowness and low physical activity. In the baseline study of 2016–2017, 2907 of 3014 individuals fulfilled all five components of FFP. The results indicated that 7.8% of the participants (n=228) were frail, 47.0% (n=1366) were prefrail and 45.2% (n=1313) were robust. The prevalence of frailty increased with age in both sexes; in the group aged 70–74 years, 1.8% of men and 3.7% of women were frail, whereas in the 80–84 years age group, 14.9% of men and 16.7% of women were frail. Women tended to exhibit a higher prevalence of frailty than men in all age groups.Future plansThe KFACS plans to identify outcomes and risk factors associated with frailty by conducting a 10-year cohort study, with a follow-up every 2 years, using 3014 baseline participants.

•Cyproheptadine is a safe appetite stimulant in patients with poor appetite.•Patients administered with the cyproheptadine experienced significant increases in weight and body mass index.•The most common side effect was drowsiness and cyproheptadine was well tolerated with few serious adverse events. Cyproheptadine, an antihistamine and antiserotonergic agent, is an appetite stimulant that is efficacious in promoting weight gain in children and adults with poor appetite. Despite numerous studies showing that cyproheptadine achieved positive outcomes, studies documenting its effectiveness on appetite are limited. This study evaluated the efficacy and tolerability of cyproheptadine in adults with poor appetite in South Korea. Patients aged 19 to 64 years with poor appetite were randomly assigned to receive either cyproheptadine or placebo for 8 weeks. The primary end point was the difference between the groups in change in appetite, as measured by the Korean version of the Edmonton Symptom Assessment System from the beginning to the end of the study period. The secondary end points included effects on weight, anthropometrics, body composition, Simplified Nutritional Appetite Questionnaire–measured appetite, and toxicities. A total of 375 patients were randomly assigned to the two groups (189 cyproheptadine, 186 placebo). The cyproheptadine group experienced a mean (SD) change in appetite score of –2.42 (0.12) compared with –2.03 (0.13) in the placebo arm, representing a statistically significant appetite gain in the cyproheptadine group (difference, +0.38 [0.18]; 95% CI, –0.73 to –0.04; P = 0.0307). Patients in the cyproheptadine group experienced significant increases in weight and body mass index. The most common adverse event was somnolence, as predicted. Cyproheptadine was well tolerated, with one serious adverse event (colitis) which was classified as a moderate adverse effect unlikely to be related to the study drug. We present the largest randomized, double-blind, placebo-controlled clinical trial of cyproheptadine versus placebo in healthy adults with poor appetite using the lowest effective dosage of cyproheptadine. Cyproheptadine is a safe treatment option in patients with poor appetite. Our findings provide important information for the use of cyproheptadine to ameliorate poor appetite in adults. Further randomized studies focused on the effect of cyproheptadine in older populations are needed.

Elevated neutrophil to lymphocyte ratio (NLR) has been reported as a marker for chronic inflammation, associated with poor prognosis in ischemic stroke patients, but there has been no study that investigated its association with ischemic stroke risk. This study was conducted to investigate elevated NLR as an independent risk factor for ischemic stroke incidence. Our retrospective cohort study included 24,708 generally healthy subjects aged 30-75 who received self-referred health screening at Seoul National University Hospital. Data on ischemic stroke incidence was retrieved from national medical claims registry. Median follow-up time was 5.9 years (interquartile range 4.2 years). Adjusted for major cardiovascular risk factors, compared to subjects with NLR<1.5, subjects with 2.5≤NLR<3.0, 3.0≤NLR<3.5, and NLR≥3.5 had elevated risk for ischemic stroke incidence with aHR (95% CI) of 1.76 (1.09-2.84), 2.21 (1.21-4.04), and 2.96 (1.57-5.58), respectively. NLR showed significant improvement in discrimination for ischemic stroke incidence compared to traditional cardiovascular risk factors (C-index 0.748 vs. 0.739, P = 0.025). There was significant net improvement in reclassification in Framingham risk for ischemic stroke incidence after addition of NLR, with IDI 0.0035 (P<0.0001), and NRI 6.02% (P = 0.0015). This reclassification for ischemic stroke incidence by NLR was markedly pronounced among subjects with atrial fibrillation with CHA2DS2-VASc<2 (NRI 42.41%, P = 0.056). Our study suggests elevated NLR to be an independent risk factor for ischemic stroke incidence in generally healthy adults. Future studies are needed to validate our results and further assess how subjects with elevated NLR should be managed within current guidelines.