Journal of Yeungnam medical science最新文献

Background: The question of whether large language models (LLMs) possess consciousness has been increasingly debated. Integrated information theory (IIT) offers a quantitative framework for assessing consciousness through a measure of integrated information.

Methods: This study applied IIT principles to the architecture of transformer-based LLMs, focusing on causal integration, temporal persistence, and system irreducibility. Ablation experiments on Generative Pretrained Transformer 2 (GPT-2) were performed, selectively removing individual attention heads and measuring changes in perplexity as a behavioral proxy for integrated information to empirically approximate the measure of integrated information.

Results: The ablation study of a single attention head produced minimal or negative changes in perplexity in four out of five representative sentences, indicating redundancy or noise. Only one sentence revealed a significant increase in perplexity change (ΔPPL +11.29), reflecting a localized but nonessential contribution. A comparison with biological systems demonstrated that LLMs meet the IIT criterion of differentiation, but fail to meet the criteria of integration, causal closure, and temporal persistence. These findings confirm that LLMs are architecturally decomposable, lack persistent internal states, and do not sustain global causal irreducibility. Philosophical considerations, including Searle's Chinese Room argument, further support the idea that the linguistic fluency of LLMs arises from syntactic manipulation rather than semantic understanding.

Conclusion: Current LLMs do not satisfy the structural and informational requirements of consciousness under IIT. Although capable of simulating intelligent language, LLMs remain unconscious systems with a negligible amount of integrated information, underscoring the distinction between linguistic competence and conscious experience.

After a year of exchange in Montreal, a South Korean academic physiatrist and his Canadian colleague have reflected on the strengths and weaknesses of their respective healthcare systems. They have focused more specifically on physiatrist-delivered pain medicine treatments. This article is written based on personal perspectives. It aims to present the differences between the systems in South Korea and Quebec, highlighting the issues arising from each system and providing perspectives on potential solutions.

Pancreatoblastoma is an extremely rare pediatric pancreatic tumor that primarily affects children <10 years of age, with a mean age of onset of 5 years. Risk factors such as vascular and lymph node involvement often lead to incomplete resection, necessitating a multidisciplinary approach. Despite these strategies, the role of radiotherapy in the management of pancreatoblastoma remains unclear. A quantitative literature search of the PubMed database was performed to identify relevant case reports and series that explicitly documented the use of radiotherapy for pancreatoblastoma. The search covered the period from January 1986 to November 2024. Of the 36 records retrieved, seven case reports comprising eight patients fulfilled the inclusion criteria. Six patients underwent radiotherapy at the primary tumor site with external beam therapy doses ranging from 36 to 46.2 Gy. Intraoperative radiotherapy was also administered in two cases, with doses of 15 and 20 Gy. Additionally, stereotactic radiotherapy was administered to two patients with intracranial metastases, demonstrating its effectiveness in managing brain metastases. Although the role of radiotherapy in pancreatoblastoma remains ambiguous, it demonstrates promise in cases of incomplete resection, recurrence, or non-resectable disease. However, pediatric patients require careful consideration because of potential long-term side effects. Further research is required to optimize radiotherapy protocols and integrate emerging therapies.

Background: Escherichia coli (EC), Escherichia fergusonii (EF), and Citrobacter freundii (CF) are clinically significant Gram-negative bacteria that are difficult to differentiate because of their shared 16S rRNA gene sequences.

Methods: This study presents a novel approach utilizing adenylate kinase (adk) gene polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis for the precise discrimination of EC, EF, and CF. Analysis of adk sequences revealed unique restriction sites for BtsIMutI, BtgI, and AgeI restriction enzymes at nucleotide positions 93 and 96.

Results: Theoretical predictions translated into distinct banding patterns during agarose gel electrophoresis following PCR/restriction digestion. Experimental validation with reference strains and clinical isolates, including 84 EC and CF strains, demonstrated the efficacy of this method for differentiating these species. Assay specificity was confirmed by selective digestion of adk amplicons with BtsIMutI for EC and AgeI for CF.

Conclusion: This molecular technique provides a rapid and accurate method to discriminate between closely related bacterial species and is promising for clinical diagnostics and epidemiological studies. Thus, our adk PCR/restriction digestion assay is a valuable tool for the advancement of bacterial typing methods for EC, EF, and CF, and contributes to the ongoing exploration of microbial diversity and epidemiology.

Background: Motorcycles are widely used in various transportation sectors, but riders are directly exposed to external risks. Consequently, motorcyclists are more vulnerable to severe injuries. Road speed limits serve as key policy interventions to mitigate this risk. This study aims to evaluate the effects of reducing urban road speed limits on motorcyclist traffic accidents.

Methods: In this study, National Emergency Department Information System data from the seven largest cities in South Korea were analyzed by comparing a pre-implementation (April 17, 2018 to April 16, 2019) and post-implementation (April 17, 2021 to April 16, 2022) phase. The Pearson chi-square test was used. Additionally, univariable and multivariable logistic regression analyses were performed to assess the effects of the policy on emergency operations, intensive care unit (ICU) admission, and clinical outcomes. Statistical significance was set at p<0.05.

Results: The number of patients decreased from 16,124 to 13,201, along with a reduction in emergency surgeries (n=61) and ICU admissions (n=184); however, unfavorable outcomes increased (n=9). The risk of emergency surgery (adjusted odds ratio [aOR], 1.093; 95% confidence interval [CI], 0.935-1.277) was not statistically significant. However, the risk of ICU admission (aOR, 1.147; 95% CI, 1.015-1.296) and unfavorable outcomes (aOR, 1.502; 95% CI, 1.052-2.145) increased significantly in the post-implementation period.

Conclusion: Although the number of patients significantly decreased, there was no corresponding improvement in clinical outcomes. Instead of abolishing the policy, revising it would be a more appropriate approach. Therefore, additional public interventions and educational programs are required.

Chronic thromboembolic pulmonary hypertension (CTEPH) leads to increased vascular resistance and progressive right heart failure resulting from occlusion of proximal pulmonary arteries by fibrotic intravascular material. The elective surgical treatment for CTEPH is pulmonary endarterectomy (PEA), which involves removal of the chronic thromboembolic material from the entire pulmonary arterial tree. This study aimed to verify the effects of acute and subacute postoperative rehabilitation on the functional exercise capacity, dyspnea, and quality of life (QoL) of patients with CTEPH undergoing PEA. This was a systematic review of seven primary databases. At the end of the selection process, five documents were included in the final analysis. Three of these five studies were conducted in Italy, one in Korea, and one in Germany. Of 204 patients, 95 (47%) were male. This systematic review determined that in patients with CTEPH pre-PEA, the 6-minute walk distance (6MWD) ranged between 284.7 m and 371.95 m and that at 6 to 12 weeks post-PEA, after having attended postoperative rehabilitation, the 6MWD was 434.1 m to 483.6 m. The Short Form-36 Health Survey (SF-36) questionnaire was administered to evaluate QoL 3 and 22 weeks after PEA. At 22 weeks, the SF-36 physical component summary score improved from baseline (42.78±18.37 points) by 19.55±19.42 points (p=0.001), and the SF-36 mental component summary score improved from baseline (55.76±23.94 points) by 6.36±20.44 points (p=0.137).

This comprehensive review examines the crucial role of micronutrients in the health of children and adolescents, focusing on their growth and development. Micronutrients, including vitamins and trace elements, are essential for various biochemical processes and biological functions. We explored the roles, assessment methods, deficiency patterns, and intervention strategies for six essential micronutrients: iron, zinc, vitamin A, vitamin D, iodine, and folate. These nutrients were selected based on their fundamental importance in pediatric development. By analyzing the current literature from PubMed, Embase, and Web of Science databases, we synthesized findings regarding the impact of these micronutrients on health outcomes in children and adolescents, examining both regional and global prevalence data, with particular attention paid to Korean population data. This review provides evidence-based insights into the assessment and management of micronutrient status in children and adolescents and offers recommendations for clinical practice.