Background: Large language models (LLMs) have the potential for clinical decision support; however, their use in specific tasks, such as determining the RhD blood type for transfusion, remains underexplored. Therefore, we evaluated the accuracy of six LLMs in addressing RhD blood type-related issues in Korean healthcare. Methods: Fifteen multiple-choice and true/false questions, based on real-world transfusion scenarios and reviewed by specialists, were developed. The questions were administered twice to six LLMs (Clova X, Gemini 1.0, Gemini 1.5, ChatGPT-3.5, GPT-4.0, and GPT-4o) in both Korean and English. Results were compared against the performance of 22 transfusion medicine experts. For particularly challenging questions, prompt engineering was applied, and the questions were reevaluated. Results: GPT-4o demonstrated the highest accuracy rate in Korean (0.6), with significant differences compared with those of Clova X and Gemini (P < 0.05). In English, the results were similar across all models. The transfusion experts achieved a higher accuracy rate (0.8). Among the five questions subjected to prompt engineering, only GPT-4o correctly responded to one, whereas the other models failed. All LLM models changed their responses or did not respond when the same question was repeated. Conclusions GPT-4o showed the best overall performance among the models tested and may be beneficial in RhD blood product transfusion decision-making. However, its performance suggests that it may serve best in a supportive role rather than as a primary decision-making tool.

Background: and Purpose: The SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention (SUPERBRAIN) proved the feasibility of multidomain intervention for elderly people. One-quarter of the Korean population over 65 years of age has mild cognitive impairment (MCI). Digital health interventions may be costeffective and have fewer spatial constraints. We aim to examine the efficacy of a multidomain intervention through both face-to-face interactions and video communication platforms using a tablet personal computer (PC) application in MCI. Methods: Three hundred participants aged 60–85 years, with MCI and at least one modifiable dementia risk factor, will be recruited from 17 centers and randomly assigned in a 1:1 ratio to the multidomain intervention and the waiting-list control groups. Participants will receive the 24-week intervention through the tablet PC SUPERBRAIN application, which encompasses the following five elements: managing metabolic and vascular risk factors, cognitive training,physical exercise, nutritional guidance, and boosting motivation. Participants will attend the interventions at a facility every 1–2 weeks. They will also engage in one or two self-administered cognitive training sessions utilizing the tablet PC application at home each week. They will participate in twice or thrice weekly online exercise sessions at home via the ZOOM platform. The primary outcome will be the change in the total scale index score of the Repeatable Battery for the Assessment of Neuropsychological Status from baseline to study end. Conclusions This study will inform the effectiveness of a comprehensive multidomain intervention utilizing digital technologies in MCI.

Purpose: This study was aimed to identify the effects of professional autonomy and teamwork on clinical performance to improve the clinical performance of tertiary hospital nurses. Methods: Data were collected from June 1 to June 30, 2017 and a total of 172 nurses from three tertiary hospitals participated in this study. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Scheffé test, Pearson’s correlation and stepwise multiple regression analysis using SPSS 25.0. Results: Clinical performance showed a statistical difference depending on the number of education session for competency, and it showed a positive correlation with professional autonomy and teamwork. The factors affecting the clinical performance of the tertiary hospital nurses included in teamwork (β=.40, p<.001), professional autonomy (β=.27, p<.001). These factors accounted for 31% of clinical performance (p<.001). Conclusion It is important to find ways to improve clinical performance of tertiary hospital nurses. Furthermore, there is a need to include continuous and systemic education programs for professional autonomy and suitable programs to elevate teamwork.

PURPOSE: While there is an urgent need for diagnosis and therapeutic intervention in patients with primary immunodeficiency diseases (PIDs), current genetic tests have drawbacks. We retrospectively reviewed the usefulness of flow cytometry (FCM) as a quick tool for immunophenotyping and functional assays in patients suspected to have PIDs at a single tertiary care institute.METHODS: Between January 2001 and June 2018, patients suspected of having PIDs were subjected to FCM tests, including lymphocyte subset analysis, detection of surface- or intracellular-target proteins, and functional analysis of immune cells, at Samsung Medical Center, Seoul, Korea. The genetic diagnosis was performed using Sanger or diagnostic exome sequencing.RESULTS: Of 60 patients diagnosed with definite or probable PID according to the European Society of Immune Deficiencies criteria, 24 patients were provided with useful information about immunological dysfunction after initial FCM testing. In 10 patients, the PID diagnosis was based on abnormal findings in FCM testing without genetic tests. The FCM findings provided strong evidence for the diagnosis of severe combined immunodeficiency (n = 6), X-linked chronic granulomatous diseases (CGD) (n = 6), leukocyte adhesion deficiency type 1 (n = 3), X-linked agammaglobulinemia (n = 11), autoimmune lymphoproliferative syndrome-FASLG (n = 1), and familial hemophagocytic lymphohistiocytosis type 2 (n = 1), and probable evidence for autosomal recessive-CGD (n = 2), autosomal dominant-hyper-immunoglobulin E (IgE)-syndrome (n = 1), and STAT1 gain-of-function mutation (n = 1). In PIDs derived from PIK3CD (n = 2), LRBA (n = 2), and CTLA4 mutations (n = 3), the FCM test provided useful evidence of immune abnormalities and a tool for treatment monitoring.CONCLUSIONS: The initial application of FCM, particularly with known protein targets on immune cells, would facilitate the timely diagnosis of PIDs and thus would support clinical decisions and improve the clinical outcome.
Agammaglobulinemia ; Diagnosis ; Exome ; Flow Cytometry ; Genetic Testing ; Granulomatous Disease, Chronic ; Humans ; Immunophenotyping ; Korea ; Leukocytes ; Lymphocyte Subsets ; Lymphohistiocytosis, Hemophagocytic ; Phenotype ; Retrospective Studies ; Seoul ; Severe Combined Immunodeficiency ; Tertiary Healthcare