Evaluation of colorectal liver metastases using virtual monoenergetic images obtained from dual-layer spectral computed tomography.

PURPOSE: To assess the potential of virtual monoenergetic images in assessing colorectal liver metastasis (CRLM) compared with conventional CT images. METHODS: This single-center, retrospective study included 173 consecutive patients (mean age, 65.5 ± 10.6 years; 106 men) who underwent dual-layer spectral CT (DLSCT) between November 2016 and April 2021. Portal venous phase images were reconstructed using hybrid iterative reconstruction (iDose) and virtual monoenergetic imaging at 50 keV. Four radiologists independently and randomly reviewed the de-identified iDose and 50 keV images. Lesion detection, CRLM conspicuity, and CRLM diagnosis were compared between these images using a generalized estimating equation analysis. The reference standards used were histopathology and follow-up imaging findings. RESULTS: The study included 797 focal liver lesions, including 463 CRLMs (median size, 18.1 mm [interquartile range, 10.9-37.7 mm]). Lesion detection was better with 50 keV images than with iDose images (45.0% [95% confidence interval [CI]: 39-50] vs 40.0% [95% CI: 34-46], P = 0.003). CRLM conspicuity was higher in the 50 keV images than in the iDose images (3.27 [95% CI: 3.09-3.46] vs 3.09 [95% CI: 2.90-3.28], P < 0.001). However, the specificity for diagnosing CRLM was lower with 50 keV images than with iDose images (94.5% [95% CI: 91.6-96.4] vs 96.0% [95% CI: 93.2-98.1], P = 0.022), whereas sensitivity did not differ significantly (77.6% [95% CI: 70.3-83.5] vs 76.9% [95% CI: 70.0-82.7], P = 0.736). Indeterminate lesions were more frequently noted in 50 keV images than in iDose images (13% [445/3188] vs 9% [313/3188], P = 0.005), and 56% (247/445) of the indeterminate lesions at 50 keV were not CRLMs. CONCLUSION: The 50 keV images obtained from DLSCT were better than the iDose images in terms of CRLM conspicuity and lesion detection. However, 50 keV images did not improve CRLM diagnosis but slightly increased the reporting of indeterminate focal liver lesions associated with CRLMs.

Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association.

Local ablation for hepatocellular carcinoma, a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the first-line treatment for early-stage hepatocellular carcinoma. The lack of organized evidence and expert opinions regarding patient selection, preprocedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-Guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients.

A Comparative Study of SonoVue and Sonazoid for Contrast-Enhanced Ultrasound CT/MRI Fusion Guidance During Radiofrequency Ablation of Poorly Visualized Hepatic Malignancies: A Prospective Intra-Individual Analysis.

PURPOSE: This study aimed to evaluate the effectiveness of two contrast agents, SonoVue (SV) and Sonazoid (SZ), by comparing them intra-individually in contrast-enhanced ultrasound (CEUS)-CT/MRI fusion imaging (FI) to improve the visibility of inconspicuous liver malignancies on B-mode sonography for guiding percutaneous radiofrequency ablation (RFA). Additionally, the radiologists' preference between SonoVue- CT/MRI FI (SV-FI) and Sonazoid-CT/MRI FI (SZ-FI) was determined. METHODS: This prospective study enrolled 23 patients with inconspicuous hepatic malignancies (≤ 3 cm) on B-mode US who underwent both SV-FI and SZ-FI for RFA guidance. The patients underwent real-time CEUS FI with CT/MRI on the same day, utilizing both SV and SZ with at least 15-min intervals. Tumor visibility and radiologists' preferences were assessed and graded using a 4-point scale during the dynamic phases of both SV-FI and SZ-FI and the Kupffer phase of SZ-FI. RESULTS: The tumor visibility scores obtained from CEUS-CT/MRI FI were significantly better than those obtained from US-FI. Indeed, SV-FI and SZ-FI demonstrated comparable visibility scores when corresponding phases were compared (p > 0.05). However, the Kupffer phase images of SZ-FI displayed superior visibility scores (3.70 ± 0.56 vs. 2.96 ± 0.88; p = 0.002) than the late vascular phase images of SV-FI. The radiologists favored SZ-FI in many cases, exhibiting moderate inter-observer agreement (Kappa value = 0.587; 95% CI, 0.403-0.772). CONCLUSION: Although CEUS-CT/MRI FI with either SV or SZ substantially improved the visibility of inconspicuous tumors on US-CT/MRI FI, radiologists preferred SZ to SV to guide the RFA procedure.

Content validity of measures in early numeracy in children up to eight years: A COSMIN systematic review.

Early numeracy skills are considered essential predictors for later mathematical and educational achievement. Therefore, there is a need for early numeracy measures with psychometrically sound properties. This systematic review aimed to determine the content validity of all current early numeracy measures in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework and methodological guidelines, and was conducted and reported by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and checklist. Systematic literature searches were conducted in January 2024 in five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Eligible measures assessed numeracy, targeted children up to eight years of age, were published in English in 1995 or later, and had psychometric data on measure dimensionality. Eligible psychometric reports that were published in English described instrument development and/or content validity of included measures. The measures' methodological quality was assessed using the COSMIN Risk of Bias checklist, after which all three aspects of content validity (i.e., relevance, comprehensiveness and comprehensibility) were evaluated. Six early numeracy measures and eleven psychometric reports were included. None of the measures could be recommended for use in clinical practice, education, or research due to a lack of high-quality evidence on content validity. However, no high-quality evidence was found to indicate insufficient content validity, therefore, all measures still have the potential to be used. Limited access to measures in the domain of early numeracy, despite having contacted both publishers and instrument developers, may have negatively impacted the completeness of the current overview of content validity of early numeracy measures. In line with the COSMIN guidelines, after the initial evaluation of content validity, future studies should evaluate the remaining psychometric properties of the included measures to identify the most robust measures in terms of validity, reliability, and responsiveness.

Rational strategy for power doubling of monolithic multijunction III-V photovoltaics by accommodating attachable scattering waveguides.

While waveguide-based light concentrators offer significant advantages, their application has not been considered an interesting option for assisting multijunction or other two-terminal tandem solar cells. In this study, we present a simple yet effective approach to enhancing the output power of transfer-printed multijunction InGaP/GaAs solar cells. By utilizing a simply combinable waveguide concentrator featuring a coplanar waveguide with BaSO4 Mie scattering elements, we enable the simultaneous absorption of directly illuminated solar flux and indirectly waveguided flux. The deployment of cells is optimized for front-surface photon collection in monofacial cells. Through systematic comparisons across various waveguide parameters, supported by both experimental and theoretical quantifications, we demonstrate a remarkable improvement in the maximum output power of a 26%-efficient cell, achieving an enhancement of ~93% with the integration of the optimal scattering waveguide. Additionally, a series of supplementary tests are conducted to explore the effective waveguide size, validate enhancements in arrayed cell module performance, and assess the drawbacks associated with rear illumination. These findings provide a comprehensive understanding of our proposed approach towards advancing multi-junction photovoltaics.

Manufacturing of Ni-Co-Fe-Cr-Al-Ti High-Entropy Alloy Using Directed Energy Deposition and Evaluation of Its Microstructure, Tensile Strength, and Microhardness.

High-entropy alloys (HEAs) have drawn significant attention due to their unique design and superior mechanical properties. Comprising 5-35 at% of five or more elements with similar atomic radii, HEAs exhibit high configurational entropy, resulting in single-phase solid solutions rather than intermetallic compounds. Additive manufacturing (AM), particularly direct energy deposition (DED), is effective for producing HEAs due to its rapid cooling rates, which ensure uniform microstructures and minimize defects. These alloys typically form face-centered cubic (FCC) or body-centered cubic (BCC) structures, contributing to their exceptional strength, hardness, and mechanical performance across various temperatures. However, FCC-structured HEAs often have low yield strengths, posing a challenge for structural applications. In this study, a Ni-Co-Fe-Cr-Al-Ti HEA was manufactured using the DED method. This study proposes that the addition of aluminum and titanium creates a γ + γ' phase structure within a multicomponent FCC-HEA matrix, enhancing the thermal stability and coarsening the resistance and strength. The γ' phase with an ordered FCC structure significantly improves the mechanical properties. Analysis confirmed the presence of the γ + γ' structure and demonstrated the alloy's high tensile strength and microhardness. This approach underscores the potential of AM techniques in advancing HEA production for high-performance applications.

[Current Status of Chemotherapy in Colorectal Cancer: Updated Treatment Strategies].

Colorectal cancer remains a significant health burden in South Korea, being the third most diagnosed cancer in the country. Despite advances in treatment, patients with metastatic colorectal cancer still face limited survival rates, with resection often deemed impossible for the majority. This review discusses the current state of chemotherapy in colorectal cancer treatment, focusing on both adjuvant chemotherapy post-surgery and palliative chemotherapy for metastatic cases. The article highlights recent updates in treatment guidelines, including the use of immunotherapy and the role of circulating tumor DNA (ctDNA) in personalized medicine. The integration of these novel approaches aims to enhance treatment efficacy, improve patient survival, and reduce recurrence rates, paving the way for more tailored and effective therapeutic strategies in colorectal cancer management.

Regional disparities in the risk of secondary fractures in patients with hip fractures.

PURPOSE: We aimed to examine the regional disparities in secondary fracture incidence among patients with hip fractures in South Korea. METHODS: This observational, retrospective, cohort study was conducted using data of 6,213 South Korean nationals from the National Health Insurance Service-National Sample Cohort (2004-2019). Secondary fractures included hip, wrist, humerus, spine, ankle, and pelvis fractures that occurred 6 months after hip fracture. The position value for relative composite index was used to identify medically vulnerable regions. Cox proportional hazards models were used for statistical analysis. RESULTS: Among the 6,213 (1,949 male, 4,264 female) patients with hip fracture, 981 lived in medically vulnerable areas and 5,232 in non-vulnerable areas. Patients residing in vulnerable areas had a higher risk of secondary fractures than did those residing in non-vulnerable areas (hazard ratio [HR]: 1.24, 95 % confidence interval [CI]: 1.05-1.47); the factors that increased their risk included female sex (HR: 1.30, 95 % CI: 1.08-1.57), age ≥71 years (HR: 1.23, 95 % CI: 1.01-1.44), and not receiving osteoporosis medication (HR: 1.47, 95 % CI: 1.14-1.89). Ten years after hip fracture surgery, the risk of secondary fracture more than tripled in the vulnerable areas than that in the non-vulnerable areas. CONCLUSION: Patients living in vulnerable regions had a higher risk of secondary fractures than that of those in non-vulnerable regions. Prevention and medication policies should thus be implemented to reduce regional healthcare disparities.

Effects of Glucagon-Like Peptide-1 Receptor Agonist on Bone Mineral Density and Bone Turnover Markers: A Meta-Analysis.

AIMS: Glucagon-like peptide-1 receptor agonist (GLP-1RA) may promote bone formation, but conversely, they could also weaken bones due to the reduction in mechanical load associated with weight loss. However, the clinical effects in humans have not been clearly demonstrated. This meta-analysis aimed to evaluate whether GLP-1RAs affect BMD and bone turnover markers. MATERIAL AND METHODS: PubMed, Embase, and Scopus were searched on June 13, 2024. The eligibility criteria were: (1) human studies, (2) receiving a GLP-1RA for more than 4 weeks, (3) an untreated control group or a placebo group, (4) reporting of at least one BMD or bone turnover marker, and (5) an RCT design. The risk of bias was assessed using the Cochrane risk of bias 2 tool. Fixed- or random-effects meta-analysis was performed according to heterogeneity. RESULTS: Seven studies were included in the meta-analysis. GLP-1RAs did not significantly change BMD in the femoral neck (mean difference [MD], 0.01 g/cm2; 95% CI, -0.01-0.04 g/cm2), in the total hip (MD, -0.01 g/cm2; 95% CI, -0.02-0.01 g/cm2), and in the lumbar spine (MD, 0 g/cm2; 95% CI, -0.02-0.02 g/cm2). C-terminal telopeptide of type 1 collagen (CTX), a bone resorption marker, significantly increased after GLP-1RA treatment (MD, 0.04 µg/L; 95% CI, 0.01-0.07 µg/L). GLP-1RAs did not significantly change bone formation markers such as procollagen type 1 N-terminal propeptide, bone-specific alkaline phosphatase, osteocalcin. CONCLUSIONS: GLP-1RA did not affect BMD and bone formation markers. However, GLP-1RAs led to a significant increase in CTX.

Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association.

Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the first-line treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients.

Profiling the Cardiovascular Toxicities of CDK4/6 Inhibitors: A Real-World Pharmacovigilance Study.

Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors are approved for the treatment of human epidermal growth factor receptor 2 (HER-2)-negative, hormone receptor-positive breast cancer. The cardiovascular toxicity of CDK4/6 inhibitors is not well understood. This study aims to profile the cardiac events associated with CDK4/6 inhibitors. Reports from 2015Q1 to 2024Q1 were obtained from the FDA Adverse Event Reporting System (FAERS). Reports identifying palbociclib, ribociclib, and abemaciclib as the primary suspect were examined for cardiovascular toxicity, including hypertension, cardiac failure, cardiomyopathy, arrhythmia, myocardial infarction, and myocarditis. Signal detection was performed using the proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). A total of 69,139 reports were analyzed. The median time to adverse events was 69 days (interquartile range [IQR], 18-260 days). Of these, 2065 reports documented cardiac adverse events. Ribociclib and QT prolongation were re-confirmed as a signal (PRR 8.43, ROR 8.65, IC025 2.86). Hypertension and cardiac failure were the most frequently reported cardiovascular toxicities. This study demonstrates that the use of CDK4/6 inhibitors is associated with cardiovascular adverse events, such as heart failure and hypertension. Further research is needed to understand the mechanisms and risk factors contributing to the cardiovascular toxicity of CDK4/6 inhibitors.

Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association.

Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.

Incremental high power radiofrequency ablation with multi-electrodes for small hepatocellular carcinoma: a prospective study.

Radiofrequency ablation (RFA) offers a minimally invasive treatment for small hepatocellular carcinoma (HCC), but it faces challenges such as high local recurrence rates. This prospective study, conducted from January 2020 to July 2022, evaluated a novel approach using a three-channel, dual radiofrequency (RF) generator with separable clustered electrodes to improve RFA's efficacy and safety. The study employed a high-power, gradual, stepwise RFA method on HCCs (≤ 4 cm), utilizing real-time ultrasound-computed tomography (CT)/magnetic resonance imaging (MRI) fusion imaging. Involving 110 participants with 116 HCCs, the study reported no major complications. Local tumor progression (LTP) and intrahepatic remote recurrence (IRR) rates were low, with promising cumulative incidences at 1, 2, and 3 years for LTP (0.9%, 3.6%, 7.0%) and IRR (13.9%, 20.5%, 31.4%). Recurrence-free survival (RFS) rates were similarly encouraging: LTP (99.1%, 96.4%, 93.0%) and IRR (86.1%, 79.5%, 68.6%). This innovative gradual, incremental high-power RFA technique, featuring a dual switching monopolar mode and three electrodes, represents an effective and safer management option for small HCCs. TRIAL REGISTRATION: clinicaltrial.gov identifier: NCT05397860, first registered on 26/05/2022.

Metal-Organic Frameworks as a Thermal Emitter for High-Performance Passive Radiative Cooling.

Passive radiative cooling represents a transformative approach to achieving sustainable cooling on Earth without relying on energy consumption. In this research, the optical characteristics of five readily accessible metal-organic frameworks (MOFs): ZIF-67(Co), MOF-74(Ni), HKUST-1(Cu), MOF-801(Zr), and UiO-66(Zr) are meticulously explored. The objective is to identify the pivotal factors that influence their ability to facilitate radiative cooling. Through an in-depth analysis encompassing spectroscopic features, surface texture, and porosity, it is found that the MOFs' cooling efficacy is largely influenced by their optical bandgaps and functional groups, although other factors like chemical composition and structural characteristics remain to be considered. Notably, UiO-66(Zr) emerged as the standout performer, boasting an impressive solar reflectance of 91% and a mid-infrared emissivity of 96.8%. Remarkably, a fabric treated with UiO-66(Zr) achieved a substantial sub-ambient cooling effect, lowering temperatures by up to 5 °C and delivering a cooling power of 26 W m-2 at 300 K. The findings underscore the vast potential of MOFs in offering new opportunities to advance passive radiative cooling technologies, paving the way for their extensive application in this field.

Analyses of Osteogenesis Imperfecta in South Korea Using the Nationwide Health Insurance Service Claim Data: A Propensity Score-Matched Study.

Osteogenesis imperfecta (OI) is the most common inherited form of bone fragility and includes a heterogeneous group of genetic disorders that most commonly result from defects associated with type I collagen. Although genetic analyses have been developed, nationwide research on the incidence and associated fractures in OI is lacking. This study aimed to investigate the patterns of OI prevalence, incidence, fracture rate, etc. in South Korea using National Health Insurance Service (NHIS) claims data. We found 1596 patients newly diagnosed with OI between March 2002 and February 2020. We evaluated the incidence, prevalence, and history of fractures, fracture site, prescription of anti-osteoporosis drugs, etc. To compare medical costs, fracture rates, and scoliosis rates, we created a control group comprising patients without OI using 1:1 propensity score matching. The prevalence of OI increased slightly each year, with an annual incidence of 20.20 per 100,000 live births. Mean fracture frequency in OI patients was 17 (2-32) times per patient and the most frequent fracture site was the lower leg. A total of 21.4% patients were prescribed anti-osteoporosis drugs, and the most popular drug was pamidronate. After 1:1 propensity score matching, in terms of scoliosis, OI patients had a 3.91 times higher prevalence of scoliosis than in healthy patients which was statistically significant. The sum of medical care expenses for patients with OI was 3.5 times higher than that for patients without OI. We identified nationwide trends in OI occurrence, fractures, and medication use. This study also highlighted the real-world data of scoliosis and medical costs compared to the control group.

A seamless auxetic substrate with a negative Poisson's ratio of -1.

Auxetic metamaterials are a unique class of materials or structures with a negative Poisson's ratio and a wide array of functionalities. However, their inherent porosity presents challenges in practical applications. Filling the inherent perforations while preserving their unique auxeticity is difficult because it demands the seamless integration of components that have highly distinct mechanical characteristics. Here we introduce a seamless auxetic substrate film capable of achieving a negative Poisson's ratio of -1, the theoretical limit of isotropic materials. This breakthrough is realized by incorporating a highly rigid auxetic structure reinforced by glass-fabric, with surface-flattening soft elastomers. We effectively optimize the mechanical properties of these components by systematic experimental and theoretical investigations into the effects of relative differences in the moduli of the constituents. Using the developed auxetic film we demonstrate an image distortion-free display having 25 PPI resolution of micro-LEDs that is capable of 25% stretching without performance degradation.

Predicting avian diversity based on land use and cover on a national scale.

This study explores the relationship between landscape features and avian diversity in South Korea, examining both taxonomic and functional diversity. The Korean Peninsula serves as a pivotal habitat for resident bird species and a migratory pathway in the East Asia-Pacific flyway. Using a national dataset with block sizes ranging from 3.5 to 4.5 kilometers per side, we found that less urbanized open plains exhibit higher taxonomic diversity, while coastal regions with diverse water bird populations show higher functional diversity. These findings underscore the significance of conserving the existing land types and qualities in specific regions to substantially impact bird distribution and regional biodiversity. Remarkably, closed forests display diversity patterns akin to urban/built-up areas, despite their disparate land use characteristics. The stability of bird diversity indices across different land use types enables us to predict bird diversity indices based on the particular land use and land cover configurations. This study emphasizes the complementary nature of functional biodiversity indices in comprehending bird distribution patterns alongside taxonomic diversity indices.

Compact Solid Electrolyte Interface Realization Employing Surface-Modified Fillers for Long-Lasting, High-Performance All-Solid-State Li-Metal Batteries.

The implementation of polymer-based Li-metal batteries is hindered by their low coulombic efficiency and poor cycling stability attributed to continuous electrolyte decomposition. Enhancement of the solid electrolyte interface (SEI) stability is key to mitigating electrolyte decomposition. This study proposes surface-functionalized silica mesoball fillers to fabricate a composite polymer electrolyte (MSBM-CPE). As a result of surface modification, the polyethylene oxide matrix benefits from the uniform distribution of the filler, which provides a large surface area and Lewis acid sites. Molecular dynamics simulations reveal that the dissociation energy of lithium bis(trifluoromethanesulfonyl)imide in the filler is fourfold higher (-1.95 eV) than that of the filler-free electrolyte. Consequently, the MSMB-CPE diffusivity is 30 times higher than its filler-free counterpart. The MSMB-CPE of ionic conductivity of 1.16 × 10-2 S cm-1 @60 °C and a venerable Li-ion transference number of 0.81. The excellent compatibility of MSMB-CPE with the Li anode is demonstrated by its stable symmetric cell performance under high current density (200 µA cm-2 @60 °C) for over 5000 h. Approximately 85.60% retention capacity of the [Li/MSMB-CPE/LiFePO4] full cell after 700 cycles. Furthermore, compositional analysis reveals that the SEI layer in MSMB-CPE is smooth with fewer by-products at the electrolyte/Li interface.

Association between Alcohol Use Disorder and Suicidal Ideation Using Propensity Score Matching in Chungcheongnam-do, South Korea.

Objectives: This study aimed to analyze the association between alcohol use disorder (AUD) and suicidal ideation (SI) in the general Korean population. Methods: The 2022 Mental Health Awareness Survey was collected from the Chungcheongnam-do Mental Health Welfare Center (CHMHC). Before Propensity Score Matching (PSM), 823 participants were included in this study. After 1:4 PSM, the 255 participants were analyzed using the chi-square test and matched conditional logistic regression. Results: The AUD group had higher odds of experiencing SI than the non-AUD (adjusted odds ratio [AOR]: 2.40, 95% confidence intervals [CI]: 1.10-5.22). Stratified matched conditional logistic regression showed that, among the female, <40 years and single group, the AUD group was more likely to experience SI compared with the non-AUD, respectively (AOR:3.53, 95% CI: 1.20-10.44/AOR:3.45, 95% CI: 1.03-11.55/AOR:4.83, 95% CI: 1.18-19.69). However, among the male, ≥40 years and married group, we discovered no association between AUD and SI. Conclusions: Through this study, we found a strong association between the AUD group and SI. This association was particularly strong among female, <40 years, and single groups. This study elucidates the relationship between AUD and SI in the Chungnam region, which had not been previously identified in Korea, and it is expected to serve as foundational data for reducing the high suicide rate in this region. However, due to the limitation of being a cross-sectional study, future longitudinal research is required.

CWAS-Plus: estimating category-wide association of rare noncoding variation from whole-genome sequencing data with cell-type-specific functional data.

Variants in cis-regulatory elements link the noncoding genome to human pathology; however, detailed analytic tools for understanding the association between cell-level brain pathology and noncoding variants are lacking. CWAS-Plus, adapted from a Python package for category-wide association testing (CWAS), enhances noncoding variant analysis by integrating both whole-genome sequencing (WGS) and user-provided functional data. With simplified parameter settings and an efficient multiple testing correction method, CWAS-Plus conducts the CWAS workflow 50 times faster than CWAS, making it more accessible and user-friendly for researchers. Here, we used a single-nuclei assay for transposase-accessible chromatin with sequencing to facilitate CWAS-guided noncoding variant analysis at cell-type-specific enhancers and promoters. Examining autism spectrum disorder WGS data (n = 7280), CWAS-Plus identified noncoding de novo variant associations in transcription factor binding sites within conserved loci. Independently, in Alzheimer's disease WGS data (n = 1087), CWAS-Plus detected rare noncoding variant associations in microglia-specific regulatory elements. These findings highlight CWAS-Plus's utility in genomic disorders and scalability for processing large-scale WGS data and in multiple-testing corrections. CWAS-Plus and its user manual are available at https://github.com/joonan-lab/cwas/ and https://cwas-plus.readthedocs.io/en/latest/, respectively.